Twogether Updates

TMHP: Very Important Information! Rejected Claims Submissions Between May 2nd and May 13th, 2022

May 23, 2022

Very Important!

Please see information from TMHP below:

Some Rejected Claims May Be Resubmitted

Some Home and Community-based Services (HCS) and Texas Home Living (TxHmL) claims that were submitted to Texas Medicaid & Healthcare Partnership (TMHP) between May 2, 2022, and May 13, 2022, were rejected in error. HCS and TxHmL claims that were rejected with the following explanations of benefits (EOBs) may now be resubmitted for processing:

Explanation of Benefits Description
F0155 Unable to determine appropriate Fund Code for Service billed, verify Medicaid Eligibility.
F0174 Claim is for a Service Group that is mutually exclusive with Service Group for previous claim.
F0286 Can only bill for incremental (0.50, 0.75, and whole) units for specified services.

Billing Dates of Service

Claims cannot be submitted on the same day as the date of service; providers should wait until the following day to submit their claim. Providers that submit claims for current or future dates may have their claim rejected, and will receive the following EOB:

Explanation of Benefits Description
F0198 Cannot bill for future Service Dates or current date.

Top Claims Rejections and Steps to Avoid Claim Rejections

HCS and TxHmL providers might see one of the following EOBs when a claim is rejected:

Explanation of Benefits Description
F0138 A valid service authorization for this client for this service on these dates is not available.
F0268 A valid service authorization for this client for these service dates is not available, or claim dates cannot overlap more than one service authorization.
F0077 Billing Code was not submitted or cannot be determined.
F0277 National Code is missing, invalid, or not billable with Procedure Code Qual.
F0325 Line Item Control Number-Required HHMM (military format.)

To avoid having claims rejected, HCS and TxHmL providers should take the following steps before submitting claims to TMHP:

  1. Check the TexMedConnect Medicaid Eligibility Service Authorization Verification (MESAV) to get client Service Auth/Level/Client Hold/Eligibility information. The following client information should be verified:
    • Services authorized for the client.
    • Service dates authorized for the client.
    • Levels authorized for the client.
  2. Use the HCS and TxHmL Bill Codes Crosswalk to check for important claims information, such as the Line Item Control Number (LICN).

Important: HCS and TxHmL claims should be submitted to TMHP for dates of service on or after May 1, 2022. Claims with dates of service before May 1, 2022, should be submitted using the HHSC Client Assignment and Registration (CARE) system.

 

For more information about submitting claims to TMHP, providers can refer to the following provider education resources:

Note: To access the TMHP Learning Management System (LMS), users must have an account. Users can register for an account here. New TMHP LMS users can access the Learning Management System (LMS) Registration and Navigation Job Aid for Providers located on the LMS homepage, or send an email to TMHP Training Support for support creating an LMS account or navigating the LMS.

For additional questions about submitting HCS and TxHmL claims to TMHP, contact the TMHP LTC Help Desk at 800-626-4117, Option 1, then Option 7.

 

Tip from Twogether Consulting:  If you are not getting a timely response from the Help Desk, or are unable to find answers to your TMHP Claim Submission Issues, please email:  Provider.relations@TMHP.com 

American Rescue Plan Act (ARPA): Provider Retention Payments Regarding HCS/TxHmL Billing Claims from March 2022-August 2022

May 19th, 2022

HCS/TxHmL providers:

Please be aware of the following for claims being paid from March 1st, 2022-August 31st, 2022 in TMHP:  There are new Procedure/Billing Codes in TMHP that reflect the ARPA short-term funding as retention payments you may be receiving for these claims billed during this time period.  If you are seeing new or different codes than you are used to, listed when you pull up “paid” claims, then you are receiving ARPA Retention payments and will be responsible for documenting how these funds were used and reporting this by July of 2022, or you are subject to recoupment from the MCO’s.  (Example: M0115, M0116, M0117…)

See rates and new codes listed in link below:

https://acrobat.adobe.com/link/track?uri=urn:aaid:scds:US:cca5939a-6173-346e-9fc2-3409490a5447

Personally, I was under the assumption that providers would have to request this assistance if they wanted it, meaning they would choose whether they utilized this funding or not.  Apparently not necessarily as some providers have noted this is showing up on their payments.  From everything I am reading, the provider letters from HHSC do seem to indicate every provider will receive the funding.

Meaning additional (ARPA) monies that the provider is receiving in claim payments for that time period, will need to be accounted for, and reporting on how funds were utilized will need to happen and be sent into HHSC. Some providers are noticing a difference in the regular rates they submitted claims for when they look at their “paid claims”.  If the provider uses the ARPA intended, attestation and reporting to HHSC must occur.

If the HCS/TxHmL provider chooses not to utilize the added-on payments to the normal rates, I believe they will need to hold back/save these additional amounts for each claim paid from March to August of 2022, in order to pay them back at a later date.  If these ARPA funds are utilized, then the HCS/TxHmL Provider will need to complete a report by July of 2022. I believe, to HHSC by the provider, or they will have to keep it in an account and saved for repayment/recoupment when requested by the MCO’s if I understand correctly.  I will keep you posted!  Also, please look for the additional FAQ’s to be published on May 23rd, 2022 for hopefully important answers to the TMHP questions and issues many providers have expressed with entering IPCs in particular (especially revisions) entering billing claims, and only getting paid for part of billing claims submitted.

 

Here Are Just Some Of The FAQ’s HHSC Recently Published May 5th, 2022 (specifically related to this issue I have noted above)

Q: What are the ARPA HCBS Provider Retention Payments?

A: HHSC’s ARPA HCBS spending plan included recruitment and retention payments for providers delivering attendant and direct care HCBS for retention bonuses or other activities. HHSC’s spending plan requires providers to use at least 90 percent of HCBS ARPA funds for one-time financial compensation for their direct care workforce, including, but not limited to, lump-sum bonuses, retention bonuses, and paid time off to receive a COVID-19 vaccination or to isolate after receiving a positive COVID-19 test.

Q: What Services are eligible for Provider Retention Payments?

A: HCBS ARPA temporary rate add-on will be applied to HCBS personal attendant and nursing services as defined in 1 TAC 355.207.  A list of eligible services is defined in Section 355.207(b)(1). An updated service list and fee schedule is available on the Provider Finance Homepage.

Q: What identifying information do I need to include with my attestation and required reports?

A: Each attestation and required report must include the following information:
• Provider Doing Business (DBA) Name
• Address
• Contact information (including email and phone number)
• Required unique identifiers (see below for a list by program) Since different provider types have various unique identifiers, HHSC has developed the following list to aid providers in submitting their required attestation and reports. HHSC requests that all providers submit two unique identifiers to ensure your organization gets credit for the required attestation and reporting.
-For fee-for-service agency providers, please include your 9-digit HHSC contract number with all submissions.
Please also include either your National Provider Identifier (NPI) or your Taxpayer Identification Number (TIN) with your submission.
-For Consumer Directed Services (CDS) employers, please include your Medicaid Identification number.
-If an organization has multiple fee-for-service contracts, please submit a required report for each Medicaid contract that delivers eligible HCBS services between March 1, 2022, and August 31, 2022.
HCS/TxHmL providers must complete attestation and required reports for each component code unless providers submit identifiers shared by all component codes/contracts within an organization (for example NPI).
Q:  What attestation is required?
A:  All providers who deliver eligible HCBS services with service dates between Match 1, 2022 and August 31, 2022, are required to complete an attestation to describe how they will use funds or face recoupment. The attestation is due by Friday July 1, 2022. Providers must attest to the following
-A provider must be actively billing Medicaid services.
-A provider must agree to use at least 90 percent of payments made under this section for recruitment and retention efforts for direct care delivering HCBS services as defined in 355.207(b). staff
-A provider must agree payments made under this section can include one-time financial compensation directed toward direct care staff, including lump-sum bonuses, retention bonuses, and paid time off to receive a COVID vaccination or to isolate after receiving a positive COVID– 19 19 test. Funds under this section can be used to support reasonable employer administrative expenses, including payroll taxes and workers’ compensation necessary to implement the financial compensation of HCBS direct care staff.
Q: What initial reporting is required?
A: An initial report detailing the number of filled and vacant personal attendant and nursing staff as of March 1, 2022, is required from all providers who deliver eligible HCBS services with service dates between March 1, 2022, and August 31, 2022. The initial report can be submitted with the required attestation and is due by Friday, July 1, 2022.
Q: What final reporting is required?
A: All providers who deliver eligible HCBS services with service dates between March 1, 2022, and August 31, 2022, are required to complete a final report detailing the number of filled and vacant personal attendant and nursing staff have at least 30 days to complete their final reportAssuming from August 31st you have 30 days. 
Q: What happens if a provider does not submit the attestation or required
reporting?
A: Providers who do not submit the required attestation, initial report, and final report
will be subject to recoupment of all HCBS ARPA funds. Claims will be reprocessed at
the non-HCBS ARPA rate that was in effect prior to March 1, 2022.
Q: Will MCOs be required to recoup any payments?
A: HHSC will notify MCOs through existing recoupment processes if a provider is
eligible for recoupment due to non-attestation or failure to report.
Q: If MCOs have to recoup, how will that work? Given the financial audits
MCOs receive, we are concerned about the process and keeping everything
straight.
A: HHSC is finalizing fee-for-service procedures and may reprocess the claims without
the add-on if a provider does not attest or does not provide the two required
reports. The capitation rates include provision for the administrative expense
through the variable administrative component to assist with the costs related to
implementing these fee schedule changes. MCOs may use the same method as
HHSC or use an existing method should the MCO recoup funds.
For a complete FAQ from May 5th, 2022 click here

May 19th, 2022

American Rescue Plan Act (ARPA) Home and Community-Based Services (HCBS) Provider Retention Payments

The Health and Human Services Commission (HHSC) American Rescue Plan Act (ARPA) Home and Community-Based Services (HCBS) Provider Retention Payments is part of the HHSC APRA Spending Plan.

The HCBS ARPA Retention Payments will be distributed as a temporary rate add-on to agency providers and consumer-directed services employers to support recruitment and retention efforts for direct care staff delivering HCBS services. Eligible providers can use the temporary add-on to provide one-time financial compensation directed toward direct care staff, including lump-sum bonuses, retention bonuses, and paid time off to receive a COVID-19 vaccination or to isolate after receiving a positive COVID-19 test.

HHSC adopted a new Texas Administrative Code rule 1 TAC 355.207 governing the HCBS ARPA Retention Payments, including the attestation and reporting requirements. Eligible providers who receive the add-ons but fail to complete the required attestation and reporting will be subject to recoupment of the associated payment add-ons.

Click here to submit the required attestation and initial report due July 1, 2022.

HHSC will provide additional information regarding the due date for the Final report at a later date. Providers will have at least 30 days to submit the final report.

Please contact the HHSC Provider Finance Department, Long-term Services and Supports Customer Information Team at PFD-LTSS@hhs.texas.gov or (512) 867-7817 if you have questions regarding HCBS ARPA Provider Retention Payments.

COVID-19 in Healthcare Relief Grants (For ICF/IID Programs)

COVID-19 in Healthcare Relief Grants

Senate Bill (SB) 8, 87th Legislature, 3rd Called Session, 2021, appropriates funding for the Health and Human Services Commission (HHSC) to issue awards to support Texas healthcare providers affected by the COVID-19 pandemic. These awards include funding for Rural Hospitals, Nursing Facilities, Assisted Living Facilities (ALFs), home health agencies (HHA), Intermediate Care Facilities for Individuals with Intellectual and Developmental Disabilities or related conditions (ICFs/IID), and providers of Community Attendant Services.

HHSC has published new information regarding the COVID-19 in Healthcare Relief Grants for the competitive award processes (“TIER 2”) here. HHSC encourages prospective Request for Application (RFA) applicants to review this information outlining general eligibility criteria, RFA application requirements, and anticipated solicitation posting dates for each of the respective RFAs.

Eligible applicants should rely on the final information published in each RFA Solicitation. Each RFA may have additional or different information than what is provided on the website.

IPC User Guides for HCS and TxHmL Waiver Programs

More Help Available For Persons Entering IPC’s Into TMHP!

More information about submitting and revising Individual Plans of Care is available in the Long-Term Care Online Portal User Guides for Home and Community-based Services and Texas Home Living Waiver Programs. These user guides are available for the following programs that submit IPC forms 3608 and 8582 in the Texas Medicaid and Healthcare Partnership LTC Online Portal:

  • HCS and TxHmL providers.
  • Local intellectual and development disability authorities.
  • Financial management services agencies billing on behalf of Consumer Directed Services employers.

Read the full alert here.

HCS & TxHmL Webinars & FAQ’s (Recordings)

For Previously Recorded Webinars & FAQ’s

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


May 5th, 2022

HCS and TxHmL FAQ Updates Available May 9 and May 23

The Home and Community-based Services and Texas Home Living Waiver Programs Frequently Asked Questions document has been updated.

HCS-TxHmL-FAQ-TMHP-TexasMedConnect

Read the full alert here.


September 21st, 2021

Updated HCS and TxHmL COVID-19 FAQ 

HHSC has revised the Updated HCS and TxHmL COVID-19 FAQ (PDF)


August 15th, 2021

 HCS and TxHmL Webinar Recording Available

” WSC Transition into HHSC LTCR”

(From August 10th, 2021)

Long-term Care Regulation hosted a webinar for HCS and TxHmL program providers to discuss upcoming HHSC organizational changes, introduce LTCR survey operations leadership, and answer questions about the Waiver Survey and Certification unit’s transition into LTCR survey operations.

A recording of August 10, 2021, HCS and TxHmL Transformation Webinar with HHSC Long-Term Care Regulation is available for those who could not attend.

Read the HCS and TxHmL Transformation Webinar (PDF).

Listen to the webinar recording here.

.


May 23rd, 2021

June Infection Control Basics for HCS and TxHmL Providers Webinars

This webinar will review basic infection control concepts such as hand hygiene, standard and transmission-based precautions, and steps to prevent the spread of infectious disease.
Registration for each class is limited to 50 participants.

June 3
10 – 11:30 a.m.
Register for the June 3 webinar.

June 10
10 – 11:30 am
Register for the June 10 webinar.

June 17
10 – 11:30 a.m.
Register for the June 17 webinar.

June 24
10 – 11:30 a.m.
Register for the June 24 webinar.


 

.March 16th, 2021 Updated

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).


March 19 Recording of Clarification of Administrative Penalties and Related Processes Webinar Available

A recording of the March 19, 2021 Clarification of Administrative Penalties and Related Processes for HCS and TxHmL Providers webinar is available for those unable to attend.

Listen to the webinar recording here.


March 4 Recording of Writing Acceptable Plans of Correction Webinar Available

A recording of the March 4, 2021 Writing Acceptable Plans of Correction webinar for HCS and TxHmL program providers is available for those unable to attend.

Listen to the webinar recording here.


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

Emergency Preparedness Guidance and Trainings

Twogether Consulting

May 15th, 2022

2022 Hurricane Season Emergency Preparedness with COVID-19

Long-term care providers in Texas are reminded to review their emergency preparedness and response plans before Atlantic hurricane season begins, which runs June 1–Nov. 30. LTC providers should make updates, if necessary.

Providers should factor in COVID-19 contingencies when reviewing their preparedness plans. For example, as applicable:

  • Are your receiving facilities and transportation contracts still viable?
  • If your provider type is allowed to evacuate to a hotel and that is in your plan, are hotels open in your destination?
  • How will you maintain infection control measures during evacuation or sheltering-in-place?
  • If you have COVID-19 positive persons in your facility, how will that affect evacuation or sheltering-in-place?
  • How will you make sure personal protective equipment is available in addition to food and medicine?

Providers affected by an adverse event, such as severe weather, or expects it will need to temporarily exceed capacity due to a disaster, should contact their HHSC LTC Regulatory regional office.

Please refer to your program’s rules for more important information regarding emergency preparedness.


August 15th, 2021

August and September 2021 LTCR Provider Training Opportunities

Long-Term Care Regulatory providers are invited to attend the following trainings hosted in August and September. Visit the Joint Training Opportunities page to register and learn more about each of these events.

Emergency Preparedness in Long-Term Care Facilities
August 18
1:30 p.m.
Register for the webinar.

August 25
1:30 p.m.
Register for the webinar.

September 13
1:30 p.m.
Register for the webinar.

September 23
1:30 p.m.
Register for the webinar.


July 4th, 2021

Hurricane and Flooding Readiness Webinars for LTC Providers

Home & Community-based Services:

Wednesday, July 21
2 -3:30 p.m.
Register for the webinar.

Intermediate Care Facilities:

Wednesday, July 21
10 -11:30 a.m.
Register for the webinar.

July 2021 LTCR Provider Training Opportunities

Long-Term Care Regulatory providers are invited to attend the following trainings hosted in July.  Visit the Joint Training Opportunities page to register and learn more about each of these events.

Emergency Preparedness in Long-Term Care Facilities

July 21
1:30 p.m.
Register for the webinar.

July 28
1:30 p.m.
Register for the webinar.


July 3rd, 2021

CMS Provides Guidance on Full-Scale Emergency Preparedness Exercises

ICF Providers, please make sure you see this.

The Centers for Medicare and Medicaid Services issued Quality Safety & Oversight Memo QSO-20-41-ALL Revised (PDF). The memo gives more guidance to providers on full-scale exercise requirements that are part of CMS regulations for emergency preparedness.
The following provider types are exempted from completing a required full-scale exercise for the 2021 cycle based on a provider’s activation of their emergency plan.

  • Nursing facilities
  • ICFs-IID
  • Home health agencies
  • Inpatient hospice providers

This exemption does not apply to the exercise of choice.
Providers should still follow all other emergency preparedness guidance in the March 26, 2021 State Operations Manual, Appendix Z (PDF).

Revision To Billing Requirements

May 8th, 2022

HHSC Publishes Revision 22-1 of the HCS and TxHmL Program Billing Requirements, CFC Billing Requirements

Revision 22-1 is effective May 2. All revisions are outlined in the Revision 22-1 Section of each document.

The Billing Requirements are located on the Long-term Care Providers webpage and Handbooks webpage and are outlined below:

Email questions to TxHmL Policy.

HCS / TxHmL / LIDDA: Updates For Submission of Claims

May 8th, 2022

 HCS and TxHmL Must Submit Claims and Forms to TMHP Beginning May 2, 2022

Home and Community-based Services (HCS) providers, Texas Home Living (TxHmL) providers, local intellectual and developmental disability authorities (LIDDAs), and financial management services agencies (FMSAs) billing on behalf of Consumer Directed Services (CDS) employers must submit claims and forms to Texas Medicaid & Healthcare Partnership (TMHP) beginning May 2, 2022, for dates of service on or after May 1, 2022.

Steps to Prepare

Program providers, LIDDAs, and FMSAs are strongly encouraged to set up the following accounts if they have not already done so:

  • Claims Submission Account:
    • TexMedConnect or
    • Electronic Data Interchange (EDI)
  • Long-Term Care (LTC) Online Portal
  • TMHP Learning Management System (LMS)

Failure to set up the necessary accounts can lead to delays in payment after implementation. Program providers, LIDDAs, and FMSAs can find resources for creating the necessary accounts and the time frames it could take to create those accounts in the following table.

read more…


April 28th, 2022

Claims Submission

Reminder: HCS and TxHmL Must Submit Claims and Forms to TMHP Beginning May 2, 2022

Reminder: HCS and TxHmL Programs can Submit 837P Professional and 837D Dental Claims Using EDI or TexMedConnect

For additional questions, providers can refer to the HCS and TxHmL Waiver Programs Frequently Asked Questions (FAQ), send an email to hcs_txhml@tmhp.com, or contact the TMHP EDI Help Desk at 888-863-3638.

COVID-19 Resources

COVID-19 Resources

May 8th, 2022

May 5, 2022 MCS COVID-19 Stakeholder Information Session

Thank you for your interest in listening to the May 5 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

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


April 10th, 2022

April 7, 2022 MCS COVID-19 Stakeholder Information Session

Thank you for your interest in listening to the April 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

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


 

January 9th, 2022

January 6, 2022 MCS COVID-19 Stakeholder 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

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


 

December 30, 2021

COVID-19 Cases Rise – Guidance for LTC Providers

COVID-19 cases are increasing across Texas. HHSC reminds providers to follow the guidelines listed below and ensure their emergency plan is up-to-date. Staff must be aware of what to do in the event of any sort of emergency, including an outbreak of flu or COVID-19.

Please review the following guidelines and rules:

  • COVID-19 mitigation and visitation rules
  • Any applicable COVID-19 response plans for your provider type
  • Your provider’s own infection prevention and control policies

Find COVID-19 resources on:

Your vigilance following infection control requirements can make a difference in protecting vulnerable Texans.

LTC providers are always required to provide services to residents or clients before, during and after an emergency. The emergency plan or policy must include:

  • Planning for staff shortages.
  • A backup plan to ensure operations and care of residents or clients continue.

Read program-specific rules related to staffing, emergency preparedness, and infection control.

checklist (PDF) is available to assist you with creating a plan for dealing with an outbreak of flu or COVID-19.

If you need help with updating your COVID Mitigation Plans within Infection Control Policies or Emergency Evacuation Plans with these new updates to Mitigation of COVID-19, please contact us.  We may be able to help you.  Contact us at:  info@twogetherconsulting.com 


 

December 30th, 2021

Dec. 13 ICF COVID-19 Webinar Recording Available

A recording of the Dec. 13, 2021, ICF/IID COVID-19 Q&A with HHSC LTC Regulation and DSHS is available for those who could not attend.

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

Listen to the webinar recording here.

Email LTCR Policy for the transcript.


 

December 29th, 2021

COVID RESOURCES FOR HCS/TXHML

Home and Community-based Services (HCS) and Texas Home Living (TxHmL)

Additional Guidance and Resources

 

Shelter-in-Place and Stay-at-Home Orders for HHSC Providers, Vendors and Contractors 

HHSC Provider, Vendor and Provider Contractor Guidance for Shelter-in-Place and Stay-at-Home Orders

All mission-essential workers for HHSC, providers, vendors and contractors whose work cannot be performed through teleworking must continue to report to their work or duty stations, including in areas where local government authorities have issued shelter-in-place or stay-at-home orders. It is critical that workers for HHSC providers, vendors and contractors continue to provide the life-sustaining and lifesaving care and benefits our clients need. It is equally critical that HHSC providers, vendors and contractors provide their workers with a safe and healthy environment in which to work. To protect those workers reporting to HHSC offices and facilities, the agency is requiring additional efforts to sanitize workspaces, implement CDC social distancing measures, and limit face-to-face interaction with clients and patients as much as possible through temporary measures, such as waiving certain interview processes and prohibiting visitors to HHSC-operated and licensed facilities.

For more specific guidance, please contact the particular HHSC program or department your services involve.

Resources

 


November 5th, 2021

Beginning May 6, 2021, HHSC has been posting pre-recorded sessions monthly. These sessions will continue to share information with stakeholders about the implementation of various Medicaid/CHIP flexibilities in response to the COVID-19 pandemic. HHSC may return to weekly sessions as needed if there are changes to the public health emergency.

 

Please click on the link below to hear recorded session from NOV 4 Texas Medicaid CHIP COVID-19 Information Session Webinar

The audio from this session can be found here.

If you need a copy of the transcript or want to download a handout of the presentation, click links below:

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

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


 

September 15th, 2021

Oct. 4 ICF COVID-19 Webinar with HHSC LTCR

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 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.

October 4, 2021
11 a.m. – noon
Register for the COVID-19 Webinar.


September 15th, 2021

Sept. 13 ICF COVID-19 Webinar Recording Available

A recording of September 13, 2021, ICF/IID COVID-19 Q&A with HHSC LTC Regulation and DSHS is available for those who could not attend.

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

Listen to the webinar recording here(link is external).


August 30th, 2021

LTC Providers May Request COVID-19 Emergency Support

For Emergency Staffing Support:

The Office of the Governor directed DSHS to use staffing agencies to provide medical personnel from out-of-state to Texas health care facilities to assist in COVID-19 operations.

This support will be available to residential long-term care providers.

-Providers must demonstrate that they have exhausted all other options.

-Also that they have urgent need for assistance before requesting emergency staffing support.

The State is asking that jurisdictions and health care entities be judicious with requests for staffing, as the State will not be able to address all staffing needs, especially as the need for emergency staffing ramps up across the state.

LTC providers are always required to provide services to residents or clients before, during and after an emergency.

The emergency plan must include:

  • Planning for staff shortages
  • A back-up plan to ensure operations and care of residents continues

For COVID-19 Vaccination, Testing Kits, PPE, Disinfection, and HAI/EPI Support:

Long-term care providers can request:

  • COVID-19 mobile vaccine clinics for residents and staff
  • BinaxNow testing kits. Read PL 2020-49 for details.
  • PPE (providers should exhaust all other options before request)
  • Facility cleaning and disinfection
  • Healthcare-associated infection and epidemiological support

To Request Support:

To initiate a request for COVID-19 support described above, contact the HHSC LTCR Regional Director in the region where the facility is located.

HHSC LTCR staff are responsible for initiating a State of Texas Assistance Request on behalf of the long-term care provider.

HHSC LTCR staff may request supporting documentation to verify need.


 

August 15th, 2021

LTC Provider COVID-19 Resource Contacts Have Changed

Federal COVID-19 Local Fiscal Recovery Funds are being distributed to cities and counties throughout Texas. HHSC urges long-term care providers in need of COVID-19 resources to use the following resources:

  • Contact your city, county or regional advisory council to find out if resources or funds will be available for health care staffing support, testing services, resident or site assessment, and disinfecting services as these resources are no longer available through HHSC.
  • For mobile COVID-19 vaccination needs, call 888-90-TEXAS to ask for a Mobile Vaccination Team to come out to your facility.
  • Contact DSHS:
  • Reach out to the HHSC Long-Term Care Regulation Regional Director in your region to ask for:
    • BinaxNow testing kits. Review PL 2020-49 (PDF) for details.
    • Health care-associated infection and epidemiological support.
    • COVID-19 vaccine. Providers should go through all other options before this one.

LTC providers can now order COVID-19 therapeutics directly.


 

July 18th, 2021

August 2 ICF COVID-19 Webinar with HHSC LTCR

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 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
August 2, 2021
11 a.m. – 12 p.m.
Register for the COVID-19 Webinar.


July 16th, 2021

July 6 ICF COVID-19 Webinar Recording Available

A recording of the June 14, 2021, ICF/IID COVID-19 Q&A with HHSC LTC Regulation and DSHS is available for those who could not attend.

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

Listen to the webinar recording here(link is external).


 

Illustration of two people looking at a computer screen

May 2021
Building COVID-19 Vaccine Confidence Webinar

The CMS Office of Minority Health, along with guest speakers from the FDA and CDC, hosted a webinar on May 13 to provide information and resources to help address vaccine hesitancy in your community.
  • Watch the recording and download the slide deck (PDF) from the presentation.
  • Download the supplemental handout (PDF) for information and outreach materials you can use to educate your community about the COVID-19 vaccine.
  • Download the Vaccinate with Confidence fact sheet (PDF) to learn about CDC tools and technical assistance available to state and territorial health departments to increase COVID-19 vaccine confidence and uptake.

 

May 12th, 2021

Quality In LTC Conference Online

Due to the COVID-19 pandemic, Health and Human Services made the decision to move forward with an online Quality in Long-Term Care conference. The conference presentations are available on the HHS Learning Portal, and can be accessed through August 2021. To obtain a certificate of completion, participants must view the selected presentation(s), and complete the associated learning quizzes and course evaluations. The certificate, noting any continuing education hours awarded, can be downloaded from the HHS Learning Portal.

Questions can be emailed to QMP@hhs.texas.gov


From HHSC May Newsletter

COVID-19 updated resources, see link below:

https://www.tmhp.com/sites/default/files/file-library/ltc/bulletins/May%202021%20LTC%20Bulletin%20No%2086.pdf


May 6th, 2021

APR 29 MCS COVID-19 Stakeholder Update

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


 

April 17th, 2021

March 18, 2021 MCS COVID-19 Stakeholder Information Session

Thank you for your interest in listening to the March 18 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

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


April 17th, 2021

Reminder: Providers Can Request Free COVID-19 Testing Kits

ALF, HCS, HCSSA, ICF/IID and NF providers in counties where the COVID-19 positivity rate is more than 10 percent can request free COVID-19 testing kits.

The test kits are only to test essential caregivers or HCSSA staff going into an NF or ALF who have direct contact with people receiving hospice services. Providers can request the free BinaxNOW point-of-care antigen COVID-19 test kits by filling out the attestation form (PDF). The attestation form includes instructions for requesting the free COVID-19 testing kits for each eligible provider type.

March 28th, 2021

Free BinaxNOW COVID-19 POC Tests Available for LTC Providers

HHSC, along with the Texas Department of Emergency Management, is expanding the criteria for requesting free BinaxNOW COVID-19 point of care test kits to all the following.

  • Nursing facilities
  • Assisted living facilities
  • Intermediate care facilities for individuals with intellectual disability or related conditions
  • Home and community-based services providers
  • Home and community support services agencies

Use these free BinaxNOW COVID-19 POC test kits to test anyone including residents, staff and visitors.

Providers must attest to adhere to certain training and reporting requirements and have one of the following.

  • Current Clinical Laboratory Improvement Amendment Certificate of Waiver
  • Current CLIA laboratory certificate

Providers must complete and submit an attestation form for free BinaxNOW point-of-care antigen COVID-19 test kits (PDF) to request free BinaxNOW COVID-19 point of care test kits. See revised PL 2020-49 (PDF) for more information. Tests are available while supplies last.


March 22 ICF COVID-19 Webinar with HHSC LTCR

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 bi-weekly 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

March 22, 2021
11 a.m. – 12:30 p.m.
Register for the COVID-19 Webinar.


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


 

EVV (Electronic Visit Verification) Updates

May 8th, 2022

EVV Portal and Training Updates

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

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

Email TMHP EVV Operations with questions


March 7th, 2022

EVV Notice for HCS/TxHmL Program Providers

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

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

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

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

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

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

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


March 3rd, 2022

EVV Policy Handbook Revisions Now Available

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

The handbook includes EVV standards and policy requirements for:

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

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

Email HHSC EVV Operations with questions.


February 28th, 2022

EVV Portal and Training Updates

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

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

For questions, email TMHP EVV Operations.


January 8th, 2022

EVV Policy Handbook Revisions – Jan. 7th, 2022

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

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

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

For questions, email HHSC EVV Operations.


November 21st, 2021

EVV Portal and Training Updates for November 2021

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

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

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

Email TMHP with questions about these updates.


November 18th, 2021

Revised EVV Policy Handbook Now Available

The Electronic Visit Verification Policy Handbook was revised.

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

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

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

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

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

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

Email questions to HHSC EVV Operations.


November 17th, 2021

EVV Visit Maintenance Unlock Request Updates

HHSC published EVV Visit Maintenance Unlock Request spreadsheet updates.

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

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

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

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

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

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

    Review the instructions on the spreadsheets for more information.

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


July 4th, 2021

EVV Visit Maintenance Policy Now Available

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

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

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


July 4th, 2021

HHSC EVV Webpage Updates Now Available

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

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


July 3rd, 2021

Revised EVV Visit Transaction Rejection Guide Now Available

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

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

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

Email TMHP with questions.


April 17th, 2021

EVV Policy Training for CDS Employers Now Available in Spanish

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

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

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

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

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

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


March 16th, 2021

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

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

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

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

For questions, email HCS Policy or CDS.


March 10th, 2021

Temporary EVV Policies for the Feb. 2021 Severe Winter Weather

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

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

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

Email questions to the HHSC EVV Mailbox.


February 7th, 2021

EVV Refresher Training on Feb. 19

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

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

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

Certificates of completion will not be issued.

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

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

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

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

Email HHSC EVV for questions.


Reminder:  Entering Schedules for EVV-Required Services

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

EVV is only required for the following services:

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

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


January 24th, 2021

EVV Portal and Training Updates for January

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

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

Email TMHP with questions about these updates.


January 24th, 2021

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

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

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

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

Email questions about EVV policy to HHSC EVV.


January 18th, 2021

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

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

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

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

Next Steps

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

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


January 10th, 2021

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 TMHPEVV@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
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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

HCS Provider Response & Visitation Emergency Rules: COVID-19-Update 2022

May 7th, 2022

HHSC Updates HCS/TxHmL COVID-19 Response Plan, FAQ Documents

HHSC Long-term Care Regulation updated the COVID-19 Response Plan and FAQ documents on May 5. The updates remove instructions on how to ask for emergency staffing from HHSC.

Read the revised COVID-19 Response for HCS Providers (PDF).

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


February 20th, 2022

HHSC Updates the HCS COVID-19 Response Plan and FAQ Documents – Feb. 18

HHSC Long-term Care Regulation updated the HCS COVID-19 Response Plan and FAQ documents.

Read the revised COVID-19 Response for HCS Providers (PDF).

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


Updated COVID-19 Provider Response and Visitation Emergency Rules for HCS Providers – Feb. 17

HHSC Long-Term Care Regulation published revised HCS COVID-19 Provider Response to COVID-19 and Expansion of Reopening Visitation Rules (PDF). HCS providers must now screen individuals and staff per HHSC guidance.

HHSC Long-Term Care Regulation published revised COVID-19 Expansion of Reopening Visitation Emergency Rules. They are for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions program providers. HHSC removed the following language:

“If an executive order or other direction is issued by the Governor of Texas, the President of the United States, or another applicable authority, that is more restrictive than this rule or any minimum standard relating to a facility, the facility must comply with the executive order or other direction.”

The rules became effective Feb. 17, 2022.


January 7th, 2022

HCS and TxHmL COVID-19 Response Plan Updated – Jan. 7th, 2022

HHSC has revised the HCS and TxHmL COVID-19 Response Plan in response to the most recent CDC guidance.


September 23rd, 2022

HCS COVID-19 Mitigation & Expansion of Visitation Rules: 

Revision Response Plan

 

COVID-19 Response Plan (PDF) in response to the revised HCS and TxHmL COVID-19 Mitigation and Visitation rules


Update:   April 17th, 2021

HHSC Publishes HCS Expansion of Reopening Visitation Rules

Original Published:  March 25th, 2021

3.0 HCS Expansion of Reopening Visitation Rule

To read more, please click on the link below: 

https://documentcloud.adobe.com/link/track?uri=urn:aaid:scds:US:a7d8cd88-7334-4f8b-89b3-5876693ceb1a

*** Please Don’t Forget To Update Your Policies & Procedures Based On The Changes.  Feel Free To Contact Twogether Consulting For Assistance!  Info@twogetherconsulting.com 

The new expanded visitation rules do not apply to host home/companion care providers unless otherwise specified in rule. See the HCS Provider Response to COVID-19 Expansion of Reopening Visitation Rule at 40 TAC 9.199 for the complete list of requirements.

The new visitation rules provide flexibility for HCS program providers that have offered a complete series of a one- or two-dose COVID-19 vaccine to individuals and staff and documented each individual’s choice to vaccinate or not vaccinate, including:

• Essential caregiver and end-of-life visits are permitted for all individuals with any COVID-19 status.
• The definition of an end-of-life visit has been expanded to include for more flexibility on when an individual is considered at end-of-life so an individual’s family and loved ones have more opportunity to visit.
• Indoor visitation no longer requires the use of a plexiglass barrier.
• A program provider may not require a visitor to provide documentation of a COVID-19 negative test or COVID-19 vaccination status as a condition of visitation or to enter the residence.
• Provider staff no longer have to escort or monitor visitors once they have passed screening and entered the facility.
• Program providers are no longer required to submit an attestation form to facilitate visitation.
• Visitation is required and a program provider must facilitate indoor and outdoor visitation without a reasonable clinical or safety cause.
The provider can continue to document the individual’s choice whether to receive a COVID-19 vaccine or not to receive a COVID-19 vaccine as applicable for new admissions or individuals who return to the residence from leave.

Visitor Limitations: (Indoor and Outdoor)

3.3 Indoor and Outdoor Visits
HCS program providers that have offered a complete series of a one- or two-dose COVID-19 vaccine to individuals and staff and documented each individual’s choice to vaccinate or not vaccinate, must allow indoor and outdoor visitation.
Program providers do not have to complete an attestation form or use plexiglass barriers to facilitate indoor or outdoor visitation. The program provider accommodates visitation based on the space available as necessary to ensure physical distancing between visitation groups and safe infection prevention and control measures.

3.3.1 Indoor Visitation

• The program provider must allow indoor visits for individuals who are COVID-19 negative, if there are no confirmed COVID-19
infections or suspected COVID-19 cases for at least 14 consecutive days among staff. • The provider must reasonably limit the number of simultaneous visitors per individual and limit the total number of visitors in the residence simultaneously, based on the size of the building and physical space and staffing capabilities.
• Plexiglass barriers are no longer required.

3.3.2 Outdoor Visitation

The program provider must allow outdoor visits for individuals who are COVID-19 negative and must:
• ensure a comfortable, accessible, and safe outdoor visiting area for outdoor visits, considering outside air temperatures and ventilation; and
• limit the duration, frequency, size, and number of visits as necessary to ensure physical distancing between visitation groups and safe infection prevention practices.

3.3.3 Limitations for Visitation

The following limitations apply to all visitation types, including essential caregiver visits, end-of-life visits, and indoor and outdoor visitation:
• Visits must be scheduled to allow time for cleaning and sanitization of the visitation area between visits.
• Indoor and outdoor visits are permitted for individuals with COVID-19 negative status only, except essential caregiver and end-of-life visits. Essential caregiver and end-of-life visits are permitted for an individual with any COVID-19 status.
• The visitor and individual they are visiting do not have to physically distance from each other but must distance from other persons in the residence.
• The visitor must wear a face mask or face covering. For individuals who rely on lip reading or facial cues for communication needs, the visitor may use face masks with a clear screen over the mouth.
• The provider must encourage the individual to wear a face mask, if tolerated, throughout the visit.
• When visitors come to the home, staff members no longer need to escort the visitor or monitor the visit, regardless of the visitation type.
• Both the individual and visitor(s), must perform hand hygiene (i.e., use an alcohol-based hand sanitizer or wash hands with soap and water) before the visit. The program provider must make hand hygiene supplies available.

 

Limited Visitation Designation and Attestation

4.0 Limited Visitation Designation and Attestation Requirements

If an HCS program provider has not offered at least one complete series of a one- or two-dose COVID-19 vaccine to individuals and staff, the program provider may allow limited personal visitation.

4.1 Essential Caregiver Visits

An essential caregiver visit is defined as a personal visit between an individual and a designated essential caregiver, permitted for all individuals with any COVID-19 status, including:
• COVID-19 negative;
• unknown COVID-19 status; or
• COVID-19 positive.
A program provider cannot require an essential caregiver visitor to provide documentation of a negative test result prior to visitation. The following requirements apply to essential caregiver visits:
• There may be up to two permanently designated essential caregivers per individual.
• Only one essential caregiver visitor at a time may visit an individual.
• The visit may occur outdoors, in the individual’s bedroom, or in another area in the home that limits the essential caregiver visitor’s movement through the residence and interaction with other individuals and staff.
• Essential caregiver visitors do not have to maintain physical distancing between themselves and the individual they are visiting but must maintain physical distancing between themselves and all other persons in the residence.
• The individual must wear a face mask or face covering over both the mouth and nose (if tolerated) throughout the visit.
• The program provider must develop and enforce essential caregiver visitation policies and procedures, which include:
o a written agreement that the essential caregiver visitor understands and agrees to follow the applicable policies, procedures, and requirement;
o training each essential caregiver visitor on proper personal protective equipment (PPE) usage and infection control measures, hand hygiene, and cough and sneeze etiquette; and
o a requirement that the essential caregiver visitor must wear a face mask and any other PPE in accordance with CDC guidance and the program provider’s policy while in the residence.
The program provider must:
• inform the essential caregiver visitor of applicable policies, procedures, and requirements;
• approve the essential caregiver visitor’s face mask and any other PPE in accordance with CDC guidance and the program provider’s policy, or provide an approved face mask and other PPE;
• maintain documentation of the essential caregiver visitor’s agreement to follow the applicable policies, procedures, and requirements;
• maintain documentation of the essential caregiver visitor’s training;
• maintain documentation of the identity of each essential caregiver visitor in the individual’s records and verify the identity of the essential caregiver visitor at the time of each visit;
• maintain a record of each essential caregiver visit, including:
o the date and time of the arrival and departure of the essential caregiver visitor;
o the name of the essential caregiver visitor;
o the name of the individual being visited; and
o attestation that the identity of the essential caregiver visitor was verified; and
• prevent visitation by the essential caregiver visitor if the essential caregiver has signs and symptoms of COVID-19, or an active COVID-19 infection.
The program provider can ask the essential caregiver to leave the residence if the essential caregiver visitor fails to comply with the program provider’s policy regarding essential caregiver visits or applicable requirements.

4.2 Limited Visitation without Attestation Form

All HCS residences can allow the following visits without completing the HCS Expanded Visitation Attestation:
• Visits by persons with legal authority to enter
• Visits by providers of essential services
• Visits by essential caregivers
• End-of-life visits
• Closed window visits
The visitors listed above must be screened prior to entry to the residence and cannot be allowed inside the residence if they fail screening.

 

Definitions and Attestation Form Update:  https://documentcloud.adobe.com/link/track?uri=urn:aaid:scds:US:a7d8cd88-7334-4f8b-89b3-5876693ceb1a


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

Letter From Twogether Consulting To Providers-Update

April 28th, 2022

Update From Twogether Consulting!

     Hope everyone’s Spring Holidays were a success:  Easter, Passover, Ramadan, and Eastern Orthodox Easter!
There are so many changes happening right now for LTC Providers, especially those in the HCS/TxHmL programs: CARE Migration to TMHP, Critical Incident Management Reporting System, New Rules Coming for the HCBS program, including  ISS and DH changes, and much more. It continues to be a huge year of change!   Please contact us directly for your care coordination, QIDP, and nursing needs at info@twogetherconsulting.com or you may contact our assistant Meghan Jones at meghanjones.tx@gmail.com. We are happy to say that we can still continue to provide for most of your needs at this time.  We are happy to provide whatever assistance we can with questions you may have, especially concerning HCS/TxHmL Care Coordination, IT and security, Nursing, or general survey requirements from LTCR department in these programs.  We also still provide assistance with the ICF/IID program.
     Many of you have asked about whether or not we will provide additional training for billing/claims in TMHP and entering IPC’s and IDRC’s.  At this time we are not providing that service as it is new to everyone, but we will continue to keep providers updated on any fixes we learn for provider issues in TMHP.  Please continue to check our “Updates” posts on the Twogether Consulting website. I have assigned a few consultants with the task of learning the system, so that hopefully we can provide some training to help reinforce and support what providers learn on the TMHP portal.
     Our team has recently expanded.  We have a new IDD Consultant who will be starting with us in May 2022.  We hope to do a formal introduction in the next few months. We can still help with  POC’s (Plans of Correction) for HCS/TxHmL and ICF as well as Directive Inservice Training as needed.  FYI-We do still have “mentoring” assistance (especially great for new nurses) from a few of our RN consultants on an as-needed basis, but we will keep you posted when we have someone else in place more regularly during 2022, we are still working on that.
     Twogether Consulting will be posting more of our upcoming webinar classes for May-July within the next 2-3 weeks, so feel free to check the website: www.twogetherconsulting.com or our next newsletter.
We have recently updated a few items on our website:
1. The page on our website previously called “Shop” on the dropdown menu under “Services”, is now called “Service Pricing” I hope this makes it much easier for providers we currently serve and new providers to find some of our services with regular pricing posted.  We do not post all of our rates and fees as most of the services providers need our help with must be tailored to the client for their specific needs.
Before 2023, we hope to add a few packages with set prices for new providers.  Some examples are:
 “On-site Assistance With Opening A Group Home” for brand new HCS providers and  “On-site Assistance With a New Admission”  (GH or HH/CC clients in HCS only)
2. We have changed the look of our “Satisfied Customers” page a bit. Please submit any quotes you have by clicking on “Contact Us” and sending us a small statement of how you feel Twogether Consulting has helped your agency, the company name and your name, and contact information.  We could really use some new quotes.
3.  We do accept payments via Venmo, as well as Paypal now:  Our Venmo address is @Twogether2004
4.  Once again, please don’t forget our “Updates” page on the Twogether Consulting website. This is where we post anything new from HHSC and anything going on with Twogether Consulting. It is fairly easy to navigate from one “post” to the other. If you want to read more on each section, just click on “read more”.
5.  I would like to remind everyone again, that if you need “Off-site Consultation” and you would like to purchase a block of time (1, 3 or 6 hrs at a time), please go to our  “Services” page to pay directly from the site.  There is a tab called “Service Pricing” in the drop-down menu where you pay your payment. 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 page on the dropdown menu under “Service Pricing”.
-There are also some additional services at a flat rate, for purchase on this page.  This includes “Off-site” ICAP Scoring, General or Nurse Consultation, and the initial consultation for HCS Provider Applicants.  We will be adding to these options in 2022!

Currently, most of our services are still technically “off-site”, due to the continued Public Health Emergency (Pandemic) but we are happy to announce that we have begun providing scheduled “on-site” training for small groups and on-site assistance to providers.  We hope to have live sessions advertised by the Fall of 2022 at the latest.

 

As I said, Twogether Consulting is available to come on-site at this time, if you are comfortable with us doing so.  We have all had our COVID-19 vaccinations and boosters at this time and we can take the rapid test for COVID, prior to the visit, if requested.  We are happy to follow specific company protocol if requested (masks, etc..)

 

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 for 2022 Services:

  • In-person group trainings/conferencesAvailable as requested as of December 29th, 2021. Most of these classes have already been moved to online webinars or training, but we can come on-site if you need us to do so.  We also have pre-recorded sessions of some of these trainings as well if you prefer.
  • 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 $45-$175 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 listThese 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 but also on-site now if requested..
  • Off-site Consultation:
    •  You may purchase a block of time for as-needed consultation:  Starting January 1st, 2022, our prices will go to $80/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, 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 case management and nursing consultation and mentoring for HCS/TxHmL and ICF programs,
    • And much more!
  • On-site Consultation:  This service is available as requested, but please understand we need ample time to schedule as we are backed up right now!:  
    • General On-Site Assistance is based on a daily flat fee (ranges from $550-$1050 per day), depending on your location and additional travel expenses.
    • On-site Training for groups is a daily flat fee however due to prep time, and additional costs for materials, # of attendees, the cost is a bit more (ranges from $850-$2800 per day).
  • The request for on-site is up to you and if you feel comfortable. We will of course respect any protocol you have for us if we do come on-site, including rapid testing for COVID (additional cost).
  • 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 and Venmo.  You are also welcome to pay via check,  e-check, or request to pay with 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

 

ICF/IID Updates

April 29th, 2022

ICF Visitation Rules Update

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

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


April 10th, 2022

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

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

The revised rule:

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

April 10th, 2022

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

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

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

– New Requirements for Infection Prevention and Control Policies and Procedures

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

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

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

-ANE & Incident definitions

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

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


April 6th, 2022

COVID Screening in ICF’s

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

.ICFs must screen individuals:

•upon admission or readmission to the facility; and

•at least once a day.

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

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

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

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

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

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

Screening Criteria:

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

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

•other signs or symptoms of COVID-19, including

-chills,

-new or worsening cough,

-shortness of breath or difficulty breathing,

-fatigue,

-muscle or body aches,

-headache,

-new loss of taste or smell,

-sore throat,

-congestion or runny nose,

-nausea or vomiting,

-or diarrhea;

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

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

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


April 6th, 2022

Reporting Confirmed Case of  COVID-19 in ICF/IID

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

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

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


April 6th, 2022

COVID-19 Mitigation and Response Emergency Rule Updated

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

It became effective April 6, 2022.

The revised rule:

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

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

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

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


February 27th, 2022

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

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

Key changes to the rule are to:

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

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

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

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

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

Listen to the webinar recording.

Email LTCR Policy for the transcript.


February. 20th, 2022

Mar. 07 ICF COVID-19 Webinar with HHSC LTCR

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

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

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

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


February 13th, 2022

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

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

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

The rule requires ICF/IIDs to:

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

January 7th, 2022

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

Document   Version    Date    Change    Comments

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

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

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

Update your Infection Control Policies and other related policies accordingly. 

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


November 21st, 2021

HHSC Publishes PL 2021-38 Medicaid Bed Reallocation

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


November 4th, 2021

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

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

October 24th, 2021

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

Super important!!!!

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

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

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

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September 15th, 2021

HHSC Publishes Amended Statutory Cap Regarding Administrative Penalties for ICFs:  (PL 21-34)

HHSC published Provider Letter 21-34 Amended Statutory Cap Regarding Administrative Penalties for Intermediate Care Facilities. PL 21-34 notifies providers of changes to how HHSC determines and imposes administrative penalties based on changes made by House Bill 3720 (87th Legislature, Regular Session, 2021).

September 5th, 2021

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

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


September 5th, 2021

ICF/IID Leave During COVID-19 Rule Reinstated

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

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

August 1st, 2021

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

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

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

Read the updated ICF FAQs (PDF).


March 24th, 2021

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

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

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

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


March 22nd, 2021

ICF COVID-19 March 22 Webinar Recording Available

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

Listen to the COVID-19 Q&A recording.

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


March 11th, 2021

Recording of ICF COVID-19 March 8 Provider Webinar Available

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

Listen to the COVID-19 Q&A recording.

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


February 8th, 2021

Draft ICF/IID Rule Changes

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 2020-43ICF/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:
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:

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

 

 

Important- Recordings Available From HCS and ICF Webinar COVID-19 from HHSC

April 28th, 2022

COVID-19 ICF/IID Webinar Recording from April 11 Available

The April 11 recording of the Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions COVID-19 Q&A with HHSC Long-term Care Regulation and DSHS is available.

The PowerPoint is updated with information given in the DSHS webinar.

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

Listen to the webinar recording here.

Email LTCR Policy for the transcrip


February 27th, 2022

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

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

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

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

Listen to the webinar recording.

Email LTCR Policy for the transcript.


February 1st, 2022

HCS, TxHmL COVID-19 Response Webinar Recording: Jan. 27 and Jan. 30

This webinar reviewed information from the revised COVID-19 Response Plan for HCS and TxHmL.

This includes strategies to rapidly identify COVID-19 and:

  • Prevent its spread
  • Protect individuals, staff, and visitors
  • Provide care to infected people
  • Recover from an outbreak

They also addressed the surge of COVID-19 across the state, address staffing shortages and provide you guidance from the CDC.

. A recording of this webinar is now available as of Jan. 31 at GoToStage.


January 27th, 2022

 HCS and ICF/IID providers who attended the webinar from HHSC on 1/19/22.

The webinar below was held in response to discussions between the 3 IDD associations and HHSC regarding the increase in COVID cases, ongoing staff (direct care and nurse) shortages (which have now been exacerbated because of COVID), limited to no access to PPE and testing resources and inconsistent (and at times unclear) rules and policies related to COVID and infection control.  
Providers have still not been able to find a resolution as of to date to these issues (i.e. staffing shortages and shortages in PPE, status of ARPA funds).
Below, however, are several actions HHSC has taken to improve communications with providers, streamline current COVID processes and policies and clarify current policies and practices:
** Note: Twogether Consulting does understand that many providers have been unsatisfied with the efforts HHSC has made to assist with staff shortages, especially since even if you do complete the checklist before requesting emergency staffing, it does not mean they will honor your requests.  I have informed at least one of the IDD associations about this concern.
  • Recently HHSC re-issued and, in some cases, issued updated policies and guidance for all IDD COVID-related documents.(1/5/22 and 1/7/22 for HCS concerning guidance booklet updates).
  • HHSC is working to reorganize the COVID-related information, including COVID flexibilities and Appendix K waivers, on the ICF/IID and HCS home webpages to facilitate ease in access. 
  • HHSC did communicate the above and other changes and policy clarifications with providers via a webinar on January 19th, 2022, however many questions were still unanswered and attendees were told that questions that were not answered should be addressed in an FAQ from HHSC within 2 weeks of the webinar.

Jan. 19 Recording of HCS and ICF/IID COVID-19 Webinar Available

A recording of the Jan. 19 for Home and Community-based Services and Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions webinar with LTCR is now available.

Listen to the webinar recording here.

Read the webinar slide presentation (PDF).

Email LTCR Policy for the transcript.

CARE Migration To TMHP: Claims Submissions (Previously Billing In CARE)

April 28th, 2022

Very Important!

Recorded Webinar For Claims Submission in TMHP

 

Below is the link to the recording of the claims submission webinar TMHP conducted.   Additional information about the migration will be sent under separate cover.

NoteHHSC will not conduct another webinar on claims submission!

 https://tmhp.exceedlms.com/student/enrollments/create_enrollment_from_token/fEmzWuXLDuXzfc3jncsErHWU

Star+Plus Pilot Information Update

April 28th, 2022

STAR+PLUS Pilot: 

TMHP Transition Guidance for Renewal of ID/RCs and for Renewal, Revised and Transfer IPCs – CLASS, HCS and TxHmL

April 28th, 2022

Effective May 1, 2022, HHSC will transition certain COVID-19 flexibilities to interim guidance in accordance with House Bill (H.B.) 4 (87th Legislature, Regular Session, 2021). The following activities are authorized through interim guidance to be provided through a telehealth (synchronous audio-visual) modality:

  • Renewal ID/RC assessments
  • Renewal, revised and transfer IPCs

This guidance applies to the following programs:

  • Community Living Assistance and Support Services
  • Home and Community-based Services
  • Texas Home Living

Access Information Letter No. 2022-27 Interim Guidance for Renewal of ID/RC Assessments and for Renewal, Revised, and Transfer IPCs for CLASS, HCS and TxHmL for more information. This letter replaces IL20-45 for HCS and TxHmL and replaces IL20-46 for CLASS only.
Email questions to the following:

House Human Services Public Hearing on May 5th: Providers & Others Invited For Testimony

April 28th, 2022

Details On Hearing

  • Date, Time & Location:  Thursday, May 5, 2022 at 10:00 a.m., Capitol Extension, E2.030
  • Purpose:  To receive invited testimony on several of its interim charges:  #1 related to Healthy Families, Healthy Texas Initiative,  #8 related to the 1115 Waiver, and, the one of importance to PPAT members, #4 related to implementation of SB1, Rider 30 (HHSC) and recommendations for reducing the interest list for waiver services for Individuals with IDD and reducing associated staffing shortages. See end of this message for text of Rider 30.
  • Organizations Invited to Testify: Though not inclusive, organizations invited to provide testimony include PPAT, the Texas Council of Community Centers, the Arc, Disability Rights Texas and PACSTX.  HHSC will also provide testimony.

 

Public Testimony
Though the general public may attend the hearing, the committee will only receive invited testimony.  Providers and other interested stakeholders may, however, submit comments to the committee electronically. Details for submitting comments can be viewed at the link below.  Please note that:
i)  Comments are limited to 3,000 characters, and
ii) Though workforce shortage is not listed as a topic in the link below, but we have been informed that workforce issues can be addressed under Rider 30, thus select Rider 30 to comment on workforce shortages..  https://comments.house.texas.gov/home?c=c310.
Viewing the Hearing
If you cannot attend the hearing, you are urged to watch the hearing remotely.  Click on the following link  below on the day of the hearing and select House Human Services Committee:  https://www.house.texas.gov/video-audio/
* Please be brief and talk about issues related to your circumstance.  This is particularly important in reference to staff shortages and rates.  In addition to the testimony of your experiences and issues, remember to also recommend possible solutions.
House Human Services Committee Members
If you reside in the district of one of the committee members, consider either sending your comments directly to that member or contacting their office before the hearing to discuss your concerns and solutions.

HOUSE HUMAN SERVICES

Phone #

Email

Committee Office

512.463.0786

N/A

James Frank, ChairWichita Falls

512.463.0534

James.Frank@house.texas.gov

Gina Hinojosa, V-Chair, Austin

512.463.0668

Gina.Hinojosa@house.texas.gov

Lacey Hull, Houston

512.463.0727

Lacey.Hull@house.texas.gov

Stephanie Klick, North Richland Hills

512.463.0599

Stephanie.Klick@house.texas.gov

Thresa “Terry” Meza, Irving

512.463.0641

Thresa.Meza@house.texas.gov

Victoria Neave, Dallas

512.463.0244

Victoria.Neave@house.texas.gov

Candy Noble, Dallas

512.463.0186

Candy.Noble@house.texas.gov

Toni Rose, Dallas

512.463.0664

Toni.Rose@house.texas.gov

Matt Shaheen, Plano

512.463.0594

Matt.Shaheen@house.texas.gov

Twogether Consulting Webinars

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.

 

 

 

May-July 2022

Most Common Nursing Violations Seen By Twogether Consulting:  Prevention & Correction

(HCS/TxHmL)

 

Please Continue To Check The Website For More Trainings


Pre-recorded sessions are available for purchase!

To Purchase these Pre-Recorded Trainings:

Go to www.twogetherconsulting.com

Or

Contact us at info@twogetherconsulting.com at Meghanjones.tx@gmail.com


Currently, we have the following pre-recorded sessions:

 

ICF/IID Pre-Recorded Webinar Sessions

QIDP In The ICF Program (3 Part Series)

Nurse In The ICF Program (3 Part Series)


HCSTxHmL Pre-Recorded Webinar Sessions

Expectations of The Nurse: HCS/TxHmL

(includes: Delegation, CNA Training, Billable Services & Documentation as well) (4 Part Series)

Care Coordination (5 Part Series)

 

CARE COORDINATION  (5 Part Series)

Part I  

“Roles & Responsibilities: The LIDDA Vs. The Provider (For HCS/TxHmL providers)

Contact us at info@twogetherconsulting.com to purchase this training and the handouts.

 

Part II   Pre-recorded sessions available for purchase!

“Important Parts of The TAC In Relation To The HCS Handbook”  (For HCS/TxHmL providers)

Contact us at info@twogetherconsulting.com to purchase this training and the handouts.

Part III   Pre-recorded sessions available for purchase!

For HCS & TxHML Providers

“Developing The IP Using Person-Centered Practices” This is part 3 of 5 of our Care Coordination series.

Contact us at info@twogetherconsulting.com to purchase this training and the handouts.

 

Part IV   Pre-recorded sessions are available for purchase!

HCS/TxHML/ICF Providers

“ICAP/IDRC/LON” Webinar  This is part 3 of 5 of our Care Coordination series.

Contact us at info@twogetherconsulting.com to purchase this training and the handouts.

 

Part V  Pre-recorded sessions are available for purchase!

(Billable Services- HCS)    This session is split up into 2 parts!  Each section is 2 to 2.5 hrs long

General Billable Services (Day 1) & then Adaptive Aids/Minor Home Mods/Dental (Day 2)

Contact us at info@twogetherconsulting.com to purchase this training and the handouts.


HCBS Rules: Concerns Regarding Room & Board Payment Process

April 20th, 2022

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

ICF/IID and HCS/TxHmL COVID-19 related HHSC Notices-Update 2022

April 18th, 2022

HHSC Updates the ICF/IID COVID-19 Response Plan and FAQ Documents – April 18

HHSC Long-term Care Regulation updated the COVID-19 Response Plan and FAQ documents for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions program.

HHSC Long-term Care Regulation updated the COVID-19 Response Plan and FAQ documents for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions program.

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

Read the updated Frequently Asked Questions for ICF/IIDs about COVID-19 (PDF).


April 10th, 2022

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

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

The revised rule:

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

April 4th, 2022

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

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


February 25th, 2022
In case you did receive or inadvertently overlooked this information, below are links to recent HHSC bulletins related to COVID-19.
 1.  HCS COVID Response Plan – Updated 2/18/2022
2.  HCS & TxHmL COVID FAQs – Updated 2/18/2022
3.  ICF/IID COVID-19 Expansion of Reopening Visitation Emergency Rules – Effective 2/17/2022
As noted in the cover notice, the rules removed the following statement:

“If an executive order or other direction is issued by the Governor of Texas, the President of the United States, or another applicable authority, that is more restrictive than this rule or any minimum standard relating to a facility, the facility must comply with the executive order or other direction.”

4.   HCS COVID-19 Provider Response and Visitation Emergency Rules – Effective 2/17/2022
5.  March 7, 2022 Webinar (11:00 to Noon) – ICF/IID Providers:  Hosted by HHSC LTCR & DSHS
6.  CMS Vaccine Mandate Update for ICFs/IID, NHs and Hospice Providers – 2/18/2022
According to the notice:  HHSC is not currently assessing compliance with CMS’s Omnibus COVID-19 Health Care Staff Vaccination rules, published in the Federal Register on November 5, 2021.  This information parallels what HHSC shared with PPAT regarding how and when HHSC would monitor for compliance with the CMS Guidance for Texas sent to members on    PPAT is trying to obtain further information and will share upon receipt.
7.  ICF/IID COVID-19 Vaccination Data Reporting & Emergency Communication System Rules – Effective 2/7/2022
Note:  According to HHSC, target date for deployment of the new emergency communication system is late Spring.  Once more details are received PPAT will send to its members.
8.  Revised End of Temporary Suspension of Certain LTCR Regulatory Requirements During the COVID-19 Outbreak for NHs, ICFs/IID, DAHS, PPECC, HCSSAs and HCS/TxHmL (PL 2021-29) – 1/26/2022
In brief, the revisions provide clarification to HCS providers on when and how to notify HHSC when they temporarily increase the capacity and return to regular business operations.

Public Health Emergency Extended Another 90 Days

April 16th, 2022

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

Texas Position on Mandate Vs. CMS/Federal Surveyor

April 13th, 2022

Texas Providers have been reminded that they can be surveyed at any time by a CMS/Federal Surveyor and will need to be in compliance if this occurs.

In short, at this time, HHSC Regulatory will not survey for compliance with the federal mandate.

The federal mandate and HHSC position apply to certified-only HCSSAs, Hospice, Nursing Homes and ICFs/IID. 

Individualized Skills and Socialization Update

April 12th, 2022

Information As of Now on Draft ISS Rules:
  • The program rules will go to MCAC on August 11, 2022. 
  • The regulatory or license rules will go to the HHSC Executive Council but no date set yet.
  • The program and regulatory rules will be published in the Texas Register for formal comment in late July, and HHSC will hold a public hearing on the rules.
  • HHSC has decided to eliminate the on-site ratios.
  • Though the off-site ratios have not been eliminated, HHSC is considering revisions to them and open to suggestions and ongoing dialogue.
  • The current draft rules do not require any benchmark regarding time persons must engage in off-site activities, and at this time, there is no consideration to establish benchmarks.  According to HHSC, this is in great part due to the limited amount of appropriations received to implement the new service.
  • No changes expected, at least for now, to the proposed rates.
  • At this time, no changes to the DH rates for persons enrolled in an ICF/IID, yet who will attend an ISS facility are anticipated to occur.
  • Based on comments received through the informal comment period, HHSC is restructuring and revising the draft regulatory/license rules.  Details were not provided.
  • Stakeholders requested consideration of a separate meeting to discuss the draft rules.  No confirmation received as to whether HHSC will schedule a meeting.
  • HHSC has created a webpage related to ISS.  To access, go to: https://www.hhs.texas.gov/providers/long-term-care-providers/long-term-care-provider-resources/individualized-skills-socialization

 

April 10th, 2022

Individualized Skills and Socialization

Texas HHSC has developed the Individualized Skills and Socialization Provider Portal, an online system for providers of individualized skills and socialization.

The Individualized Skills and Socialization Provider Portal will allow providers to:

  • Complete and review trainings on the Individualized Skills and Socialization service.
  • Find and review provider letters and other information and releases related to Individualized Skills Socialization.
  • Link to rules and other services related to Individualized Skills and Socialization.

April 10th, 2022

Individualized Skills and Socialization Provider Portal Training

Individualized Skills and Socialization Provider applicants are required to complete HHSC Individualized Skills and Socialization Provider Training as well as training on the use of the TULIP application.

  • Coming soon

Provider Communications

Additional Links

Questions about Individualized Skills and Socialization Provider Portal?

New Critical Incident Management Reporting System To Begin July 25th, 2022!

April 12th, 2022

Critical Incident Management System (CIMS):  The go-live date is late July.  See additional information below.

 


April 10th, 2022

Register Now for the April 26 Webinar on HHSC’s New CIMS Part II

HHSC is offering CLASS CMAs, CLASS DSAs, DBMD, HCS and TxHmL providers more information on the new Critical Incident Management System
debuting this summer. The webinar will be held:

Tuesday, April 26, 2022
2:30 – 4 p.m.

Register here to attend the New Critical Incident Management System Webinar.

Click here to run a test of your computer’s connectivity if you have never attended a webinar from your computer. You can run this test at any time before the date of the training and advise this be done early in case of a problem that only your IT technician can fix.

From HHSC I-2022-23 revised letter: 

The system is targeted to go live July 25, 2022. Prior to the go-live date, HHSC and FEI Systems will provide training on the new system for waiver provider staff who will use the CIMS to report critical incidents. There will be training provided by FEI Systems using webinar formats; however, there will be limited capacity and these trainings will be focused on staff using the CIMS to report incidents. Virtual training resources will be available and accessible to waiver provider staff in addition to the information provided during training webinars. The goal is to support waiver provider staff with virtual training available for reference at any time to support using the system.


 

April 10th, 2022

HHSC has Published Critical Incident Management System (CIMS) 1915(c) Medicaid Waiver Program Providers (Revised) IL-2022-23

IL-2022-23 is posted to the HHS site CLASS, LIDDA, DBMD, HCS, and TxHmL

This letter replaces Information Letter 2022-14 and is a status update on the CIMS implementation which impacts fee-for-service 1915(c) waiver program providers, CLASS Case Management Agencies and LIDDAs.

Submit questions to LTSS_Policy@hhs.texas.gov


February 27th, 2022

HHSC Publishes New Reporting System for Critical Incidents Management

 (CIMS) See Letter (IL 2022-14)

(As if providers don’t have enough new things to learn, lol)

Sorry to say, we are gearing up for a new critical incident reporting system, and I know providers have so many other new things to learn between Migrating from CARE to TMHP,  Utilizing the E-learning portal, EVV, etc.., but, HHSC has approved IL-2022-14 CIMS for CLASS, LIDDA, DBMD, HCS and TxHmL Providers.

The Health and Human Services Commission (HHSC) will implement a new statewide critical incident management system (CIMS) for reporting critical incidents. The new system will be in compliance with guidance issued by the Centers for Medicare and Medicaid Services (CMS) on March 12, 2014.  There will be training sessions leading up to the implementation date of June 1st, 2022.

Questions about this project can be submitted to the following email address:  LTSS_Policy@hhs.texas.gov


HCS and TxHmL Webinar Slated for March 10th, 2022

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

  • Webinar topics include:

    • HCS & TxHmL Forms and Claims Migration Project
    • Critical Incident Management System

    HCS and TxHmL Webinar
    March 10, 2022
    3:30 – 4:30 p.m.
    Register for the webinar

    Email questions about the webinar to your program policy mailbox:

 

Urgent Information- DH Transition to ISS Services & Portal Information Page

April 10th, 2022

HHSC Launches Individualized Skills and Socialization Portal Information Page

HHSC launched a new Individualized Skills and Socialization Services Provider Portal. This new portal allows providers access to information on Individualized Skills Socialization services. Including:

  • Complete and review trainings.
  • Find and review provider letters and other information and releases.
  • Link to rules and other services.

March 9th, 2022
At the recent HHSC IID Coordination Workgroup meeting. ISS Ratios were discussed as a topic of concern  Although the topic generated significant discussion, resolution was not reached.  There was agreement, however, to schedule a meeting for the sole purpose of discussing HHSC’s proposed ratio requirements for on and off-site activities. HHSC also indicated that it plans to have a webpage on its website by early April 2022, which will serve as a one-stop-shop location for information about the transition from Day Habilitation to Individualized Skills & Socialization.  

January 28th, 2022

IDD Systems Redesign Committee (SRAC) Agenda from January 27th, 2022

See link below or read the section below.  The webcast recording is available below:

Quoted From HHSC website,

“Texas Penal Code Section 46.03(a)(14) states: “A person commits an offense if the person intentionally, knowingly, or recklessly possesses or goes with a firearm, location-restricted knife, club, or prohibited weapon listed in Section 46.05(a) … in the room or rooms where a meeting of a governmental entity is held, if the meeting is an open meeting subject to Chapter 551, Government Code, and if the entity provided notice as required by that chapter.”

Please note that this governmental meeting is, in the opinion of counsel representing the Health and Human Services Commission, an open meeting subject to Chapter 551, Texas Government Code, and the Health and the Human Services Commission is providing notice of this meeting as required by Chapter 551. In addition, please note that the written communication required by Texas Penal Code Section 46.15(o), prohibiting firearms and other weapons prohibited under Section 46.03, will be posted at the entrances to this governmental meeting.

This meeting will be webcast. Members of the public may attend the meeting in person at the address above or access a live stream of the meeting at https://texashhsmeetings.org/HHSWebcast. Select the tab for the Winters Public Hearing Room Live on the date and time for this meeting. Please e-mail Webcasting@hhsc.state.tx.us
if you have any problems with the webcasting function.

This meeting will also be conducted via videoconference call in accordance with the requirements of Section 551.127, Government Code. The member of the Committee presiding over the meeting will be physically present at the location specified above.

Attendees who would like to provide public comment should see the Public Comment section below.

  1. Welcome and introductions
  2. Consideration of November 2, 2021, draft meeting minutes
  3. American Rescue Plan Act update
  4. House Bill 4, 87th Legislature, Regular Session (2021)
  5. Home and Community Based Services (HCBS) settings updates
    1. Statewide Transition Plan;
    2. HCBS settings rules;
    3. Individualized Skills and Socialization rules
  6. Day Habilitation and other Covid flexibilities
  7. Electronic visit verification
  8. IDD-SRAC recommendations
  9. IDD-SRAC subcommittee updates
  10. Public comment
  11. Review of action items and agenda items for next meeting
  12. Adjourn

Public Comment: The HHSC welcomes public comments pertaining to topics related to any agenda items noted above. Members of the public who would like to provide public comment may choose from the following options:

    1. Oral comments provided virtually: Members of the public must pre-register to provide oral comments virtually during the meeting by completing a Public Comment Registration form at https://texashhsmeetings.org/IDDSRAC_PCReg_Jan2022 no later than 5:00 p.m. Tuesday, January 25, 2022. Please mark the correct box on the Public Comment Registration form and provide your name, either the organization you are representing or that you are speaking as a private citizen, and your direct phone number. If you have completed the Public Comment Registration form, you will receive an email the day before the meeting with instructions for providing virtual public comment. Public comment is limited to three minutes. Each speaker providing oral public comments virtually must ensure their face is visible and their voice audible to the other participants while they are speaking. Each speaker must state their name and on whose behalf they are speaking (if anyone). If you pre-register to speak and wish to provide a handout before the meeting, please submit an electronic copy in accessible PDF format that will be distributed by HHS staff to IDD-SRAC members and State staff. Handouts are limited to two pages (paper size: 8.5” by 11”, one side only). Handouts must be emailed to IDD_SRAC@hhsc.state.tx.us immediately after pre-registering, but no later than 5:00 p.m. Tuesday, January 25, 2022, and include the name of the person who will be commenting. Do not include health or other confidential information in your comments or handouts. Staff will not read handouts aloud during the meeting, but handouts will be provided to IDD-SRAC members and State staff.
    1. Written comments: Members of the public may provide written public comments by completing a Public Comment Registration form at https://texashhsmeetings.org/IDDSRAC_PCReg_Jan2022. A member of the public who wishes to provide written public comments must email the comments to IDD_SRAC@hhsc.state.tx.us no later than 5:00 p.m. Tuesday, January 25, 2022. Please include your name and the organization you are representing or that you are speaking as a private citizen. Written comments must be emailed to HHSC immediately after pre-registering and include the name of the person who will be commenting. Written comments are limited to two pages (paper size: 8.5” by 11”, one side only). Do not include health or other confidential information in your comments. Staff will not read written comments aloud during the meeting, but comments will be provided to IDD-SRAC members and State staff.
  1. Oral comments provided in-person at the meeting location: Members of the public may provide oral public comment during the meeting in person at the meeting location either by pre-registering using the form above or without pre-registering by completing a form at the entrance to the meeting room. Do not include health or other confidential information in your comments.

Note: These procedures may be revised at the discretion of HHSC.

Contact: Questions regarding agenda items, content, or meeting arrangements should be directed to Beren Dutra, Advisory Committee Liaison, Medicaid and CHIP Services, at 512-438-4329, IDD_SRAC@hhsc.state.tx.us.

Persons who want to attend the meeting and require assistive technology or services should contact Dutra at 512-428-4329 or IDD_SRAC@hhsc.state.tx.us at least 72 hours before the meeting so appropriate arrangements can be made.”


January 21st, 2022

 HCS, TxHmL, ICF, DH Providers:  Your Comments & Virtual Testimony Concerning The Transition From DH to ISS (Individualized Skills and Socialization Services) Are Needed!

 

As mentioned in previous posts about the draft ISS rules, these draft rules along with the status of the Statewide Transition Plan and HCBS Settings rules, will be discussed during the January 27th, 2022 meeting of IDD SRAC.  The meeting will be from 1:00 to 5:00. 
See details at the link below.
I urge all to not only listen to the meeting but to also either register to provide oral comments to the committee or submit written comments.  Unless you choose to attend the meeting in person to provide comments, you must either submit written comments or register to provide comments virtually by Tuesday, January 25th at 5:00 p.m See details about providing comments at the link below. Even if you already submitted written comments to HHSC on the draft rules (which were due last Friday), this meeting affords you and other stakeholders an opportunity to provide additional comments or reiterate comments you have already submitted.
Other items on the agenda of interest will be an update on the ARPA funds, EVV and DH and Other COVID Flexibilities.

#5 on the agenda starts at 1:50 pm and ends at 2:50 pm., so depending on the length of discussion on agenda #5 items, public comment should begin around 2:50 p.m.

Note:  Public comment received on any other items will occur between 4:25 and 4:35.

January 21st, 2022

Update on Statewide Transition Plan

The Centers for Medicare & Medicaid Services (CMS) require states to submit a transition plan describing their planned initiatives and activities to achieve compliance with the federal HCBS Settings Rule.

Since 2014, HHSC has submitted four iterations of its statewide transition plan (STP) to CMS for review; however, CMS has not yet approved the STP. Previous iterations of the STP are posted on HHSC’s website.

HHSC is in the process of revising the STP in response to CMS feedback on the previous submission. The updated STP will be posted for a 30-day public comment period in early 2022. HHSC will review public comments and revise the STP, as appropriate, before submitting the updated version to CMS.


January 14th, 2022

HHSC LTCR Individualized Skills and Socialization Services Webinar

HHSC invites Home and Community-based Services, Texas Home Living, Deaf Blind with Multiple Disabilities, Home and Community Support Services Agency, and other providers to attend the Long-term Care Regulation Individualized Skills and Socialization Services Webinar.

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

Jan. 26
3–4 p.m.
Register for the webinar.

HHSC Message:  We have extended the deadline to provide informal comments on the Medicaid Individualized Skills and Socialization rules until January 14, 2022.  The date has been updated on the HHSC rules at: Comment on Proposed & Draft Rules | Texas Health and Human Services.  We know there is concern about simultaneous review of the draft Medicaid Individualized Skills and Socialization and the Long-Term Care Regulatory (LTCR) licensing rules.  As you know, we are at the beginning of the public comment process.  The timeline for the Medicaid rules targets a May Medical Care Advisory Committee (MCAC) presentation.  The draft LTCR rules will be available for review while the Medicaid/CHIP rules are still in the proposal phase.  This will allow for feedback during the formal proposal period and give all stakeholders an opportunity to request changes to the Medicaid rules based on review of the draft LTCR rules.


December 25th, 2021

Deadline for Informal Comments on HHS Draft ISS Rules Due January 14, 2022

Texas Health and Human Services (HHS) is accepting comments from stakeholders on the following draft rules.

The comment period ends January 14, 2022.

Comment on Proposed & Draft Rules | Texas Health and Human Services

Questions can be emailed to HHS Rules Coordination Office.

 


December 14th, 2021
Message from HHSC to the IDD SRAC Day Habilitation/Employment Services Subcommittee
“We wanted to make all of you aware of some guidance released by HHSC Long-Term Care Regulatory (LTCR) on Friday, December 10th regarding the new Individualized Skills and Socialization service that will be replacing day habilitation.  As you may know, the 87th Legislature approved HHSC moving forward with recommendations contained in the Rider 21 report, Transition of Day Habilitation Services, https://www.hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2021/rider-21-transition-day-habilitation-services-jan-2021.pdf, to implement the Individualized Skills and Socialization service. The report recommendations identified the need for a provider registry because HHSC currently has no way to identify providers that deliver day habilitation today.

In order to implement the registry and monitoring requirements outlined in the Home and Community-based Settings regulation in time to comply with the March 17, 2023 deadline, LTCR must utilize existing data systems and procedures for intake and compliance monitoring.  The need to use existing data systems and current regulatory processes resulted in the decision to develop a subcategory of Day Activity and Health Services licensure for Individualized Skills and Socialization providers.  This allows the providers to be tracked through the license application process and LTCR can establish rules governing how Individualized Skills and Socialization providers will be monitored under the license to ensure compliance with the Home and Community-based Settings regulations. Individualized skills and socialization providers can expect a $75.00 licensing fee, which is good for three years.

The provider letter can be found here: https://www.hhs.texas.gov/sites/default/files/documents/PL2021-42.pdf

My staff, are happy to present on this with colleagues from LTCR at the February 8th meeting.  We are also planning to attend the next full IDD SRAC meeting along with LTCR staff to discuss the guidance issued on December 10th.  My staff have drafted Medicaid rules for Individualized Skills and Socialization that will soon be published for informal comment.  We will be sure to send the link to the draft rules to the IDD SRAC committee members and will also discuss the draft rules at the full IDD SRAC meeting and your subcommittee on February 8th LTCR will have separate rules for Individualized Skills and Socialization providers and we will ensure your awareness when LTCR rules are open for comment.”

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April 9th, 2022

Change is inevitable, as we all know well in this line of work.  Our editor for the newsletter (James) has been with us for almost 8 years now and we will miss him, but his schedule has gotten super busy and he will not have as much time available. Meghan Jones will be transitioning as the new editor.  Many of you know Meghan as she is our administrative assistant and you have probably contacted her for registrations and such in the past.  Due to this change as well as the upcoming Easter and Passover Holidays, we have decided to not put out a mid-month edition for April.  Our next newsletter will go out on May 1st, 2022.  Thank you for your patience and understanding.


April 6th, 2022


March 20th, 2022


March 1st, 2022


February 20th, 2022


February 2nd, 2022


January 17th, 2022


January 2nd, 2022


December 18th, 2021


December 2nd, 2021


November 17th, 2021


November 1st, 2021


October 22nd, 2021 (late mid-month edition)


October 3rd, 2021 


September 16th, 2021


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July 18th, 2021


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Newsletter Library

Starting this month, we are going to post copies of our bi-monthly e-mail newsletters on this “Newsletter Library” page.  We use a “Mailchimp” platform

Here is our most recent bi-monthly newsletter sent out to providers.  See newsletter links below:

April 18th, 2021

April 18th, 2021 PDF Version

 

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If you would like to be on our mailing list for this free publication, please subscribe on the following newsletter subscription page:  https://twogetherconsulting.com/newsletters/

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Updated CARE Migration FAQ’s

March 7th, 2022

 (See link below to FAQ’s)


Answers to Additional Questions related to the Migration

  1. Can you clarify the next steps to get providers registered for the billing training? The claims training will be provided from TMHP. Providers need to sign up to receive TMHP alerts as the announcement will come from a TMHP alert. HHSC may send out an alert also, but providers have been missing out on announcements because they do not get TMHP alerts.

  1. What does a provider need to do to ensure communication from TMHP? Subscribe to receive HCS, TxHmL AND TMHP alerts from gov delivery.
  1. Can you clarify the notice that said providers will submit forms through CARE until May 1 – just wasn’t sure if that was accurate or whether there will be a 2 week migration like there was for the March roll-out? There will be a system down time that is necessary to do the data load. The timeframe for this has not been decided but it should be anticipated.

  1. How does the delay of migration impact the PEMS rollout? The two projects are not related. PEMS has been implemented and providers need to sign up through PEMS to ensure their Medicaid enrollment status is up to date.

  1. Even though they are different projects, would Medicaid revalidation issues in PEMs impact TMHP migration? There is no connection or correlation between PEMS account setup and revalidation and ability to create accounts for the migration.

  1. Can we continue to receive updated lists of each members readiness status? TMHP runs reports on a specific timeframe. It is difficult to run an adhoc report for this request. box.

If other questions arise, please submit to: HCS_TxHmL_Form_Migration@hhs.texas.gov

TMHP and HHSC Deployment Activities Begin Date: 04/06/22

March 9th, 2022

CARE Banner In CARE system for HCS/TxHmL providers:

Moving the date of migration of HCS and TxHmL waivers has resulted in significant technology changes. In preparation for this migration, TMHP and HHSC will begin deployment activities on 04/06/22.

Some Provider/LIDDA data entry screens in CARE will be unavailable starting COB 04/06/22 until 04/30/22. A Gov Delivery notice will be sent with a complete list of affected screens next week. 

HHSC will notify you if the migration tasks are completed prior to 05/01/22. CARE billing will continue to be available for processing during this time.

CARE Migration To TMHP HCS &TxHmL

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March 7th, 2022

Claims Training for CARE Migration:  

 Training will occur from 10:00 to Noon on March 22nd and again on March 24th.
Click on link below to register for one of the training sessions.

“TMHP is hosting HCS and TxHmL Waiver Programs webinars on March 22 and March 24 for program providers, LIDDAs, and FMSAs who submit claims on behalf of CDS employers. These webinars will train attendees how to submit and manage claims using TexMedConnect.”

For more info, copy and paste this URL into your browser: https://www.tmhp.com/news/2022-03-09-texmedconnect-claims-submission-training-hcs-and-txhml-programs


February 9th, 2022

More Clarifications From HHSC:  Migration During TMHP LTC Online Portal Outage:

1.  Please clarify what entity or entities providers should contact if they experience problems correcting the location code on an IPC?
Should they send an email to the generic HCS/TxHmL migration email box or Program Enrollment Services (PES) or Utilization Review (UR)?
And will the email box and phone lines be staffed to receive assistance before the system shuts down at 9:00 p.m. , February 9, 2022?
 The answer to this question was not clear during the 2/8/2022 IDD Coordination Workgroup meeting.   
The email box mentioned in the above question should be used for general questions about migration. 
Issues correcting a location code on an IPC should be directed to either PES  at 512-438-2484, or UR at 512-438-5055
Both phone lines are monitored and staff are available today to offer assistance.
2.  Please confirm the duration of the TMHP LTC online portal outage and HHSC Service Authorization System (SAS).   In addition, if a provider cannot correct an IPC location code by the close of business (COB) on 2/9/2022, when will they be able to make the correction and will there be any consequences or other steps or actions they need to take?
The outage begins at 9:00 p.m. 2/9/2022 and will be lifted no later than 11:50 p.m. 2/15/2022. 
Because IPCs with an incorrect location code may not be accepted during the transfer of data from CARE to TMHP, providers may need to submit an additional file or re-enter data once the outage ends.  
3.  If a provider has not entered any new IPCs into CARE by COB on 2/9/2022, what will be required for entry following the outage?
Providers should make every effort to not only correct any IPCs with location error codes by COB 2/9/2022, but also to enter any IPCs not yet entered into CARE.  Not doing so may result in the need for double entry into both systems before March 1, 2022.
4.  What are the email addresses providers may send questions to about the migration?

February 8th, 2022

Very Important !!!!  HCS & TxHmL Providers:  Migration of CARE to TMHP

“Beginning March 1, 2022, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers, local intellectual developmental disability authority (LIDDA) agencies, and financial management services agencies (FMSAs) billing on behalf of consumer-directed services (CDS) employers will submit claims and forms to the Texas Medicaid & Healthcare Partnership (TMHP). It’s important that HCS and TxHmL program providers, LIDDAs, and FMSAs set up their accounts as soon as possible to avoid any delays in payment after March 1, 2022. Program providers, LIDDAs, and FMSAs are strongly encouraged to set up the following accounts if they have not already done so:

  • Claims Submission Account
    • TexMedConnect or
    • Electronic Data Interchange (EDI)
  • Long-term Care (LTC) Online Portal
  • TMHP Learning Management System (LMS)”

To read more, please click on the link belowDon’t Delay!!!!

February 8th, 2022

Clarifications:

During the last HHSC IDD Coordination Workgroup meeting, HHSC provided an update on the migration of CARE to TMHP.   Though a summary of the discussion is provided below, know that a few questions surfaced after the meeting.  HHSC has been contacted by some of the provider organizations about these questions.
1.  The effective date of the migration remains March 1, 2022.
2.  Upcoming webinars and other information related to the migration can be found in IL 2022-07 at:  https://www.hhs.texas.gov/sites/default/files/documents/il2022-07.pdf
If you have not registered for the webinars (Part 1 & Part 2), you are urged to do so.
3.  Not all providers have set up accounts for both form and claim submission.  See slide 10 of the Feb. 8th PowerPoint presentation on TMHP Migration.  Providers MUST have accounts for both. HHSC has agreed to work with the 3 IDD associations to ensure that our respective members have set up their accounts.
4.  Currently 200 IPCs have location code errors.  According to HHSC all IPCs with this error have been flagged.  Providers MUST have fixed these by close of business (COB) – 2/9/2022.   Below is the information HHSC asked we share with providers regarding the errors and see the documents below which list some of the CARE screens to check and tips for fixing the errors.  If you have questions, contact HHSC at:  HCS_TxHml_Form_Migration@hhs.texas.gov
HHSC Message:  CARE will be unavailable beginning  2/9/2022 COB, for some period of time prior to TMHP going live, 3/1/2022.
If you have a location code exception/error, fixing it prior to 02/09/2, COB will make for a smoother transition. These errors were flagged in advance of the notice given in our call and a CARE banner was listed; as a result, many were corrected as needed prior to this notice.

We acknowledge that location errors can be tricky. Below is a list of some CARE screens to check and some hints for fixing the errors, but we know the timeframe will be tight. Please continue to work on these issues when CARE is again available.  https://documentcloud.adobe.com/link/track?uri=urn:aaid:scds:US:9c771b69-784f-3fbc-a3b1-054ee1c49e64

 


September 13th, 2021

New TMHP Account Setup Quick Reference Guide for HCS and TxHmL Providers and FMSAs

The following providers must submit claims and forms to Texas Medicaid & Healthcare Partnership beginning March 1, 2022.

  • Home and Community-based Services
  • Texas Home Living
  • Financial Management Services Agencies billing on behalf of Consumer Directed Services

To submit claims and forms, HCS and TxHmL providers and FMSAs must set up TMHP accounts.

The new TMHP Account Setup for HCS and TxHmL Waiver Programs Quick Reference Guide is available. The guide provides step-by-step directions to create new TMHP accounts or to link to existing accounts.

It has contact information for help and is available on the TMHP website and TMHP Learning Management System.

Read the notice posted on the long-term care homepage for more information.


September 5th, 2021

New TMHP Migration Implementation Date

A new implementation date of March 1, 2022 is planned for the release of forms and claim submissions to Texas Medicaid & Healthcare Partnership for Home and Community-based Services and Texas Home Living program providers, Local Intellectual Developmental Disability Authority agencies, and financial management services agencies that are billing on behalf of Consumer Directed Services employers.

Until the transition, HCS and TxHmL providers can continue to use the Client Assignment and Registration system for submitting claims and forms.

For more information, read the notice posted on the long-term care homepage.


July 17th, 2021

On Tuesday (July 13, 2021), the HHSC IDD Coordination Workgroup met.  The workgroup is comprised of HHSC staff and representatives from IDD stakeholders and advocacy organizationsHere is the discussion that followed, regarding the CARE Migration to TMHP project.
Summary of the discussion below,
  • The initial effective date of the migration (August 2, 2021) has been postponed.
  • At this time HHSC is not able to estimate a new ‘effective’ date, explaining that it needs to first reach 100% compliance in its ‘testing’ phase.  HHSC added that as of July 9th, it was at a 65% compliance rate, and that only 44.52% of providers have started the process (referring to registering/setting up a security account and practicing).
  • HHSC is using a variety of methods to reach out to providers to remind them of the importance of preparing for this transition.
  • HHSC stated there are two options from which providers can choose for claims submissionEDI or Tex Med Connect.
    • According to HHSC, choosing EDI allows one to practice using the new system before the effective date.
  • Though no details were provided, three (3) additional webinars will be held.

July 3rd, 2021

Migration to the TMHP LTC Online Portal – Aug. 2, 2021 Delayed

HHSC and TMHP just posted the official announcement regarding the postponement of the August 2, 2021 CARE migration to TMHP.  See link below.
PPAT urges members to carefully review the information.  Lastly, the announcement does not specify the ‘new’ migration effective date.  

May 23rd, 2021

Migration to the TMHP LTC Online Portal – Aug. 2, 2021 Deployment (IL 2021-24)

HHSC has published IL 2021-24 1915(c) Waivers Migration to the TMHP Long-Term Care Online Portal (LTCOP) Preparing for August 2, 2021 Deployment (PDF).

HCS and TxHmL program providers and LIDDAsmust submit the following forms online through TMHP LTCOP beginning Aug. 2, 2021:

  • HCS or TxHmL Pre-enrollment
  • 8578 Intellectual Disability/Related Condition Assessment (ID/RC)
  • 8582 TxHmL Individual Plan of Care (IPC)
  • 3608 HCS Individual Plan of Care (IPC)
  • 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

Forms 8578, 8582, and 3608 with an effective date prior to Aug. 1, 2021, which are not entered into the CARE system before July 16, 2021, will require double entry by the provider or LIDDA into both CARE and TMHP systems.

Email questions to HCS TxHmL Form Migration.


May 12th, 2021
Beginning August 2, 2021, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) providers will be required to submit their claims and forms to Texas Medicaid & Healthcare Partnership (TMHP).
HCS and TxHmL providers that do not have an account with TMHP will need to prepare for this transition.
TexMedConnect and Electronic Data Interchange (EDI)
Home and Community-based Services (HCS) and Texas Home Living (TxHmL) providers must submit claims to TMHP for dates of service on or after August 1, 2021.
Providers who want to submit claims directly will use TMHP’s TexMedConnect, a free billing software. To get started using TexMedConnect, review the Long-Term Care (LTC) User Guide for TexMedConnect, and set up a TMHP secure portal account by following the steps in the Basic Tasks for Managing an Account on the TMHP Secure Portal manual and the TMHP Portal Security Training Manual.
Providers that use a trading partner, such as a billing organization, or third-party billing software, will submit claims through EDI. To become an EDI submitter, visit the TMHP EDI web page for more information.
Note: Submission of the EDI Agreement will be required if using a third-party submitter. Providers can find the EDI Agreement on the EDI Forms webpage.
Long-Term Care Online Portal
Starting August 2, 2021, HCS and TxHmL providers and Local Intellectual or Development Disability Authorities (LIDDAs) must submit forms online through the TMHP LTC Online Portal. To prepare for this transition to the TMHP LTC Online Portal, HCS and TxHmL providers will need to create an administrator account, and a Nursing Facility (NF)/Waiver Account.
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. Completion of the LTC User Guide for General Information, Online Portal Basics, and Program Resources, and the TexMedConnect Claims Entry System is highly recommended
.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.
In the Recent News section, providers can find published bulletins containing news and information about this change, training opportunities, and other LTC news. More information about this change will be available in future articles on this website and in upcoming Long-Term Care Provider Bulletins.
Providers can sign up to receive Gov Delivery, an electronic mailer from HHSC that includes current news and topics of interest for LTC providers.
In the time leading up to this transition, providers can prepare by
:•Keeping claims submissions current in Intellectual Disability Client Assignment and Registration (ID-CARE)
•Submitting Intellectual Disability/Related Condition (ID/RC) and Individual Plan of Care (IPC) renewals in a timely manner.
•Completing Client Assignment and Registration (CARE) Data entry for services delivered before August 1, 2021
.•Reconciling any errors relating to location exceptions.
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 TMHP EDI Help Desk at 888-863-3638.
Need Help Navigating the LTC Online Portal?
Click HERE to access the LTC Online Portal Basics Computer Based Training (CBT)
**Login Required

April 27th, 2021
CARE Migration to TMHP Webinar:  HCS and TxHmL
There was a webinar hosted by HHSC on April 28th, 2021 the above-referenced subject.  To access the recording of this webinar, please click on:  CARE Transition to TMHP Webinar
In response to several providers inquiries about the webinar, in particular concerns that it’s full and that if a registrant does not get on early enough they will have to request a streaming link, HHSC has said that some dates in May and early June are being considered to conduct additional webinars regarding this initiative.  HHSC will also record the April 28th webinar and post on its website for future listening/viewing.
Note:  Persons already registered for the webinar should have received an email from Dawn Roland, HHSC, informing them about the streaming link and providing a copy of tomorrow’s presentation which is attached for your review.  Ms. Roland can be reached at:  Dawn.Roland@hhs.texas.gov
See link to pdf document below for information on filing claims in TMHP

Helpful Links

TMHP Portal Security Guide: https://www.tmhp.com/sites/default/files/file
library/edi/Portal Security Manual.pdf

TMHP EDI website: https://www.tmhp.com/topics/edi

TMHP EDI Agreement: https://www.tmhp.com/sites/default/files/provider-
forms/edi/F00021_EDI_Agreement.pdf

TMHP LTC User Guide for TMC:https://www.tmhp.com/sites/default/files/file-library/ltc/LTC_TexMedConnect_UG_092420_R.pdf

TMHP Provider Education/Training: https://www.tmhp.com/resources/provider-education-and-training

TMHP Electronic Visit Verification website: https://www.tmhp.com/topics/evv

HHSC HCS and TxHmL Bill Code Crosswalk:

Don’t Forget: Statewide Transition Plan Public Comment Period ends on 4/4/22 On HCBS Settings Rule

March 7th, 2022

Public Comment Period for STP

HHSC will submit a Statewide Transition Plan to the Centers for Medicare and Medicaid Services. This is required by the federal Home and Community Based Services Settings Rule. The STP describes HHSC’s plan to meet the requirements of the HCBS Settings Rule.

HHSC invites members of the public, including HCBS recipients and their families, providers, and other stakeholders, to submit comments on the STP.

Comments will be accepted until 11:59 pm on April 4, 2022. Access the STP and instructions for submitting public comments here.

Follow-Up Answers From Questions During 2/9/22 HCS/ TxHmL POC Training From HHSC

March 4th, 2022

If you attended the 2/9/22 Plans of Correction (POC’s) training webinar for HCS & TxHmL, here are the answers to some of the follow-up questions asked during the session: 

Q: I have experienced that the POC has a date that is 8 days in the past but the postage stamp would be 2 days ago. This leaves me with 6 days to complete the POC. Do I use the date on the letter or the postage date for the 14-day time period?

A: §9.183(f) states the program provider must submit the POC within 14 calendar days of receiving the final report for each violation identified in the plan of correction. The start date of the 14 days is when the program provider receives the final survey report, not the date of the letter or the postage date. The final report can be emailed to the program provider if the email address is on file.

If you have specific questions about the due date for the POC, please contact your regional program manager.

 

Q: Can we sign the 3724 electronically?

A: If the program provider has the capability to electronically sign, this is acceptable.

 

Q: Isn’t HHSC supposed to send the provider a pdf or word version of the violations that the provider can actually edit on the right side to enter in their POC’s?  That seems to be an issue some providers have had.

A: Form 3724s are e-mailed to program providers PDF format. A program provider should be able to edit the PDF to enter their POCs on the right-hand side. Please see Instructions for Electronic 2567/3724 for how to do this. If you’re still having trouble, you can contact your regional program manager.

 

Q: If the 3724 is mailed to the provider in a protected PDF format, how can the provider type the corrections on the form if they do not wish to hand write them?

A: Please contact your regional program manager.

 

Q: Can a POC be completed in the HCS portal?

A: No, the POC cannot be completed in the provider portal. The POC information needs to be entered on the final 3724 report that is submitted to the program provider.

 

Q: Are those letters certified to verify when the letter was actually received by the provider?

A: No, the letters are not required to be certified.

 

Q: I was told there are no debriefings during the survey process. Has this changed?

A: The surveyor will review Form 3701-A, Statement of Preliminary Findings during the survey exit conference to review each of the areas of noncompliance that were identified during the course of the survey, including findings that may result in a critical violation. Per §9.171(j), if HHSC identifies a finding that may be a critical violation not discussed during an exit conference, a new exit conference with the program provider will be held to discuss those additional finding(s).

 

Q: Is this Form 3724 that is used in the ICF Program as the CAP replacing Form 8581 that was previously used in the HCS and TxHmL Program as the CAP?

A: Form 3724 should be used for Plans of Correction for the HCS program. Form 3724 is the state form from ASPEN for the Statement of Licensing Violations and Plan of Correction.

Form 8581, Corrective Action Plan has been retired and removed from the HHSC website.

 

Q: Will HHSC surveyors provide a separate form for administrative penalties for any violations not corrected?

A: All violations must be corrected before the imposition of penalties. If violations aren’t corrected the provider will be decertified. Decertification triggers contract termination. 

Enforcement notifies the provider through certified and first-class mail of the imposition of penalties.

 

Q: Is the IDT the same as the SPT (service planning team) for HCS and TxHmL?

A: The concept is similar. Per 40 TAC 9.153(106), the definition of a Service Planning Team is

“One of the following:

(A) for an applicant or individual other than one described in subparagraphs (B) or (C) of this paragraph, a planning team consisting of:

(i) an applicant or individual and LAR;

(ii) service coordinator; and

(iii) other persons chosen by the applicant or individual or LAR, for example, a staff member of the program provider, a family member, a friend, or a teacher;

(B) for an applicant 21 years of age or older who is residing in a nursing facility and enrolling in the HCS Program, a planning team consisting of:

(i) the applicant and LAR;

(ii) service coordinator;

(iii) a staff member of the program provider;

(iv) providers of specialized services;

(v) a nursing facility staff person who is familiar with the applicant’s needs;

(vi) other persons chosen by the applicant or LAR, for example, a family member, a friend, or a teacher; and

(vii) at the discretion of the LIDDA, other persons who are directly involved in the delivery of services to persons with an intellectual or developmental disability; or

(C) for an individual 21 years of age or older who has enrolled in the HCS Program from a nursing facility or has enrolled in the HCS Program as a diversion from admission to a nursing facility, for 365 calendar days after enrollment, a planning team consisting of:

(i) the individual and LAR;

(ii) service coordinator;

(iii) a staff member of the program provider;

(iv) other persons chosen by the individual or LAR, for example, a family member, a friend, or a teacher; and

(v) with the approval of the individual or LAR, other persons who are directly involved in the delivery of services to persons with an intellectual or developmental disability.

 

Q: What do we do if the 45-day PoC completion date has already passed by the time we get the final report?

A: If you receive the final report near or after the 45-day PoC completion date, please contact your regional program manager for assistance.

 

 

Instructions for Documenting Your POC’s On Electronic Form 2567/3724 Received From HHSC

 

Provider:

  1. Open the 2567/3724 document
  2. Go to “Insert” on the toolbar
  3. Select “Text” Box
  4. Insert the “Text” Box where you want to write the PoC
  5. Insert a second “Text” Box where you put the PoC date.
  6. Right-click on the text box’s border, and choose “copy”.  (For copy and pasting)
  1. Scroll down to the second page of 2567, left-click anywhere on the page, then press “Ctrl-V” on the keyboard

                           ( or right-click with the mouse and choose “paste” ) – the text box will paste in nearly centered into the POC field

                            ( to center, press two cursors spaces to the left and two cursor spaces up ).

Repeat on the remaining pages

Save the document.

Send the document back to the region.

 

Might Need To Update Your Fire Alarm System’s Cellular Communication Services (HCS 4-bed & ICF Homes)

LTC Providers May Need to Update Fire Alarm System Cellular Communication Services

In 2022 cellular companies will retire their older 3G technology. These companies include T-Mobile, Sprint, Verizon and AT&T.

LTC providers with a fire alarm system supported by an older cellular communicator running on 3G signals should upgrade their fire alarm communication equipment.

Many fire alarm systems use cellular communication devices to send signals to a 24-hour central monitoring station. The central monitoring station contacts the local emergency response team to send help. If your cellular communication device uses 3G to relay signals, and your cellular provider no longer supports those signals, your fire alarm system will not be able to notify emergency services if there is a fire.

The major cellular companies gave the following dates for retiring their older networks:

  • AT&T began retiring its 3G network on Feb. 22, 2022.
  • Sprint will retire its 3G CDMA network on March 31, 2022.
  • Sprint will retire its 3G LTE network on June 30, 2022.
  • T-Mobile will retire its 3G UMTS network on July 1, 2022.
  • Verizon will retire its 3G CDMA network on Dec. 31, 2022.
  • T-Mobile has announced it will retire its 2G GSM network but has not set a date for that retirement.

After these dates fire alarm communication devices that connect to cellular communication systems using this older technology will not work.

LTC providers are responsible for ensuring their fire alarms systems function correctly. Providers with fire alarm systems monitored by a third-party monitoring company should contact their fire alarm service company. They need to find out if their fire alarm communication equipment needs upgrading.0

Email LTCR Policy or call 512-438-3161 with questions.

Postponed: Form Submission for HCS and TxHmL In The LTC Online Portal!

March 1st, 2022

HCS and TxHmL Form Submission on LTC Online Portal Unavailable Until May 1, 2022

Due to Postponement, submissions of Home and Community-based Services and Texas Home Living forms using the Texas Medicaid and Healthcare Partnership Long-Term Care Online Portal are unavailable until May 1st, 2022. Data migration to the TMHP LTC Online Portal took place prior to March 1st, 2022.

FYI-Any HCS and TxHmL form submitted to the LTC Online Portal before March 1 could be removed and require resubmission May 1st, 2022.

Beginning May 1, submit HCS and TxHmL forms using the TMHP LTC Online Portal. All user guides to aid form submissions are published to TMHP’s Learning Management System. All users must create an LMS account to access the materials. There is a sign-up link on the LMS homepage. Contact TMHP Training Support if you need help.

Providers can refer to the article, “Reminder: Beginning March 1, 2022, HCS and TxHmL Programs to Submit Claims and Forms to TMHP” for more information about the transition to TMHP, which now applies to May 1st, 2022.

Email questions to TMHP.

HCS/TxHmL Migration to THMP Delayed Until 5/1/2022/!

March 1st, 2022

Claims & Forms Submissions:   

The March 1 release of claims and forms submissions to Texas Medicaid & Healthcare Partnership is postponed to May 1, 2022.

  • Home and Community-based Services
  • Texas Home Living program providers

Providers should continue to use the Client Assignment and Registration system for submitting claims and forms until May 1, 2022.

The postponement allows more time for Providers to set up the necessary TMHP accounts and take relevant training courses. Future webinars covering information related to this change, including submission of claims and forms to TMHP, will be announced on the TMHP LTC homepage.

Next Steps:  What Does This Mean?

In the time leading up to this transition, Providers can prepare by:

  • Setting up all necessary accounts if they have not already done so. Please refer to the article, HCS and TxHmL Programs: Continue to Submit Claims and Forms Using CARE System Until May 1, 2022, for information about account set-up, upcoming webinars and training resources.
  • Keeping claims submissions current in Intellectual Disability Client Assignment and Registration (ID-CARE).
  • Submitting Intellectual Disability/Related Condition (ID/RC) and Individual Plan of Care (IPC) renewals in a timely manner.
  • Completing Client Assignment and Registration (CARE) data entry.
  • Reconciling any errors relating to location exceptions.

Providers can refer to the HCS and TxHmL Waiver Programs Frequently Asked Questions (FAQ) or contact the TMHP EDI Help Desk at 888-863-3638 with questions.


February 26th, 2022

In case you have not see the banner in The CARE system, the  HCS/TxHmL migration to THMP has been delayed until 5/1/2022, thankfully!  

Hopefully, this will give ample time for providers to attend live training on the migration, set up their portals if they have not done so already, and also take the CBT training modules for billing in TMHP on the E-learning portal.  

Since the go-live date for the CARE migration to TMHP has been moved from March 1 to May 1, 2022,  HHSC and TMHP will not move forward with the claims training they were planning to conduct next week. (Week of Feb. 28th-March 4th) 
****Twogether Consulting will keep you posted on the date change for this training.

See the banner below from CARE: 

“Migration of HCS/TxHmL data and claims entry to THMP is being delayed. This is to allow for more detailed claims training and account setup with TMHP. All Provider and LIDDA CARE data entry screens have been restored and are now available. Billing screens remain available. DO NOT SUBMIT HCS/TxHmL FORMS ON THE TMHP LONG-TERM CARE ONLINE PORTAL. More information to follow.”

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

February 28th, 2022

COVID-19: HHSC Publishes In-Home Day Habilitation Information for Program Providers (IL 2022-15)

HHSC is temporarily waiving certain requirements in Section 3710, 4381.3, 4381.7(6) and 4381.7(7) of the Home and Community-based Services Billing Guidelines and the Texas Home Living Billing Guidelines. This is due to COVID-19 and provides access to needed day habilitation services.

HHSC has published a revision to this guidance in IL 2022-15 In-Home Day Habilitation Information for Program Providers for COVID-19 (PDF). This replaces IL 2022-09.

It extends the temporary guidance through March 31, 2022, unless the COVID public health emergency ends sooner. HHSC will provide guidance if there are any changes.

Email questions to HCS Policy


February 28th, 2022

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

HHSC has lifted the ban on service providers of respite and Community First Choice PAS/HAB. They can now live in the same home as the person receiving Home and Community-based Services and Texas Home Living program services.

This gives access to needed services for people living in their own or family’s home. A person’s spouse, child or teenager’s parent still cannot be a paid service provider of these services due to guidelines in HCS, TxHmL and CFC handbooks located under Long-term Care Waiver Programs.

This is a temporary policy change. It is effective March 27, 2020 through March 31, 2022, unless the COVID public health emergency ends sooner. HHSC will provide guidance if anything changes.

Program providers must complete the required background checks for all service providers. They must follow:


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 needs only complete an IPC revision and IP update.

New Crosswalk Billing Codes For DH As of March 1st, 2022

February 27th, 2022

HCS and TxHmL Billing Changes In The Crosswalk for DH

HCS and TxHmL providers must use the HCS and TxHmL Bill Code Crosswalk starting March 1, 2022 to submit claims for all services. The bill code was updated Dec. 28, 2021.

The HCS and TxHmL Bill Code Crosswalk includes new bill codes for the services that require electronic visit verification.

For HCS program providers:

  • Providing out of home day habilitation or in-home day habilitation in a host home or companion care setting, program providers must use the out-of-home day habilitation bill codes.
  • Not participating in the COVID add-on program, in-home day habilitation provided in a three-person residence or four-person residence, program providers must use the out-of-home day habilitation bill codes.
  • Participating in the COVID add-on program, in-home day habilitation provided in a three-person residence or four-person residence, the program provider must use the out-of-home bill codes below with the modifiers “KX” and “CR.
    • For LON 1: M0944
    • For LON 5: M0945
    • For LON 8: M0947
    • For LON 6: M0946
    • For LON 9: M0948

Contact the HCS Policy Box with questions.

Quarterly Stakeholder’s Webinar (HCS/TxHmL) March 10th, 2022

February 27th, 2022

HCS and TxHmL Webinar Slated for March 3 moved to March 10th, 2022

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

Webinar topics include:

  • HCS & TxHmL Forms and Claims Migration Project
  • Critical Incident Management System

HCS and TxHmL Webinar
March 10, 2022
3:30 – 4:30 p.m.
Register for the webinar

Email questions about the webinar to your program policy mailbox:

Last Chance For LTC TMHP Migration HCS & TXHML Waiver Webinar Part II-March 10th, 2022

February 26th, 2022

If you missed part II of the LTC TMHP Migration HCS & TxHmL Waiver Webinar Training, you will have an additional chance on March 10th, 2022

10am-12:30pm Central

Please click here register here

The Long-Term Care (LTC) Online Portal Training for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs is a two-part webinar for providers and Local Intellectual and Developmental Disability Authorities (LIDDAs).

Attendees can register for any of the first sessions, and any of the second sessions; but are strongly encouraged to complete the first session before attending the second session.

Part 2 of this webinar will cover the following topics:

• Purpose and Workflow of the 3608/8582 Individual Plan of Care (IPC) Form

• Purpose and Workflow of the Individual Movement (IMT) Form

• Purpose and Workflow of the 3615 Request to Continue Suspended Services Form

• Purpose and Workflow of the 3616 Request for Termination of Waiver Program Services Form

• Purpose and Workflow of the HCS Provider Location Update (PLU) Form

• Navigation of the LTC Online Portal • Available HHSC and TMHP resources for providers and LIDDAs This webinar will not provide billing training.

***For more information about billing with TMHP, refer to the Learning Management System (LMS) at learn.tmhp.com, and search for TexMedConnect or Claims in the keyword search feature.


February 26th, 2022

Additional Training Resources From TMHP

It is highly recommended that program providers, LIDDAs, and FMSAs create a TMHP Learning Management System (LMS) account at learn.tmhp.com before the webinar to access current training related to the LTC Online Portal and claims submissions. New TMHP LMS users can access the Learning Management System (LMS) Registration and Navigation Job Aid for Providers located on the LMS homepage or email TMHP Training Support for help creating an LMS account or navigating the LMS.

Suggested training resources include:

For more information, contact tmhptrainingsupport@tmhp.com

LTC TMHP Migration HCS & TXHML Waiver Webinar Handouts-Part I-Feb. 8th, 2022

February 8th, 2022

For those of you who missed today’s training (part I) or who did not download the documents, I have provided them on this “Updates” post from Twogether Consulting

Link to Resource Document from Webinar on 2/8/22 (TMHP Training Part I)

Webinar Handout Part I Training 

LTC TMHP Portal Provider User Guide

TMHP Migration (HCS & TxHmL) FAQ’s


This webinar will be repeated on March 8th, 2022

10am-1pm central

The Long-Term Care (LTC) Online Portal Training for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs is a two-part webinar for providers and Local Intellectual and Developmental Disability Authorities (LIDDAs). Attendees can register for any of the first sessions, and any of the second sessions; but are strongly encouraged to complete the first session before attending the second session.
Part 1 of this webinar will cover the following topics:
• Management of waiver program assessments and forms in the LTC Online Portal
• Purpose and Workflow of the HCS/TxHmL Pre-enrollment Form
• Purpose and Workflow of the 8578 Intellectual Disability (ID)/Related Condition (RC) Assessment
• Purpose and Workflow of the 3608/8582 Individual Plan of Care (IPC) Form • Available HHSC and TMHP resources for providers and LIDDAs

Additional Claims Trainings For THMP

February 23rd, 2022

Claims Training For The Transition To TMHP Next Week 

HHSC and TMHP will conduct the training next week. They will let us know in the next few days when the training is set.
Webinar will be 2 hours.  Training will include a step-by-step walk-through. A  large portion of time will be used to answer questions providers have about billing. Look at the considerations to use applications to improve your business.
HHSC & TMHP webinars have a 1,000 person limit.  Though they are trying to expand the webinar capacity, if they cannot expand , 2 webinars will be held.
TMHP will send providers materials related to the training in advance so providers can review and be prepared with questions.
Links to access training materials are provided below.
*The 1st link provides provider claims training information.
*The 2nd link provides instructions on how to create a Learning Management Systems (LMS) account to access training.

Provider claims training, using TexMedConnect- https://tmhp.exceedlms.com/student/path/181116-texmedconnect-for-long-term-care-ltc-providers.

Providers will need to create a Learning Management System (LMS) Account to access the training- https://www.tmhp.com/sites/default/files/file-library/LMS%20Registration%20Job%20Aid%20for%20Providers.pdf

HCS_TxHmL@tmhp.com Provider Mailbox for transition-related issues and assistance.


Other Helpful Resources

Recent provider notification related to upcoming transition and webinar and training resources. https://www.tmhp.com/news/2022-01-21-reminder-beginning-march-1-2022-hcs-and-txhml-programs-submit-claims-and-forms-tmhp

TMHP Long-Term Care page https://www.tmhp.com/programs/ltc Also keep an eye under the Recent news for provider notifications. It is located in the gray column on the right of the page.

TMHP Long-Term Care Resource page- https://www.tmhp.com/programs/ltc/reference-material

TMHP Account Setup for HCS and TxHmL Waiver Programs– QRG to assist provider with account setup activities

FAQ’s for TMHP:  Frequently Asked Questions – Home and Community-based Services (HCS) Texas Home Living (TxHmL) Waiver Programs– This document is being updated on a regular basis.

CMS Vaccine Mandate- LTC Providers (Update)

February 14th, 2022
The CMS Interim Final Rule related to the vaccine mandate only applies to certified providers regulated by CMS such as ICFs/IID, Nursing Homes, certain Home Health Agencies, etc. See complete list at:  https://ogletree.com/insights/cms-gives-a-boost-and-takes-a-shot-at-full-vaccination-for-millions-of-u-s-healthcare-workers/
***The end of the list states that home and community-based services are not included.  As such (and confirmed by HHSC), the CMS Interim Final Rule does not apply to HCS/TxHmL.
See page 5 of the updated FAQ (link below) which provides greater detail regarding home and community-based services.
Lastly, at this time HHSC is still reviewing the ‘New CMS Guidance for Texas’ and will soon share information regarding implementation and enforcement.

CARE as of March 1st: Client Assessment, Review, and Evaluation (CARE) Report and Screen Crosswalks Now Available

February 13th, 2022

HCS/TxHmL Providers & LIDDA’s: Client Assessment, Review, and Evaluation (CARE) Report and Screen Crosswalks Now Available

The CARE report and screen crosswalks for HCS, TxHmL providers and LIDDAs are now available to assist with daily operations.

Click the following link to view the files:

Provider and LIDDA CARE Report Crosswalk

Provider and LIDDA CARE Screen Crosswalk

HCS and TxHmL providers will use these crosswalks to locate relevant individual and provider data needed for day-to-day operations beginning March 1, 2022.

If you have questions, contact the HHSC HCS TxHmL Form Migration mailbox at HCS_TxHmL_Form_Migration@hhs.texas.gov.


February 13th, 2022

HHSC Publishes Information on data migration from the CARE system to the to the TMHP LTC Online Portal (IL 2022-12)

HHSC has published IL 2022-12 that provides information to HCS and TxHmL Program Providers and FMSAs about the CARE screens that are unavailable from Feb. 9 (5:00pm) to March 1, as data is migrated from the CARE system to TMHP LTC online portal.

It also provides information about form submissions after Feb. 9, and HCS and TxHmL claims submission for services delivered prior to March 1, and on March 1, or later.

Submit question about HCS & TxHmL Forms and Claims Migration Project here.


February 13th, 2022

Inactive Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Provider Client Assignment and Registration (CARE) Screens

Due to the HCS and TxHmL migration to Texas Medicaid and Healthcare Partnership (TMHP), the following CARE screens will be inactive beginning 9 p.m. Wednesday, Feb. 9, until Monday, Feb. 14.

L01 — CONSUMER ENROLLMENT
L02/C02 — INDIVIDUAL PLAN OF CARE
L03 — ENROLLMENT PACKET CHECKLIST
L05 — PROVIDER CHOICE
L06 — CONSUMER TRANSFER
L23/C23 — WAIVER ID/RC ASSESSMENT
L30 — MRA ASSIGNMENT NOTIFICATION
L31 — HCS IPC MRA REVIEW (HCS)
L32 — ID/RC ASSESS MRA REVIEW (HCS)
C18 — INDIVIDUAL DISCHARGE
C29 — MODIFY PROVIDER SERVICE AUTH

Below are screens that will be inactive and retired as of Feb. 10.

Note: Providers will not be able to submit entries until effective Feb. 16. Effective Feb. 16, Wait List and SLOT will be entered into SLOT and CSIL.

A20 — AUTHORIZE LOCATIONS
A29 — SLOT TYPES
A30 — SLOT ALLOCATION
A31 — SLOT STATUS UPDATE
A32 — SLOT ALLOCATION REMOVAL
A40 — RATE OPT OUT
A58 — WAIVER ID/RC ASSESSMENT(E)
A71 — WAIVER SLOT AVAILABILITY
A73 — SLOT TRACKING

L20 — GUARDIAN INFORMATION UPDATE
L26 — CLIENT ASSIGNMENTS
L61 — WAIVER SLOT COUNTS
L62 — WAIVER SLOT DETAIL
L64 — IPC EXPIRATION
L65 — ID/RC ASSESSMENT EXPIRATION

C20 — GUARDIAN INFORMATION UPDATE
C24 — LOCATION
C25 — LOCATION TYPE MODIFICATION
C26 — CLIENT ASSIGNMENTS
C64 — IPC EXPIRATION
C65 — ID/RC ASSESSMENT EXPIRATION
C75 — PRIOR APPROVAL
C88 — CONSUMER HOLDS
W21 — INTEREST LIST UPDATE
W27 — TRAVIS QUESTIONNAIRE ENTRY
W28 — TRAVIS QUESTIONNAIRE SEARCH

For questions or information, see:

CBT (Computer Based Training) For Entering Claims For HCS & TxHmL Services As Of March 1st, 2022

February 8th, 2022

CBT (Computer Based Training) For TMHP Billing of Services/Entering Claims

For those of you asking where to submit claims for HCS & TxHmL services after March 1st, this will be via TMHP.  CARE will no longer be used to submit these claims as of March 1st, 2022.  Training on how to submit your claims can be found on the TexMedConnect for LTC Providers portal via CBT training.

TexMedConnect for Long-Term Care (LTC) Providers

“This CBT contains information about using TexMedConnect to verify client eligibility, enter and submit claims and appeals, and find claim status.

The TexMedConnect for Long Term Care Providers CBT helps providers with:
– Logging on to TexMedConnect;
– Using the Medicaid eligibility and service authorization verification (MESAV) function;
– Entering, saving, and submitting claims and adjustments:
– Using the Claim Data Export, Claim Status Inquiry (CSI), Pending Batch, and Batch History functions; and
– Viewing Remittance and Status (R&S) Reports and Claims Identified for Potential Recoupment (CIPR) Provider Reports.”

See the link below for CBT Training for claims and other TMHP functions:

https://tmhp.exceedlms.com/student/path/181116-texmedconnect-for-long-term-care-ltc-providers

Can An HCS Program Provider Provide Services To Their Own Child Or Family Member?

I recently received this response from HHSC and thought it might be helpful to some providers who may have this concern:

There is no rule or regulation that prohibits an HCS Program Provider from providing services to their own child or family member.

The program provider’s operations must prevent conflict of interest as required by 40 TAC §9.177(f):

§9.177 Certification Principles: Staff Member and Service Provider Requirements

(f) The program provider’s operations must prevent:

  (1) conflicts of interest between the program provider, a staff member, or a service provider and an individual, such as the acceptance of payment for goods or services from which the program provider, staff member, or service provider could financially benefit, except payment for room and board;

  (2) financial impropriety toward an individual including:

    (A) unauthorized disclosure of information related to an individual’s finances; and

    (B) the purchase of goods that an individual cannot use with the individual’s funds;

  (3) abuse, neglect, or exploitation of an individual;

  (4) damage to or prevention of an individual’s access to the individual’s possessions; and

  (5) threats of the actions described in paragraphs (2) – (4) of this subsection.

And, the program provider must ensure they are not disqualified from being a service provider as described in Section 3420(b)-(d) of the HCS Billing Requirements:

3420 Service Provider Not Qualified

Revision 21-3; Effective September 1, 2021

(b) Spouse Not Qualified as Service Provider

A service provider is not qualified to provide a service component or subcomponent to the service provider’s spouse.

(c) Relative, Guardian or Managing Conservator Not Qualified as Service Provider for Certain Services

A service provider is not qualified to provide case management, residential support, supervised living, behavioral support services or social work services to an individual if the service provider is:

(1) a relative of the individual (Appendix II, Degree of Consanguinity or Affinity, explains who is considered a relative for purposes of these requirements);

(2) the individual’s guardian; or

(3) the individual’s managing conservator.

(d) Parent, Spouse of Parent or Contractor Not Qualified as Service Provider for Minor

A service provider is not qualified to provide a service component or subcomponent to a minor if the service provider is:

(1) the minor’s parent;

(2) the spouse of the minor’s parent; or

(3) a person contracting with DFPS to provide residential child care to the minor, or is an employee or contractor of such a person.

According to Section 3430 of the HCS Billing Requirements:

3430 Relative, Guardian or Managing Conservator Qualified as Service Provider

Revision 21-1; Effective January 1, 2021

If a relative, guardian or managing conservator is not otherwise disqualified to be a service provider as described in Section 3420, Service Provider Not Qualified, or in Section 4000, Specific Requirements for Service Components Based on Billable Activity, the relative, guardian or managing conservator may provide audiology services, dietary services, occupational therapy, physical therapy, speech and language pathology services, day habilitation, in-home day habilitation, registered nursing, licensed vocational nursing, specialized registered nursing, specialized licensed vocational nursing, transportation as a supported home living activity, host home/companion care, respite, in-home respite, employment assistance or supported employment if the relative, guardian or managing conservator is a qualified service provider for the particular service component or subcomponent being provided.

HCS/TxHmL Writing Acceptable Plans of Correction Webinar-Feb. 9th, 2022

February 1st, 2022

HCS/TxHmL Writing Acceptable Plans of Correction Webinar

 

“WHAT IS A POC? 42 CFR §488.401 defines a Plan of Correction to mean a plan developed by the facility and approved by CMS or the survey agency that describes the actions the facility will take to correct deficiencies and specifies the date by which those deficiencies will be corrected.Apr 19, 2021″

Program providers can register for the Writing Acceptable Plans of Correction for HCS and TxHmL webinar. This webinar covers the process for writing an acceptable plan of correction for HCS and TxHmL program providers. No CE is awarded for this webinar. However, a certificate of attendance will be provided.

This will be an ongoing offering posted on the HHCS HCS/TxHmL Joint Training website.

Wednesday, Feb. 9
1 – 4 p.m.
Register for the webinar.

Email questions to Joint Training.

Allowance of Delivery of PT, OT, and ST Services Via Telehealth (IL 2022-08)

Telehealth | Wright Physical Therapy

February 1st, 2022

HHSC Publishes Information on Delivery of PT, OT, and ST Services (IL 2022-08)

HHSC is issuing interim guidance allowing telehealth delivery of physical therapy, occupational therapy, and speech therapy services. Access Information Letter No. 2022-08, HB4: Physical Therapy, Occupational Therapy, Speech Therapy Services Delivered by Synchronous Audio-Visual. The letter notes which therapies are not allowed to be delivered through telehealth modalities because the service requires in-person delivery.

This guidance applies to the following programs:

  • Community Living Assistance and Support Services Providers
  • Deaf-Blind with Multiple Disabilities Providers
  • Home and Community-based Services Program Providers
  • Texas Home Living Program Providers

Email the LTSS policy mailbox with questions about this alert.

COVID-19 Cases Continue to Rise – What Should LTC Providers Do?

February 1st, 2022

Guidance for LTC Providers

COVID-19 cases continue to increase across Texas. HHSC reminds providers to follow the guidelines listed below and ensure their emergency plan is up to date. Staff must be aware of what to do in the event of any sort of emergency, including an outbreak of flu or COVID-19.

Please review the following rules, guidelines, and policies:

  • COVID-19 mitigation and visitation rules for your provider type
  • Any applicable COVID-19 response plans for your provider type
  • Your organization’s infection prevention and control policies

All provider types must continue to screen residents, clients, staff, and visitors for signs and symptoms of COVID-19.

Staff for all provider types must continue to use appropriate personal protective equipment (PPE).

Where required by rules for your provider type, providers must continue effective cohorting of residents based on COVID-19 status.

Find COVID-19 resources for your provider type online:

Your maintaining vigilance in following infection control requirements makes a difference in protecting vulnerable Texans.

LTC providers are always required to provide services to residents before, during, and after any emergency. Your organization’s emergency plan or policy must include:

  • Planning for staff shortages
  • Back-up plans to ensure operations and care of residents or clients continues

Read program-specific rules related to staffing, emergency preparedness, and infection control:

The U.S. Department of Health and Human Services has developed a COVID-19 Healthcare Planning Checklist (PDF) that you can use to assist you in creating a plan for dealing with an outbreak of flu or COVID-19.

For questions, email LTCR Policy.

HHSC has published ICF and HCS Emergency Staffing Requests Letter – Jan. 10th, 2022

HHSC has published ICF and HCS Emergency Staffing Requests – Jan. 10

HHSC has published ICF and HCS Emergency Staffing Requests (Provider Letter 2022-02). This letter provides information for Intermediate Care Facilities for Individuals with an Intellectual Disability (ICFs) or Related Conditions and Home and Community-based Services (HCS) program providers facing staffing shortages related to the COVID-19 public health emergency.

STATUS OF HCS RATES!

Status of HCS Rates as of January 17th, 2022

HCS and TxHmL Day Habilitation Rates, Respite Rates and Other Concerns
  • The Public Health Emergency (PHE) was renewed until April 16, 2022, and
  • Clarification:  The HCS & TxHmL rates posted on HHSC’s webpage listed as Effective March 1, 2022 to Current. are a bit confusing
HCS Day Habilitation (DH) & Respite Rates Some members have inquired about the HCS rates posted on HHSC’s website at:  https://pfd.hhs.texas.gov/sites/rad/files/documents/long-term-svcs/2022/03-01-2022-hcs-rates.pdf
This is a bit confusing according to those who have viewed it already, since the rates posted are the same as the 2020 rates.  Such is further confusing when only the DH and Respite rates note an effective date of March 1, 2022 and the statement at the bottom of the DH rate pages reads:  Effective March 1, 2022:  DH includes in-home and out-of-home. Some have questioned whether this statement means that the COVID add-on rate is ending March 1 – a date that contradicts the statement on the LTSS Rate home webpage:   https://pfd.hhs.texas.gov/long-term-services-supports .
The temporary COVID-19 rate increases were effective April 1, 2020, and are estimated to conclude at the end of the federally-declared public health emergency (PHE). The PHE is anticipated to end on March 16, 2022, unless the PHE is withdrawn before this date or extended. The official PHE notifications can be viewed here.
This action does not impact the current COVID add-on rate for the provision of in-home DH in HCS.  As noted in the above italicized paragraph, the PHE has been renewed.  Unfortunately, HHSC inadvertently erred in its statement that the PHE is now “anticipated to end on March 16th”.  PHEs are renewed on a 90-day basis, meaning that HHSC needs to correct this statement to read that the PHE is anticipated to end on April 16 unless withdrawn before that date or extended.

Status of HCS Rates as of Jan., 1st, 2020

HCS Rates 2020

https://pfd.hhs.texas.gov/sites/rad/files/documents/long-term-svcs/2020/2020-09-hcs-rates.pdf


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.

ICF & HCS Surveys: Backlog of Surveys and Compliance Expectations

January 14th, 2022

ICF/IID and HCS Surveys:  HHSC has responded to questions providers have asked regarding the current backlog of surveys and what time period will be reviewed/surveyed when a provider finally receives its survey.
Should you have further questions, please email HHSC at:  LTCRPolicy@hhs.texas.gov
In regards to ICF surveys, the facility needs to be able to show compliance at all timesSome areas of compliance require (at least) annual updates (i.e. Individual program plans), other areas may be something with a 3 year follow-up (i.e. pap smear/gynecologist follow-up).  Regardless of when the annual survey took place, the facility would be responsible for showing that those things occurred.  26 TAC Ch. 551.191 (h) reads “a facility must make all books, records, and other documents that are maintained by or on behalf of the facility accessible to HHSC on request.”

HCS program providers also need to be able to show compliance at all times.

For recertification surveys, surveyors will look at records from after the last recertification survey exit date forward to the present survey. 40 TAC 9.178(g) provides that “the program provider must make available all records, reports, and other information related to the delivery of HCS Program services and CFC services as requested by HHSC, other authorized agencies, or CMS and deliver such items, as requested, to a specified location.”

In regards to the backlog, as per our survey ops partners, ICF/IID should be up-to-date on their annual surveys and LTCR is working on completing [HCS/TxHmL] surveys and working through any outstanding backlogs.

Vaccine Mandate Updates

January 14th, 2022
Vaccine Mandates: Earlier today the Supreme Court issued its rulings on the CMS and OSHA Vaccine Mandates. The Supreme Court stayed the OSHA mandate and permitted the CMS mandate.  As a reminder, the CMS mandate applies to ICFs/IID.  For further details, go to:  https://www.supremecourt.gov/

December 1st, 2021
Judge Doughty, U.S. District Court, Western District of Louisiana, blocked enforcement of the CMS Interim Final Rule (which among other LTC programs, applies to ICFs/IID) regarding the vaccine mandate nationwide. Below are links to several articles regarding the ruling.
Important Information:
Links #1 and #3 provide access to the 32 page court ruling.
Link #2 is an article about some Texas legislators calling for a 4th Special Session to enact legislation to ban the COVID-19 vaccine mandate.

Texas COVID-19 Coronavirus Resources & Guidance for People with Disabilities

Check Out These Resources For Persons With Disabilities From The              Office of Texas Governor Greg Abbott

https://gov.texas.gov/organization/disabilities/coronavirus

Government COVID 19 Information and Resources

https://tcdd.texas.gov/resources/covid-19-information/government/

Other Texas Organizations

There are a number of disability-related organizations in Texas that are sharing information and resources related to COVID-19. Below you’ll find links to their COVID-19 webpages and links to subscribe to receive their emails.


Texas COVID-19 Coronavirus Resources & Guidance for People with Disabilities

The Governor’s Committee on People with Disabilities (GCPD) has created this page to act as a warehouse for information related to the novel coronavirus and emergency guidance related to people with disabilities. If you believe you or a loved one may be sick, follow the guidance put out by the Department of State Health Service (DSHS). You can also dial 2-1-1 and select option 6.

State Agencies and Councils COVID-19 Pages


Effective Communication Tips for Community Vaccination Sites


Accessible Guidance


COVID-19 Vaccine Information in ASL


The ADA and Face Mask Policies

The Great Plains ADA Center has created a frequently asked questions page to help clarify some of the questions surrounding the ADA, mask orders, and disability.


Mental Health Support

The Substance Abuse and Mental Health Services Administration (SAMHSA) operates a free, 24/7, 365-day-a-year disaster distress helpline. This line provides crisis support and counseling to people experiencing emotional distress related to natural or human-caused disasters. Call or text 1-800-985-5990 to connect with a trained crisis counselor. Deaf and hard-of-hearing callers can contact the same number through their videophone to access 24/7 ASL support.


Rules for Everyone

The Texas Department of State Health Services (DSHS) recommends these simple, everyday actions to help prevent the spread of COVID-19:

  • Wash your hands often and for at least 20 seconds (long enough to sing “Happy Birthday” twice). Be sure to encourage friends and family to do the same;
  • If no soap and water are available, use hand sanitizer with at least 60% alcohol. Remember that soap and water are the gold standard;
  • Cover coughs and sneezes with a tissue (if you don’t have a tissue, sneeze into the crook of your elbow), then throw the tissue away. Wash your hands after!
  • Avoid touching your eyes, nose, and mouth with unwashed hands;
  • Disinfect frequently touched surfaces like buttons, handles, knobs, and counters. Your cell phone is your “third hand,” be sure to sanitize it often.
  • Avoid close contact with people who are sick;
  • Practice social distancing- this includes avoiding crowds and maintaining six feet of distance between you and others in public.
  • DSHS has created a social media toolkit as well as other resources that you can use to spread the word on how to help slow the spread of COVID-19.

Follow Texas DSHS COVID-19 Updates


Emergency Rental Assistance

The Texas Department of Housing and Community Affairs (TDHCA) has received $1.3 billion in Emergency Rental Assistance funds from the Coronavirus Relief Bill. TDHCA’s Texas Rent Relief program website and phone systems are active. TDHCA accepts applications from landlords and tenants.

  1. To learn more about the program and apply online go to TexasRentRelief.com
  2. To learn more about the program and apply by phone, call 833-9TX-RENT / 833-989-7368.

For more information on the Texas Rent Relief program go to the TDHCA FAQ page.

Additionally, the Texas Eviction Diversion Program (TEDP) was created by the Supreme Court of Texas, Texas Office of Court Administration and TDHCA to help eligible tenants stay in their homes and provide landlords with an alternative to eviction. A portion of the Texas Rent Relief funds is reserved for this activity.


Guidance on “Long COVID” as a Disability Under the ADA, Section 504, and Section 1557

Although many people with COVID-19 get better within weeks, some people continue to experience symptoms that can last months after first being infected, or may have new or recurring symptoms at a later time. This can happen to anyone who has had COVID19, even if the initial illness was mild. People with this condition are sometimes called “long-haulers.” This condition is known as “long COVID.” In light of the rise of long COVID as a persistent and significant health issue, the Office for Civil Rights of the Department of Health and Human Services and the Civil Rights Division of the Department of Justice have joined together to provide the following guidance:

U.S. Departments of Justice and Health and Human Services  Guidance on “Long COVID” as a Disability Under the ADA, Section 504, and Section 1557


GCPD COVID-19 Webinars

COVID-19 Vaccine and People with Disabilities Q&A, presented on March 9, 2021

HHSC and TEA COVID-19 Disability Policy Q&A, presented on April 17, 2020

COVID-19: Considerations for Individuals with Disabilities, presented on April 1, 2020


Communication

Tips for Successful Communication with People with Disabilities

Communication Tips in Word Format
Communication Tips in PDF Format
Communication Tips in Spanish

It is imperative emergency management information be made accessible in order to integrate the needs of people with disabilities. The Americans with Disabilities Act (ADA) and the 21st Century Communications and Video Accessibility Act (CVAA) require emergency management information to be made accessible in order to integrate the needs of people with disabilities. Accessible information helps support the needs of the whole community and makes sure no one is left without potentially lifesaving information. GCPD reminds broadcasters of the steps that need to be taken in order to make sure information is accessible, as well as the availability of the State of Texas Effective Communications toolkit.

The Federal Communications Commission (FCC) has released additional guidance on accessible televised emergency communication. Community situations such as pandemics are considered emergencies. Information about a current emergency that is intended to further the protection of life, health, safety, and property must be provided visually and aurally.


Education

The Texas Education Agency (TEA) COVID-19 page provides updates on school closures as well as the continued responsibility to provide education to students with disabilities.

As colleges and universities have transitioned to digital learning platforms as part of a campus mitigation plan, GCPD reminds them of their legal responsibility to ensure access to curriculum and instruction for students with disabilities. This includes practical considerations, such as making sure instructional materials are captioned and making use of Video Remote Interpreting and Video Relay Services to provide interpreters in class.

The CDC and Department of Education have provided additional guidance on providing services to students with disabilities during COVID-19. By helping childcare programs, schools, and their partners understand how to prevent the transmission of COVID-19 within their communities and facilities, administrators can help flatten the curve. In addition to mitigation planning, this guidance includes considerations to help administrators plan for the continuity of teaching and learning. Finally, this guidance includes a decision tree to help schools and facilities determine which mitigation plan is best in three scenarios: all schools regardless of community spread, no community spread, and minimal to moderate or substantial community spread.


Health

Governor Abbott has waived certain regulations in order to increase access to telemedicine and prevent unnecessary exposure via in-person doctor visits.

The Texas Health and Human Services Commission (HHSC) has issued guidance relating to certain Medicaid waivers, such as Home and Community-Based Service (HCS) and Texas Home Living (TxHmL). Similar to the guidance prohibiting non-essential visitors in nursing homes and other institutions, HHSC has mandated HCS and TxHmL providers prohibit visitation from non-essential personnel. Given that many group homes serve medically fragile individuals, it is necessary to take strong precautions to prevent the spread of COVID-19 among this population.

HHSC’s, DSHS & CDC Update: COVID-19 Omicron Variant

January 10th, 2022

When was Omicron Variant First Found in Texas and What is This Variant of COVID-19?  (Please see article below)

Texas Identifies Case of COVID-19 Omicron Variant
News Release
Dec. 6, 2021

The first known Texas case of the COVID-19 B.1.1.529 variant has been identified in a resident of Harris County. The adult female resident was recently diagnosed with COVID-19. Results of genetic sequencing this week showed that the infection was caused by the Omicron variant strain. The case is being investigated by Harris County Public Health and the Texas Department of State Health Services.

“It’s normal for viruses to mutate, and given how quickly Omicron spread in southern Africa, we’re not surprised that it showed up here,” said Dr. John Hellerstedt, DSHS commissioner. “Getting vaccinated and continuing to use prevention strategies, including wearing a mask when you are around people you don’t live with, social distancing, handwashing and getting tested when you have symptoms, will help slow the spread of the virus and help end the pandemic.”

The B.1.1.529 variant was identified in South Africa last month and appears to spread more easily from person to person than most strains of the coronavirus. Currently, it is unclear if the Omicron variant is associated with more severe disease. Studies have commenced to determine how effective vaccines are expected to be against infection. However, vaccination is expected to continue to offer protection against hospitalization and death. Omicron is thought to be responsible for a small proportion of the current COVID-19 cases in Texas and the United States.

Vaccination remains the best protection against serious illness and death from COVID-19. Everyone 5 years and older is eligible for vaccination, and everyone 18 years and older should get a booster shot when they are eligible. The latest on COVID-19 in Texas is available at dshs.texas.gov/coronavirus, including daily case data and information on testing and vaccination.


HHS  

Corona Virus Testing and Testing Information  (Includes videos and information about finding testing locations near you and home-testing as well)

Booster Shot Information 


DSHS

Below are frequently asked questions (FAQs) about the variants of COVID-19, including the Delta and Omicron variants.

How can I tell if I have the Delta or Omicron variant? Do labs report that to the state?

That information may not be readily available. The viral tests that are used to determine if a person has COVID-19 are not designed to tell you what variant is causing the infection. Identifying COVID-19 variants requires a special type of testing called genomic sequencing. Due to the volume of COVID-19 cases, sequencing is not performed on all viral samples. However, because the Omicron variant now accounts for the majority of COVID-19 cases in the United States, there is a strong likelihood that a positive test result indicates infection with the Omicron variant.

Are the symptoms different for the Delta or Omicron variant? If so, what are they?

Because Delta and Omicron are variants of the same virus—SARS-CoV-2, the virus that causes COVID 19—the symptoms and the emergency warning signs are the same. However, some variants may spread more easily or may cause more severe symptoms and illness. Because of this, scientists are actively monitoring and studying new variants to learn more about how easily they spread, whether they make people more or less sick, and how well they respond to existing vaccines, treatments, and tests.

Is Texas tracking variants of COVID-19?

Yes. Public health officials at the federal, state, and local levels continue to study variants, monitor their spread, develop strategies to slow their spread, and test how variants may respond to existing therapies, vaccines, and testing. For information on variants of concern in Texas, see the Variants and Genomic Surveillance for SARS-CoV-2 in Texas section of the DSHS website.

Who is most at risk of contracting a variant of COVID-19?

Unvaccinated people are most at risk of contracting COVID-19, including any of its variants. The Delta and Omicron variants are more aggressive than other known variants and spread most rapidly in communities with fewer fully vaccinated people.

The absolute best protection for yourself and those close to you is getting fully vaccinated. The vaccine is proven to safely protect you from COVID-19’s worst effects and lowers your chances of spreading the virus. Greatly increasing the number of fully vaccinated Texans is the only way to prevent a devastating rise in the spread of the pandemic virus.

Are the newer variants worse than the early COVID-19 strains? Will a variant make me sicker than previous strains?

Omicron appears to spread much more easily than other known variants, which means it’s more contagious than other variants. We are still learning whether Omicron may put infected people at higher or lower risk of hospitalization than other variants.

What’s the treatment for patients with the Delta or Omicron variant?

There are different treatment options available for all COVID-19 variants, but some treatments may be more effective for certain variants. In many cases, treatments are reserved for certain high-risk groups. If you or a loved one is sick, check with your healthcare provider about your specific case.

What is the current travel guidance?

Travel recommendations may vary depending on whether you are fully vaccinated or not. Some travel destinations may have different requirements for vaccinated and unvaccinated travelers.

Keep in mind that travel and other guidance may change as we learn more about the virus variants and breakthrough cases. Stay up to date with CDC travel recommendations by visiting the Travel page of the CDC website.

Are people of certain ages at higher risk for infection with the newer variants?

Yes. Anyone who is not fully vaccinated is at greater risk of getting COVID-19. Children up to 5 years old are not yet eligible to receive the COVID-19 vaccine. Anyone who is old enough and able to get the vaccine should do so to protect those who are unable to get it, as well as those for whom the vaccine is less protective. That includes children under age 5 and people with certain medical conditions. It’s also important for those people who qualify to get the booster dose, too.

How many known variants are there?

There are many. Because viruses constantly change through mutation, new variants occur all the time. Sometimes they disappear, and sometimes they persist. Variants are classified in four ways, from least to most severe: Variants Being Monitored, Variants of Interest, Variants of Concern, and Variants of High Consequence.

Public health officials are currently studying two that are classified as Variants of Concern: Delta and Omicron. These are variants that show evidence of an increase in transmissibility, more severe disease (increased hospitalizations or deaths), and/or reduced effectiveness of tests, treatments, or vaccines.

In the U.S., there are currently many Variants Being Monitored, but no Variants of Interest or Variants of High Consequence.

To learn more about variants in the U.S., visit the About Variants of the VirusVariant Classification, and Variant Surveillance pages on the CDC website.

What are the differences between the variants?

Variants vary by their genetic markers. These differences in genetic markers may affect how easily the virus is spread, the severity of illness, how well existing tests can detect the virus, the effectiveness of treatments and vaccines, and more.

Each variant is slightly different. Think of variants like branches on a tree. Each branch is slightly different than others on the tree, but they have similarities, too. Scientists study the differences in COVID-19 variants, so they can label and track them according to those differences.

Do the vaccines protect against the Omicron variant?

Early data suggest that the available vaccines are effective against severe disease and hospitalization caused by the Omicron variant. The best protection against any COVID‑19 variant is getting fully vaccinated. And a booster dose of vaccine is a proven way to maximize the protection against infection and severe disease.

Which vaccine provides better protection against the virus?

In mid-December 2021, CDC updated their vaccine recommendations with a preference for mRNA vaccine (Pfizer and Moderna) over the Johnson & Johnson (J&J) vaccine. However, public health experts continue to say that getting any vaccine is better than being unvaccinated. J&J vaccine will remain available for people who are unable or unwilling to get an mRNA vaccine.

Read CDC’s media statement to learn more about the updated vaccine recommendations.

Keep in mind that guidance may change as we learn more about the virus variants. DSHS will update information as it becomes available.


LTC Regulatory Services

Incident Reporting

HHS regulated providers can self-report incidents affecting resident health/safety, including issues related to COVID-19, online to the Health and Human Services Commission or by calling 1-800-458-9858.

Intermediate Care Facilities (ICF/IID)

Home and Community-based Services (HCS) and Texas Home Living (TxHmL)

Free Webinar Series

Our free webinar session recordings previously recorded are currently posted on our “Gotostage” page.

Free Webinars!!

January 2021 Free Webinar

 “1099 Contractor Concerns” Presented by ADP Payroll & HR”

Twogether Consulting is happy to have ADP Payroll & HR Services again as a resource for IDD providers in our free webinar series for the month of January 2022!

Free Webinar Series Hosted By: Twogether Consulting

Pre-Registration is required, click on the “Registration” button below to attend this free webinar!!

REGISTRATION

or Visit our website:  www.twogetherconsulting.com and click on the Free Webinar calendar

Guest Presenter:                                                                                                                                                                                                Stevi Laas/Enterprise Sales Executive For WorldMarket  (Partner of ADP)

Cell: 830 708 3384
Stevi.Laas@adp.com

 

Topics For Discussion During The Resource Webinar

  1. What’s happening with today’s independent contractor workforce and how companies are tapping into this talent.
  2. How technology can help you efficiently and compliantly organize, manage and pay your 1099 workers
    1. Electronic onboarding of new contractors 
    2. How to keep track of certification and training expirations, background checks, etc
    3. Managing assignment workflow and keeping up with contractors’ work hrs/time on jobs
    4. Compliantly paying workers through convenient and flexible pay arrangements
    5. Compliance for tax and year-end reporting


 

Previous Free Webinars in Oct. and Nov. 2020

See Links to recorded sessions 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  Emailhilary@hrstonline.com
You can also go to their website:  www.hrstonline.com 

Check out this great page they have devoted to COVID-19 Resourceshttps://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

TimeNoon-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 

 

 

Revised Guidance for LTC Facilities Experiencing COVID-19 Staffing Shortages

Revised Guidance on Staff Work Restrictions and Return to Work

HHSC has issued revised guidance for long-term care providers experiencing staffing shortages due to COVID-19. The requirement to contact LTCR before implementing CDC guidance on staff work restrictions and return-to-work has been removed.

“Guidance and Protocol for Long-Term Care Facilities Experiencing Staffing Shortages due to the COVID-19 Public Health Emergency.

This checklist provides guidance for long-term care facilities and residential providers facing staffing shortages related to the COVID-19 public health emergency.

This checklist incorporates CDC guidance with state and federal staffing requirements.

Facilities facing staffing shortages must use this checklist before requesting emergency staffing resources. The CDC’s mitigation strategies are meant to be implemented sequentially (i.e., contingency strategies before crisis strategies). The conventional strategies must be followed when the facility has adequate staffing.

As a reminder, facilities are required to cohort residents based on their COVID-19 status: COVID-19 negative (COVID-negative), COVID-19 positive (COVID-positive), and unknown COVID-19 status (COVID-unknown).1 Healthcare personnel (HCP) are considered “boosted” if they have received all COVID-19 vaccine doses, including a booster dose, as recommended by CDC.”

For more….  Read the updated guidance.

LTC (Long Term Care) Online Portal BasicsWebpage

January 9th, 2022

Please click on link below to take you to the “LTC Online Portal Basics” page with important information on usages for the portal,  e-learning training sessions, and pdfs of manuals needed for navigating the portal

LTC Online Portal Basics page

  • By Provider Training Services
  • Published: Mar 5, 2021
  • Duration1h

This interactive training provides a basic overview of the Long Term Care (LTC) Online Portal including an overview of the features of the blue navigational bar and the yellow Form Actions bar. Demonstrations and simulations are available to provide opportunities for hands-on experience. For program-specific details of the features discussed, you will be referred to the CBT or User Guide for your LTC program.

Length: Modules vary from 2 to 20 minutes

When you have completed this CBT, you should be able to:

    • Follow the requirements for obtaining and using a National Provider Identifier (NPI) or Atypical Provider Identifier (API);
    • Log in to the LTC Online Portal;
    • Create an administrator account on the LTC Online Portal;
    • Use the features of the blue navigational bar;
    • Use the features of the yellow Form Actions bar; and
    • Understand general information for the LTC Online Portal, including:
      • Required fields;
      • Unlocking forms;
      • Entering dates;
      • History trail;
      • Error messages; and
      • Time-out.

 

Below are some helpful PDF’s

 

TMHP LTC and HHSC IDD Operations Portal For Providers-Additional Trainings Update 2022

January 9th, 2022

Register for HCS and TxHmL Webinars, Additional Training Resources

Texas Medicaid and Healthcare Partnership is hosting Long-term Care Home and Community-based Services and Texas Home Living Waiver Program webinars for program providers, Local Intellectual and Developmental Disability Authorities, and financial management services agencies that submit claims on behalf of Consumer Directed Services employers.

Each webinar is composed of two sessions. Attendees can register for any first session and any second session by clicking on the dates below but should complete the first session before attending the second session.

The two-session webinar will cover the LTC Online Portal, management of waiver program assessments and forms in the portal, purpose and workflow of various forms, and available resources for program providers, LIDDAs and FMSAs.

Participants can submit questions during the webinars that will be answered during the webinar’s Q&A session.

Session one webinars are scheduled from 10 a.m.–1 p.m.

Session two webinars are scheduled from 10 a.m.–12:30 p.m.

Additional Training Resources

Program providers, LIDDAs and FMSAs should create a TMHP Learning Management System account before the webinar to access the LTC Online Portal and claims submissions training. New TMHP LMS users can access the LMS Registration and Navigation Job Aid for Providers (PDF) located on the LMS homepage.

Suggested training resources include:

 For questions and help navigating the LMS, email TMHP Trainings Support.


 

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.

Monthly Provider COVID-19 Reporting Requirements- Compliance with SB 809 and Rider 143

January 9th, 2022

Reminder: SB 809 / Rider 143 COVID-19 Reporting

The Health and Human Services Commission (HHSC) is posting the list of healthcare institutions, as identified by HHSC, who must submit reports in compliance with Senate Bill 809 or Rider 143. The list also identifies those providers who have not submitted a SB 809/Rider 143 Report. The list can be found on the Provider Finance website under SB 809/Rider 143 COVID-19 Reporting Healthcare Institution List. Note: this list is for the reporting periods of January 2020 – August 2021, September 2021, and October 2021, which were all due 5:00 PM CST on December 1, 2021.

If you believe there is an error in the list, please email us with “SB 809/Rider 143 Reporting” in the subject line by 5:00 PM CST on January 5, 2022.

If all required reports by a provider have not been received by 5:00 PM CST on January 5, 2022, HHSC will begin immediate enforcement of disciplinary actions as authorized by Title 1 Texas Administrative Code Section 355.7201 (TAC) related to the penalties for failure to report. The health care institutions that have “not submitted” are deemed non-compliant at this time.

The initial report required from providers includes funding and cost data covering the period January 2020 through August 2021. The subsequent reports will be ongoing and will cover a single month; each monthly report will be due on the 1st of the second following month following the end of the month (for example, the report for November 2021 data will be due January 1, 2022).


 

December 30th, 2021

GovDelivery Update: SB 809 / Rider 143 COVID-19 Reporting

This is a notification that HHSC has identified an error in the list of healthcare institutions that have submitted and have not submitted a SB 809 / Rider 143 report. HHSC has now resolved this matter.

HHSC has published a corrected list on the Provider Finance website under SB 809/Rider 143 COVID-19 Reporting Healthcare Institution List.

If you have any questions or concerns regarding this list, please email us with “SB 809/Rider 143 Reporting” in the subject line by 5:00 PM CST on January 5, 2022.


 

December 14th, 2021

Very Important Hanging Sign Clipart Images

Very Important News! The due dates for the SB 809 Monthly COVID-19 Reports have changed.

Previously the reports were due on the 15th of the month following the month which the report covered.  They are now due on the 1st of the second following month.  Example:  The report covering November is now due January 1, 2022 rather than December 15, 2021. See updated message on HHSC’s webpage below.

The initial report located here includes funding and cost data covering the period January 2020 through August 2021 and is due October 1, 2021. The subsequent reports (located here) will be ongoing and will cover a single month; each monthly report will be due on the 1st of the second following month following the end of the month (for example, the report for September 2021 data will be due November 1, 2021.)


November 30th, 2021

 All IDD providers are required to complete the surveys (beginning with the initial survey, followed by the ongoing surveys) regardless of whether the provider received federal COVID-19 Provider Relief Funds (PRF).
The survey was updated November 9, 2021.  As the result, providers which were in compliance with the requirement prior to November 9th need to resubmit their surveys using the updated survey.  This includes the ‘initial’ survey and the ‘ongoing’ surveys covering September and October.
Before completing the reports, please read carefully all instructions, the FAQs and, most importantly, the PDF versions of the reports.  The PDF versions of the initial and ongoing surveys highlight the questions which apply to certain provider types only.
This is important because many, if not all, of the questions on the revised initial and ongoing surveys DO NOT apply to IDD providers.
After reviewing the PDF versions of the surveys and FAQs, use the links below to access the surveys you need to complete/submit. 
 Before clicking to submit the survey, please print a copy for your records.
When emailing questions to HHSC about the requirement and surveys, it is highly recommended that you indicate which program or programs you operate as well as your NPI/TIN.  In this way HHSC can provide an accurate response and you, the provider, will not be answering survey questions which do not apply to the programs you operate.  HHSC email address:  HHSC_RAD_Survey@hhs.texas.gov
Though previously stated, providers have until November 30, 2021 to submit the first three surveys; i.e., the initial survey, the survey covering the month of September and the survey covering the month of October.  Thereafter, reports are due the 15th of the month following the reporting period.
Example:  The report covering the month of November is due December 15, 2021, the report covering the month of December is due January 15, 2022, etc.

November 14th, 2021

PROVIDER REPORT GRACE PERIOD

HHSC is granting a “grace period” to allow providers time to come into compliance if they fail to meet any deadlines between October 1, 2021, and November 30, 2021. While the deadlines to report will not change, HHSC will not take any of the available actions against a provider as long as the provider submits all the required reports due between October 1, 2021, and November 30, 2021. The grace period ends December 1, 2021.

Because vendor hold can be imposed for lack of compliance and non-compliance will impact a provider’s eligibility to receive the state-controlled ARPA funds made available through SB 8 (Nelson, 3rd Special Session). Please share this information!

COVID-19 Monthly Reporting Requirements: This requirement does apply to ICFs/IID, HCS, TxHmL, CLASS & DBMD.  To view the requirements, FAQs, and other related information, click on the following link for Monthly COVID 19 Reports
The report MUST be submitted monthly regardless of whether one accepted Provider Relief Funds through the CARES Act during the Public Health Emergency (PHE) or whether one has already expended funds they received. She noted that even though one may report $0.00 on the Provider Relief Fund question, the survey contains other questions regarding ongoing costs one may have.
There has been an update report form to include additional questions. The bulletin further directs that providers need to update their prior reports or complete new reports for prior reporting periods.  It has been suggested to HHSC that providers contact HHSC at the email address below to request their prior reports to complete the newly added questions as opposed to totally redoing the reports. The link is not working correctly according to some providers and I hope to notify you as soon as I am aware it has been corrected by HHSC.
Note: If you overlooked previous HHSC  emails regarding this requirement, we urge you to complete and submit the reports you missed and thereafter continue submission on a monthly basis.  Providers have until December 1st to complete the reports required thus far.  Reporting forms can be accessed on HHSC’s website at: https://pfd.hhs.texas.gov/long-term-services-supports

 

Very Important!!!     State-Controlled ARPA Funds in relation to COVID-19 Reporting Requirements:  Section 33, Subsection (b) of SB 8 states “it is the intent of the legislature that HHSC prioritizes grants to grantees that comply with Rider 143 (SB 1, 87th Session) and SB 809 (87th Session).”  [Rider 143 DOES NOT apply to ICFs/IID, HCS, TxHmL, CLASS or DBMD].  This statutory provision may result in many providers not being eligible to receive these fundsMany providers may have overlooked the notices related to the monthly reporting requirement or believed that the requirement did not apply to them, thus they have asked whether HHSC would be amenable to allowing providers to come into compliance before the grants are distributed.

HHSC has said that providers have until December 1st, 2021 to come into compliance.  Non-compliance during this ‘grace’ period would not impact one’s eligibility, but non-compliance after the grace period would have an adverse impact on a provider receiving the grant. While excellent news, we would urge providers to comply with the requirement and submit any reports previously not submitted.  As stated under the COVID-19 Monthly Reporting Requirement section of this message, non-compliance can also result in vendor hold.

For questions about the reporting process, email HHSC Provider Finance Survey for assistance at: HHSC_RAD_Survey@hhs.texas.gov

Information and FAQs Please visit the HHSC Provider Finance Department Communications web page for more information about the report.  Then click on “Monthly SB 809/Rider 143 COVID-19 Reporting.”

Read More….


October 3rd, 2021

Don’t Forget, The 1st  Monthly Ongoing Provider Report is Due October 15th, 2021!

The ongoing SB 809 and Rider 143 report and further information—including a PDF version of the report questions—are available on the HHSC Provider Finance Department website, and may be accessed on the main webpages for Acute Care ServicesHospitals and Clinic Services, and Long Term Services and Supports. Please note that this Microsoft Form link is separate from the initial report that covered the period of January 31, 2020 – August 31, 2021.

Grace Period

HHSC is granting a “grace period” to allow providers time to come into compliance if they fail to meet any deadlines between October 1, 2021, and November 30, 2021. While the deadlines to report will not change, HHSC will take no action against a provider as long as the provider submits all required reports due between October 1, 2021, and November 30, 2021, prior to the end of the grace period. The grace period ends December 1, 2021.


 

Sept. 18th, 2021

FAQ’s For Compliance With SB809 & Rider 143: Monthly Provider Reporting Requirements Concerning COVID-19 Funding

Introduction:

The 87th Texas Legislature directed the Health and Human Services Commission (HHSC) to report federal COVID-19 funding from specific health care institutions, and certain costs those providers have spent related to COVID-19 public health emergency. HHSC has developed a monthly report to obtain the information required by Rider 143 (.pdf) (2022-23 General Appropriations Act, Senate Bill (S.B.) 1, 87th Legislature, Regular Session, 2021 (Article II, HHSC, Rider 143) and S.B. 809 (.pdf) (87th Legislature, Regular Session, 2021).

Frequently Asked Questions (FAQ):

View the HHSC created list of “frequently asked questions ” (FAQ) (.pdf) with the answers to common questions to assist providers in completing the report.

Reporting: 

The initial report located here includes funding and cost data covering the period January 2020 through August 2021 and is due October 1, 2021. The subsequent reports will be ongoing and will cover a single month; each monthly report will be due on the 15th of the month following the end of the month (for example, the report for October 2021 data will be due November 15, 2021.

You will receive a confirmation once your report has been fully completed and submitted.

A pdf version of the report is available here (.pdf) for review prior to submitting the report.

If you are unable to meet the reporting deadline please contact the Provider Finance Department at HHSC_RAD_Survey@hhs.texas.gov for assistance.

Failure to submit:

Failure to complete and/or submit the required monthly report(s) on time will result in:

  1. A report to the Department of State Health Services or HHSC Regulatory Services and potential adverse actions on your licensure and/or
  2. HHSC may initiate payment holds for providers who fail to submit the required monthly reports.

HHSC is granting a “grace period” to help providers come into compliance if they fail to meet any deadlines between October 1, 2021, and November 30, 2021. While the deadlines to report will not change, HHSC will not any of the actions listed above against a provider as long as the provider submits all the required reports due between October 1, 2021, and November 31, 2021. The grace period ends December 1, 2021.

List of Some Of The Providers Required to Complete Reports: 

Here are some of the following entities that are required to complete the report:

  • Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID);
  • Community Living Assistance and Support Services (CLASS) or Case Management Agency (CMA) Providers;
  • Deaf-Blind with Multiple Disabilities (DBMD) Providers;
  • Home and Community-Based Services (HCS) Providers;
  • Texas Home Living (TxHmL) Providers;

Please email the HHSC Provider Finance Survey for assistance at HHSC_RAD_Survey@hhs.texas.gov.


September 18, 2021

As required by Senate Bill (SB) 809 and Rider 143 of the 87th Legislature (regular session)(copied below), HHSC will begin collecting information on the total value and uses of COVID-19 related Federal funds through monthly reports. The first report is due October 1, 2021. Reminder of Publication of Proposed Rules

HHSC published proposed rules related to SB809 and Rider 143 in the Texas Register on August 13, 2021, pages 4928-4931. The comment period ends September 3, 2021.

 

Rider 143

Reporting Requirement: COVID-19 Funding to Nursing Facilities and Hospitals. Out of funds appropriated above in Strategy B.1.1, Medicaid Contracts and Administration, the Health and Human Services Commission (HHSC) shall develop a report detailing the total value and uses of COVID-19-related Federal Funds, including Provider Relief Funds, provided directly to nursing facilities and hospitals contracting with HHSC since the beginning of the public health emergency. The report should include any temporary rate increases provided to nursing facilities related to the COVID-19 pandemic. Any facilities that do not provide information requested by the commission necessary to complete the report shall be identified in the report. The first submission of the report shall also include a description of any requirements implemented for nursing facilities in response to the COVID-19 pandemic, the cost to nursing facilities to implement the requirements, and recommendations on whether or not the requirements should be continued after the end of the public health emergency. HHSC shall submit the report to the Governor, Legislative Budget Board, and any appropriate standing committee in the Legislature on December 1st and June 1st of each fiscal year. The format and content of the report shall be specified by the Legislative Budget Board and posted on the HHSC website. Appropriations in Strategy A.2.4, Nursing Facility Payments, for fiscal year 2023 are contingent on the submission of the reports due December 1, 2021 and June 1, 2022.

Please look for forthcoming announcements from HHSC regarding these important reporting requirements. For more information, please contact HHSC Provider Finance.

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

“Study & Prep Session For HCS Provider Applicant Test” 

Contact us for a copy of pre-recorded session from November 3rd, 2021

This Training is Not Affiliated In Any Way with HHSC
It is Provided by Twogether Consulting, a private consulting company for HCS/TxHmL & ICF providers  (As well as persons  seeking Information about these Medicaid programs)
(We will be reviewing some TxHmL information as well)

Cost:  $150/person

To register, please go to:

 

Topics:      

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 and Interpretive Guidance Booklet,

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

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

 


Books and Breakfast at the Ridgefield Library

HCS/TxHmL-Provider Applicant Test Study Material (Update)

Some additional helpful study material prior to taking the HCS Provider Applicant Test, are listed below.

HCS/TxHmL Interpretive Guidance Booklet  (as Required byHouse Bill (H.B.) 3720, 87thLegislature, 2021)

This guidance booklet was meant to assist providers and surveyors with surveyor expectations and considerations when handing out administrative penalties for violations of the certification principles 

HCS & TxHmL Joint Training Opportunities HHSC website page  (Please see free webinars that review the 9 major certification principles from the HCS TAC code.  These principles are also noted in the HCS Handbook and the new Interpretive Guidance Booklet)

For additional information on the Joint Training Opportunities webinars or requesting a link to pre-recorded webinars you may have missed, please   email LTCRJointTraining@hhs.texas.gov

 

 

*In addition don’t forget the primary study material is the:  HCS Handbook, the HCS TAC, and for TxHmL TAC for those also taking the TxHmL test.


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:

HCS Provider Applicant- Provider Applicant Training (PAT) and 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

 

HCS/ICF Provider Job Openings & Job Positions Desired

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 neccesarily 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)

The Center For Pursuit
Position: HCS Case Manager  (Posted  12/28/21)  (Houston, Tx)

Pay:  Between $40K- $45K depending on experience

Contact: Chief Operating Officer, Kevin Kern

Phone: 713-525-8363  Mobile: 281-830-2686

Email: kkern@thecenterforpursuit.org 

Address: 4400 Harrisburg Blvd Houston, TX 77011

 

POSITION SUMMARY

-Looking for someone wanting a change, for HCS Case Manager position!

-Experience as HCS Case Manager or with IDD services is preferred ,but other experience will be considered as well.


 

Mark I Residential HCS

Mark Henson-CEO/Owner

Ph:  512-789-4079

Location:  Austin, Texas

Starting Pay:  $50,000

Position: Case Manager (Need immediately, approximately 20-35 client caseload/primarily medically fragile individuals in Group Homes)

Job Qualifications:

Previous experience in case management  working with individuals with intellectual and developmental disabilities, preferred, but will consider other experience with IDD serivces.  i.e.. HCS, TxHmL or ICF program or other DD programs.  Must be comfortable working with individuals with high medical needs. Contact us for more information.


 

Important-HCS and TxHmL Webinars and Claim Payment Account Setup (Coming Soon!)

HCS and TxHmL program providers, Local Intellectual and Developmental Disability Authority agencies, and Financial Management Services Agencies billing on behalf of Consumer Directed Services employers can register for webinars starting next month. These webinars will cover information about the Long-Term Care Online Portal and forms that HCS and TxHmL program providers will use.

The webinars will:

  • Include a live Q&A session
  • Begin in February 2022

Details, including dates, times, and registration links will be in a future article on the Texas Medicaid & Healthcare Partnership website. Providers should check the Recent News section of the LTC webpage often for current information.

HCS and TxHmL program providers, LIDDAs, and FMSAs will begin submitting claims and forms to TMHP on March 1, 2022. Program providers, LIDDAs, and FMSAs should set up the following accounts, if not yet done:

  • One of the following for Claims Submission Account:
    • TexMedConnect
    • Electronic Data Interchange
  • LTC Online Portal
  • TMHP Learning Management System

Failure to set up the necessary accounts can lead to payment delays after March 1, 2022. Program providers, LIDDAs, and FMSAs can find resources for creating the necessary accounts and the time frames it could take to create those accounts linked below.

Providers can refer to the HCS and TxHmL Waiver Programs Frequently Asked Questions (FAQ) or contact the TMHP EDI Help Desk at 888-863-3638 with questions.

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

December 25th, 2021

The extension for DH goes through January 31st, 2022 now.  See Nov. 21st, 2021 information below.


November 21st, 2021

HHSC Publishes In-Home Day Habilitation Information Revision/Update for Program Providers for COVID-19 (IL 2021-53)

Texas HHSC is temporarily waiving certain requirements in Section 3710, 4381.3, 4381.7(6) and 4381.7(7) of the Home and Community-based Services Billing Guidelines and the Texas Home Living Billing Guidelines. This is due to COVID-19 and to provide access to needed day habilitation services.

HHSC has published a revision to this guidance in IL 2021-53 , which replaces In-Home DH Guidance IL 2021-51 and 2021-45 prior to that.

It extends the temporary guidance through December 31st, 2021

Email questions to HCS Policy.


October 3rd, 2021

HHSC Publishes In-Home Day Habilitation Information for Program Providers for COVID-19 (IL 2021-45)

Texas HHSC is temporarily waiving certain requirements in Section 3710, 4381.3, 4381.7(6) and 4381.7(7) of the Home and Community-based Services Billing Guidelines and the Texas Home Living Billing Guidelines. This is due to COVID-19 and to provide access to needed day habilitation services.

HHSC has published a revision to this guidance in IL 2021-45 In-Home Day Habilitation Information for Program Providers for COVID-19 (PDF). This replaces IL 2021-39. It extends the temporary guidance through Oct. 31, 2021 unless the public health emergency ends sooner. HHSC will update if there are any changes.

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 30th, 2021:
●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 2021-45 

HHSC Publishes Active, Unemployable Work-Around (Provider Letter 2021-44)

December 20th, 2021

Check LEIE/OIG and check With the implementation of FBI-based fingerprinting in 2021, Long-term Care Regulation (LTCR) also implemented Occupations Code (OC), Chapter 53, related to the consequences of a criminal conviction, specifically the 2019 legislative update to OC §53.023 concerning additional factors for licensing authorities to consider after determining a conviction directly relates to the occupation.

Policy Details & Provider Responsibilities Long-term care facilities and agencies must check and continue to check an applicant’s criminal history, Nurse Aide Registry status, and Employee Misconduct Registry. Use the HHSC Employability Status Search at https://emr.dads.state.tx.us/DadsEMRWeb/ (link is external), which includes information regarding Sanctions. OC § 53 requires an employer to consider only convictions directly related to the occupation.

PL 2021-44 

With this new implementation, it is possible for an individual to receive a license, permit, or certification who is not employable or only employable in limited settings according to Health and Safety Code (HSC) §250.006.

Beginning December 20, 2021, long-term care facilities and agencies must also check the Excel document linked below to determine if an individual is licensed/permitted/certified but is unemployable in one or more long-term care settings licensed by LTCR. This file contains the names of nursing facility administrators, nurse aides, and medication aides that have active licenses/permits/certifications but are unemployable according HSC §250.006 in one or more long-term care settings.

https://www.hhs.texas.gov/sites/default/files/documents/active-unemployable.xlsx

HHS is updating the Employability Search with information on active but employable individuals. Until this update is complete, providers will be required, in addition to checking the Employability Search, to check the Active but unemployable Excel File in the resources section of this Provider Letter.

Resources Active but unemployable Excel File

Contact Information

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

SB8- New HHSC Grants Webpage

December 17th, 2021

The link doesn’t inform providers about current information but will provide future information about ARPA funds, and will be available on the newly created HHSC Grants webpage.
Press Release: Governor Abbott, HHSC Announce $128 Million To Support Staffing Needs At Rural Hospitals, Nursing Facilities | Office of the Texas Governor | Greg Abbott

According to the HHSC Provider Finance representative- Ms. Ellison at LTCR Dec. 7th meeting with the IDD workgroup, this is the information on how the state-controlled ARPA funds appropriated via SB 8 (3rd Special Session) will be distributed.  [Remember: These funds are separate from the HCBS 10% FMAP funds.]
Click on Agenda Item #6 at the following link:  https://texashhsc.swagit.com/play/12082021-510
1.  SB 8 appropriated $200 million for nursing homes and $178 million for ICFs/IID, ALFs, Home Health agencies and community attendants (which includes CDS and non-CDS providers).
2.  According to HHSC there are two options for distributing the $178 million:  a)  Option 1 would award a little less than $5,000 to each eligible facility or program entity.  b) Option 2, a Request for Application (RFA) process, will ensure providers receive more than $5,000. Specific amount not offered.  Option 2 will be used.
3. As stated above, the funds (or grants) will be distributed through a Request for Application (RFA) process.  Each program or entity (or sub-pool) will have its own RFA process and criteria that must be met to receive the funds.  According to HHSC, using a RFA is a shorter process; i.e., 5 months versus an approximate 10 months.
4.  HHSC estimates there are 36,000 ICF/IID, ALF, Home Health and community attendant providers.  Note:  While 36,000 seems high, HHSC explained that although a provider or organization may operate 20 ICFs or 10 ALFs, each facility the provider operates is counted as a ‘provider.’
5.  Allocation of the funds across the above-mentioned programs and entities (or sub-pools) has yet to be determined though allocation could be based on client count.
** Note:  HHSC stakeholders asked HHSC to consider attendant utilization in awarding the funds citing that group homes require 24/7 staff whereas services in the other sub-pools do not. 
6.  Of the 4 programs and entities referenced in SB 8, HHSC is establishing 5 sub-pools. The 5 sub-pools with facility or provider count noted are as follows:
  • ALFs:   2.025 facilities
  • ICF/IID:  708 facilities
  • Home Health:  6,945 (count based on on number of unique entities/facilities listed as HCSSA)
  • Community Attendants which will be separated into 2 groups – CDS and non-CDS:   23,494 CDS providers; 3,498 non-CDS and based on billing data.
**Note:  HHSC stated that HCS residential and CFC PAS/HAB will be included.  Though HHSC did not clarify under which sub-pool or program these services be placed, it is assumed they will fall under the non-CDS community attendant category.

Transition of DH to ISS

December 12th, 2021

Transition clipart 6 » Clipart Station

ISS (Individualized Skills and Socialization)  

Changes to Day Habilitation (DH) programs are coming for HCS/TxHmL!  The link below contains a discussion concerning the implementation of a recommendation in the Rider 21 Report (General Appropriations Act for FY 2020-2021, 86th Session) related to the monitoring of DH programs which will transition to the provision of ISS.

To view, the report go to:  https://www.hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2021/rider-21-transition-day-habilitation-services-jan-2021.pdf

HHSC will soon release a Provider Letter explaining that DH programs that intend to provide ISS will need to obtain a DAHS license. HHSC will modify current DAHS rules and licensing requirements to add an ISS service category.  The ISS category will include rules appropriate to the provision of the new service.
 A small licensing fee will be applied – $75.00.  The license will need to be renewed every three years.
Note: it is not known at this time whether a ‘public’ DH provider will need to pay the license fee.
HHSC will conduct webinars beginning in January (probably late January) to inform providers of the changes including the related rule changes (rules to effect the change are still in the development stage).       
Which providers will need to obtain the DAHS license and which providers will not?
  • Current DAHS providers who want to also provide ISS.
  • HCS/TxHmL providers operating a DH and serve persons eligible to receive ISS.
  • Independent DH providers serving persons eligible to receive ISS.
  • ICF/IID providers who operate a DH and only serve persons receiving ICF/IID services will not be required to obtain the license. However, if the ICF/IID provider opens its DH program to serve persons eligible to receive ISS, such as persons enrolled in HCS/TxHmL, it will need to obtain the license.
FYI- The report above does mention that in order to meet the federal compliance deadline of March 17, 2023, HHSC recommends implementing this new service on September 1, 2022.