Twogether Updates

STATEWIDE TRANSITION PLAN: HCBS

January 16th, 2023

Statewide Transition Plan

CMS requires states to submit a transition plan describing the state’s planned initiatives and activities for achieving compliance with the federal HCBS Settings Rule. HHSC has received initial approval of its transition plan and has updated the plan to include additional information required for CMS to grant final approval.

This version of the STP includes new information about site-specific assessments, ongoing monitoring and oversight, non-disability specific setting options, communications with beneficiaries regarding provider choice, and notification of provider non-compliance.

HHSC will submit a final Statewide Transition Plan (STP) to the Centers for Medicare and Medicaid Services (CMS). The STP is posted for public comment.  All states must obtain final approval of their STP from CMS to comply with the federal Home and Community-Based Services Settings (HCBS) Rule. The STP describes HHSC’s activities and planned initiatives for meeting 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 Feb. 13, 2023. 

Access the STP and instructions for submitting public comments here.


Written comments, requests to review comments or both may be sent by U.S. mail, overnight mail, special delivery mail, hand delivery, fax, or email.

Email: Medicaid_HCBS@hhs.texas.gov  

Fax:
Attention: Rachel Neely, Office of Policy at 512-438-5835

U.S. Mail:
Texas Health and Human Services Commission
Attention: Rachel Neely, Office of Policy
John H. Winters Complex
701 W 51st Street
Mail Code H-600
Austin, TX 78751

Overnight mail, special delivery mail, or hand delivery:
Texas Health and Human Services Commission
Attention: Rachel Neely, Office of Policy
John H. Winters Complex
701 W 51st Street
Mail Code H-600
Austin, TX 78751
Phone number for package delivery: 512-438-4297

 

TMHP Portal Town Hall Meeting on 1/11/23: Helpful Information From This Session

January 16th, 2023

Helpful Information:  From TMHP Portal Town Hall Meeting on 1/11/23

-A representative from one of the LIDDAs  (Alamo Area Council of Governments) relayed the following information:

  1. If an individual moves from one LIDDA to another (LIDDA to LIDDA transfer) and they are going to new HCS or TxHmL provider, the old LIDDA has to do INT form 1st and then the new LIDDA has to do the transfer to the new provider.  These things must happen in this order, or it will hold things up in your transfer.
  2. One of the major problems the LIDDA’s have is that the LOCATION code is being changed by the system (a glitch of some sort in TMHP) and then it is greyed out by the system so they can’t put anything in that spot where location code goes.  They can’t edit it to correct it. This has caused many of the delays in transfers and this is why alot of providers might be thinking the LIDDA is causing the delay.  However, that may not be the case because of this issue.  Good news: Enhancement to allow the LIDDA to type in location code instead of grey out barrier. This is happening Friday Jan. the 13th.  This should provide a resolution to this “glitch” in the system.  Hopefully, it will allow a lot of transfers to go through.  This problem has been happening since April of 2022 for LIDDA’s.
  3. FYI-HHSC sent out a letter to LiDDAS, that they should not hold up on transfers if the location code is not correct.  They can then contact HHSC about correcting the location code after the fact.

 

-In some situations, if the LIDDA itself is not changing during the transfer (transfer from one provider to another, but LIDDA the same), then the provider needs to make the changes on the IMT form before the -LIDDA can submit.  They have to complete the process in that order before the transfer can be submitted.  Meaning the previous form must be done before the new form should be completed.

-One of the HCS providers shared the following information:  Somewhat related to location codes.  She was closing a couple of location codes after the home was no longer open.  Noticing that the drop-down list is out of sync.  She would put in the address of the new location and go to close the old location code and the drop-down link showed a different address for the location being closed out than it should.  It is like it is out of sync.   This fix happening this Friday should also fix that for the provider. Basically using right code but the wrong address is showing up in the dropdown menu’s.  Referring to PLU system.

-If providers are experiencing any delays with LIDDA not submitting any forms they are required to submitted. Please try to resolve that by escalating that to LIDDA director, so HHSC says they want you to then send an email to interestlistpreenroll_liddahelp@hhs.texas.gov.  then they can reach out to them directly.

To escalate tickets:  Email. LTCOPS-Escalations@TMHP.com to escalate tickets

-Another provider noted the following issue: When they migrated to TMHP, somehow their contract address was now incorrect.  The provider’s company name was no longer associated with the right contract #.  It is not something the provider did on their side. So far, they have had no luck in changing that address to the correct address for their contract #.  Provider information update.  They will need to check it on the provider system data to find out.  Contract and Administration and Monitoring will have to help with the correction of the error.  This is also the case if providers have questions about a contract’s begin and end date, or when it expires, etc.. Go to the contract manager. HHSC acknowledges that there has been alot of turnover in this department.  (Don’t I know it, lol.)  Information provided by Kaliope Schmidt was to do the following: Go to iddwaivercontractenrollment@hhsc.state.tx.us and cc Kaliopi.schmidt@hhs.texas.gov

One Provider had a Transfer since May of 2022 that hasn’t gone through because the old provider’s address is showing on the location since transferring, so it does not match the contract of the new provider. Hopefully, the fix will come from the Friday the 13th, 2023 enhancement. 

Client assignment question:  In the CARE system, this was done differently than in THMP so has caused a domino effect.  i.e. Individual on temp discharge, would be re-assign to a different temp discharge location code.  The local authority wanted her back into rotation. …….  We can’t view who is assigned to what location on what date, so couldn’t figure out how to move people sometimes.  People at the help desk don’t even know how to look up people’s locations and assignments.  What can we do? 

To do that in the portal for now until June 2023, when they will have an enhancement out to correct this issue, providers must use the form status inquiry page (FSI) you can search for the consumer’s forms by imputing their Identifier (Medicaid or CARE #) and put in with search criteria.  Leave the form blank but put in the date range or a little bit longer time if needed and search that.  In the list should receive list of forms for the consumer for your organization.  The effective date on the forms, if you click it, the system will show the list by effective date and which code has the latest effective date, and then that form as the latest location code.  But won’t help unless the form is completed already.  Location availability information is limited. The provider has to keep trying to look up everything in a fashion that seems long and very backward.  It is the opposite of what the provider needs.  It ends up being the longest way to look if up.  The provider asked if they would create something in their June enhancement, that shows the moves of a person, hoping to build the function to search the function by location, what client is with them. 

-If on temp discharge is the individual still assigned a code from the facility or a new code form (IMT suspension purpose code form)?  Because the provider currently has to wait for the suspension form to finish the process so it is considered complete before they can do anything. How long does that usually take?  Ask CARE people to get back to you.

-Another provider said they can’t do IMF form til the Residential component is changed but can’t change the residential component until IMF changed.  Moving from 1 location to the other inside the same agency.  Moving from HH/CC to RSS.  So, when they try to change the residential type, it won’t let her progress from there in TMHP.  Provider needs to submit IPC revision to change residential type.  Then at the same time on that revision form, then the location code is updated for you to update IMF automatically. Don’t need to do the IMT, just the IPC revision form to change the residential type and location code.  That changes the residential component type, submit IPC revision or transfer if that is the case. 

-How do you know what claims to pay when you get your overpayment letter? To request a list, please contact the  THMP-LTC Help desk at 1-800-626-4177 or 1-800-626-5436 (Option #1  then Option #7). The provider will need to provide a secure email for them to send the list. Should get within 24 hrs.  Can also go to your Tex Med connect and remittance status screens.

HHSC asked providers to limit ISS questions at this time, but here is one that came up during the session:

-In-Home ISS come March 1st, 2023-does the provider need to submit documentation like BCBA documentation or medical/physician’s order of need, before it is entered into TMHP billing?  Anything the provider needs to be prepared for?  They have to go back and find out about it.  Don’t know now.

 


Other Important Contacts:

Issues that go to UR (Utilization Review): • 8578 ID/RC form with purpose code 3 or 4 on the LTC Online Portal  • Renewal or revision IPCs

Utilization Review (UR)
512-438-5055  email:  deskURLONIPC@hhs.texas.gov


Issues that go to PES (Program Enrollment Services)  • 8578 ID/RC with a purpose code 2 forms * initial or transfer IPCs forms • Suspensions • 3615 Continuation of Suspension forms • 3616 Request for Termination forms • Individual Movement (IMT) forms for LA Reassignments

Program Eligibility and Support (PES)

512-438-2484
enrollmenttransferdischargeinfo@hhs.texas.gov

When Will HCS New Rules and Status of Statewide Transition Plan (STP) Be Adopted?

January 16th, 2023

Adoption Date of HCS Rules and Status of Statewide Transition Plan (STP): 

gave HHSC preliminary approval of its STP on 12/21/2022.  The STP will be posted for public comment this Friday (Jan. 20th, 2023).

It is unclear when the HCS rules will be adopted.

See graph of draft rules below (pages 12-17 for HCS).  Includes CLASS, TxHML, MDCP, and DMDB programs as well.

Appendix A: Home and Community-Based Services (HCBS) Settings Statewide Transition Plan

 

 

ISS Updates & New Rules (HCS/TxHmL)

January 16th, 2023

Questions concerning ISS and to the recently published IL 2022-03 ISS Automatic Service Authorizations and EVV for In-Home ISS in OHFM Settings  HHSC asked the 3 IDD associations to send them a list of questions.  If you have not already, please send your questions to your provider associations (PPAT, PACSTX, and TCDD).
Questions to which answers have been received are as follows:
  • The ‘new’ IPC referenced in IL 2022-03 will most likely not be ready until March.  They did not have answers as to what providers should do in the interim or even how service logs should be revised until new ones are available. (The letter does indicate that those individuals receiving DH at the time of the switch to ISS (March 1st, 2023) will initially roll over automatically to ISS ).
  • After Feb. 28th this would apply to all current clients as far as IPC units are concerned. Persons who don’t have any Day Hab units/days on their plan as of Feb. 28th, 2023 and want ISS hours, will have to do a new PDP and request IPC hours.   Providers will have a new IPC form, with ISS on it, before March 1st, 2023.
  • To date, no provider has been issued an ISS license.
  • Providers can confirm that an entity has an ISS license by checking the DAHS directory on the DAHS webpage:   https://www.hhs.texas.gov/providers/long-term-care-providers/day-activity-health-services-dahs
 Unfortunately, no definitive answers have been obtained or decisions reached concerning processes related to service authorizations, IPC revisions and renewals and the automatic addition of ISS units.   It was agreed that a separate meeting on this topic was needed to address some of these issues.
TULIP-related Issues:  Concerns were expressed about challenges accessing TULIP, completing the application and receiving timely and productive assistance from TULIP.  We were told to submit concerns to Stephanie Allred and, depending on the issue, Ms. Allred or her team would address, or Ms. Allred would escalate to TULIP Support:  Ms. Allred may be reached at:  Stephanie.Allred@hhs.texas.gov

ISS FAQs and Upcoming Webinars:

Last Friday HHSC posted updated FAQs for the new service. Read the FAQ here.

On January 26, 2023, from 9:00 to 10:30 HHSC will conduct its quarterly LTC webinar which will focus on ISS.  To register for the webinar, go to:  https://register.gotowebinar.com/register/5204373791714060639


January 12th, 2023

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

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

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

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

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

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

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

IL-2023-03


January 3rd, 2023

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

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

HHSC Bulletin:

Effective Jan. 1, 2023, HHSC adopts new Individualized Skills and Socialization rules for providers who want to deliver individualized skills and socialization services. New rules provide guidance regarding:

  • applying for an Individualized Skills and Socialization license;
  • provider requirements; and
  • HHSC survey and enforcement actions.

Read the new rules in Title 26 of the Texas Administrative Code, Chapter 559, Subchapter H.

HHSC also published Provider Letter 2023-01 New Regulatory Rules for Long-term Care Regulation (LTCR) Individualized Skills and Socialization Services. This PL provides guidance to Individualized Skills and Socialization providers about the new rules.

Read PL 2023-01.


December 23rd, 2022

NEW RULES FOR ISS & ISS LICENSE

The Individualized Skills and Socialization rules are now published.
See below for the link and pages on which the rules begin for DBMB. TxHmL and HCS, as well as the license rules.
Note:  The other set of rule changes (i.e., changes being made to align with the other federal HCBS Settings rule) have not yet been published as adopted.
To view the rules, click on the following link and then scroll to the pages presented below for each program.
DBMD:  Adopted rules start on page 157 of the pdf
TxHmL:  Adopted rules start on page 164 of the pdf
HCS: Adopted rules start at bottom of page 174 of the pdf (actual rules begin at top of page 175)
License Rules:  Adopted rules start on page 188 of the pdf

December 18th, 2022

HHSC Adds Individualized Skills and Socialization to Email and Text Updates

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

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

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


November 28th, 2022

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

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

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

Register for the webinar: Licensing Process Webinar


November 19th, 2022

DAHS ISS Licensing Application Available!

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

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

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

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


October 13th, 2022

Licensing Application Process For ISS:  

* HHSC will conduct a TULIP Navigation training webinar in the near future to assist providers in how to use TULIP.
HHSC has stated that the application will look very much like the DAHS application with certain sections marked as not necessary for an ISS application and several new ISS-specific questions/sections added.
-The Information Letter (IL) related to potential prohibitive settings/locations for an ISS setting/location should be published soon.
This letter will include instructions for providers which believe their ISS setting/location will need to undergo the heightened scrutiny process to contact HHSC.  HHSC will, in turn, conduct a review which will also have to be approved by CMS.  If approved, the prospective ISS provider may proceed with the license application process. 
The application will include questions that request verification that approval was secured.
-HHSC has stated that a directory of all licensed providers will be available for providers to confirm the license status of ISS providers.
*If an application is completely and correctly filled out, the provider will receive a temporary license (good for 180 days) until HHSC surveys the site/location.
The effective date of one’s license will be the date the temporary license is issued.
*The license fee will be paid via the Texas.gov process/portal.
-Community centers will be required to pay the license fee if they apply for an ISS license.

October 2nd, 2022

Register for Individualized Skills and Socialization Provider Portal Trainings

Individualized Skills and Socialization Provider applicants are required to complete HHSC Individualized Skills and Socialization Provider Trainings. Below are two computer-based trainings, which will assist Individualized Skills and Socialization Providers with applying for a license and preparing for an inspection.

  • Prelicensure Training for Individualized Skills and Socialization Providers
    This training was designed for providers who wish to offer individualized skills and socialization services. Prior to surveys or inspection, an entity must submit an application for a Day Activity and Health Services license. Information about the requirements to obtain a license will be shared. Register for the training.
  • Preparing for an Inspection
    This training was designed to assist Individualized Skills and Socialization Providers to prepare for an inspection. In this course, information about the inspection process and licensure rules will be shared. Register for the training.

Email questions to LTCR Policy.


September 24th, 2022

HHSC Moved The Individualized Skills and Socialization Webpage

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

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


August 23rd, 2022

No Public Hearing on ISS Licensing Rules

There is no scheduled public hearing on the proposed license rules for the new ISS service. However, providers can submit written comments on the proposed license rules.
Written comments on the proposal may be submitted to:
HHSC Long-term Care Regulation Policy and Rules,
Mail Code E-370, 701 W. 51st Street, Austin, Texas 78751,
Or you may email them to:

Comments must be submitted no later than 31 days after the date the rules were published in the Texas Register; i.e., 31 days after August 12, 2022.. Comments must be (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered before 5:00 p.m. on the last working day of the comment period; or (3) emailed before midnight on the last day of the comment period. If the last day to submit comments falls on a holiday, comments must be postmarked, shipped, or emailed before midnight on the following business day to be accepted. When emailing comments, please indicate “Comments on Proposed Rule 22R050” in the subject line.


Public Hearing on ISS Program Rules

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

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


August 13th, 2022

Proposed Licensing Rules for Individualized Skills & Socialization (ISS)
The proposed rules governing the above-referenced rules were published in the Texas Register a few days ago.
See page 2 for instructions for submitting comments.  Interested stakeholders have 31 days from today to submit comments to HHSC.
FYI:  For those of you attending the PPAT (Private Provider’s Association of Texas) Conference,    HHSC is conducting a 2-hour session at PPAT’s conference on ISS.  This is session members and other interested stakeholders will not want to miss.  If you have not registered for the conference, please do so at:  https://www.ppat200.com/overviewregistration.html

August 8th, 2022
ISS Resources page

Texas HHSC has developed the Individualized Skills and Socialization Provider Portal, an online source of information 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.

Provider Communications


August 6th, 2022

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

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

Rule Review:  When reviewing the proposed HCS and TxHmL Individualized Skills and Socialization rules, note the following:
  • The anticipated adoption date is October, 2022 with an effective date of November 2022.  These dates also apply to the proposed rules for the DBMD waiver program.
  • Very few changes were made from comments HHSC received during the informal comment period earlier this year. Though we had been apprised of such before this positing, know that any comments you submitted during the informal comment period will need to be resubmitted.
  • Carefully review the introduction to the HCS and TxHmL rules on pages 1 -4, including the sections on Issues and Alternatives and Stakeholder Involvement on page 3.
  • Carefully review the preamble to the rules before reading the actual rules and pay attention to the sections on Impact to Small Businesses.
  • The proposed HCS and TxHmL rules are included in one document.  To help you navigate the document, the following is offered:
~  Introduction to the HCS and TxHmL proposed rules:  Pages 1-4.
~  Preamble to proposed TxHmL rules:   Pages 5-12;  Pages 10-11 contain statements about impact on small businesses.
~  Proposed TxHmL rules:  Pages 13-28.
~  Preamble to proposed HCS rules:  Pages 29 – 36;  Page 34 addresses impact on small businesses.
~  Proposed HCS rules:  Pages 37 – 52

HCS/TxHML: /TMHP Recoupment, Due To Overpayment

January 15th, 2023

TMHP Recoupment Letters

Recoupment Letters:   Upon request, TMHP will send a list of affected/over-paid claims to providers.
Providers who experience any issues receiving the list should contact Marie Redman at HHSC (marie.redman@hhs.texas.gov).
HHSC urges providers to keep their ticket numbersWhy? Because the calls are recorded, and if there’s an issue, the ticket number allows HHSC to listen to the call associated with the ticket number.  This is just one of the numerous ways for HHSC to monitor TMHP for compliance.  That said, please keep a list of ticket numbers by date and brief notation of purpose of your call.
When asked if there could be an extension in adjusting the affected claims, HHSC replied no extension will be granted.

December 12th, 2022

Avoiding HCS and TxHmL Overpayment of Services

Effective Jan. 2, 2023, Texas Medicaid and Healthcare Partnership (TMHP) will perform monthly calculations on services for the Individual Plan of Care that overlaps the May 1, 2022 implementation of the new process for submitting Home and Community-based Services and Texas Home Living forms and claims.

On a quarterly basis, TMHP will calculate all services that have been paid through Client Assignment and Registration System and TMHP and will recoup services that exceed the authorized IPC amount.

Read the full alert.

On-Site Assessments of HCS Group Homes & Certain HH Settings From CMS

January 15th, 2023

Help With The New Residential Agreements

Concerning the on-site assessments, HHSC plans to help providers with the soon-to-be required residential agreements.
According to HHSC, the assistance is to ensure providers’ agreements meet the minimum requirements of the rule.  There was no elaboration of the type help to be offered other than HHSC will reach out to each provider.
HHSC further stated that an Information Letter would soon be posted directing providers to initiate contact with the LIDDA SCs should an individual’s PDP need to be changed related to the operable lock on bedroom doors and access to food requirements.  These would be referred to as “modifications”.
Example of need for modification: John’s LAR does not want him to have an operable lock with access to it on his bedroom door, as she feels he is too low functioning to keep track of a key, or remember the combination, and she also has concerns about his ability to get out of his room if it is locked on the inside and there is a fire or medical emergency, where staff may not get in in time or do not realize in time that John is in distress.  He is also non-verbal and can’t communicate easily when he is in distress.

October 13th, 2022
Visits are being made at this time to group homes and select Host Homes.  These are not part of HHSC’s residential review process, and the provider will not be receiving any violations/citing providers during these assessments, according to HHSC. 
**They will have the HCS provider complete a “plan of action” if corrections are required, and the corrections and probable dates of completion must be in the “plan of action”. 
 HHSC reiterated that compliance is not expected at this time, particularly since the rules have yet to be adopted.  According to HHSC, these assessments are just an information-gathering project at this time. The plan of action will be done to get the provider ready for compliance.
 On-site assessments of the group homes have already started with assessments of certain HH Settings starting next week.  For more details, see IL 2022-49,
They will be looking for 3 main things:
-An individual has a lease agreement with the provider that provides protections against eviction that tenants have under the landlord/tenant laws of the state.
-An individual’s bedroom door is lockable by the individual, with only appropriate staff having keys to doors.
– An individual has access to food at any time.
(Providers are encouraged to make these adjustments now and adjustments to R&B agreements now to ensure smooth transition)
They will only be looking at host home settings where the HH/CC provider is not a parent or family member of any of the individuals in the home.
**They will be looking at your residential agreements, but these do not have to be maintained in each group home.  They should only be asking the provider for a copy of the agreement – not state that it was a requirement for the agreements to be in the homes.
**Providers are encouraged to let HHSC know of any other misinformation being shared with providers by surveyors during the on-site assessments.

TMHP: HCS and TxHmL Waiver Programs: Trending Issue Support

 

January 14th, 2023

HCS and TxHmL Waiver Programs:  Trending Issue Support, Volume 15


December 16th, 2022

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 13

Since May 2, Home and Community-based Services and Texas Home Living program providers, local intellectual and developmental disability authorities, and financial management services agencies billing on behalf of Consumer-Directed services have been submitting claims and forms to the Texas Medicaid and Healthcare Partnership (TMHP).

TMHP has received feedback from providers and LIDDAs indicating additional support is needed. Resolutions regarding the most frequently reported issues may be found by reading the full alert.


November 20th, 2022

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 12

Since May 2, Home and Community-based Services and Texas Home Living program providers, local intellectual and developmental disability authorities, and financial management services agencies, billing on behalf of Consumer-Directed Services, have been submitting claims and forms to the Texas Medicaid and Healthcare Partnership (TMHP).

TMHP has received feedback from providers indicating additional support is needed. Resolutions regarding the most frequently reported issues may be found by reading the full alert.


October 17th, 2022

HCS and TxHmL Waiver Programs: Migration Trending Issue Support, Volume 10

-Portal Enhancements & 10/05/2022 Webinar Recording
All previous Trending Issue Support documents are also available at the link above as are other important notices and links to other migration-related resources.
Also, LTC on-line portal enhancements for HCS and TxHmL providers are coming soon.  For details go to: https://www.tmhp.com/news/2022-10-14-coming-soon-ltc-online-portal-enhancements-hcs-and-txhml-waiver-programs
The recording of the first TMHP and HHSC migration webinar can be accessed at:  https://attendee.gotowebinar.com/recording/8539536703755804930

October 7th, 2022

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 9

Since May 2, Home and Community-based Services and Texas Home Living program providers, local intellectual and developmental disability authorities, and financial management services agencies, billing on behalf of Consumer-Directed Services, have been submitting claims and forms to the Texas Medicaid and Healthcare Partnership.

TMHP has received feedback from providers indicating additional support is needed. Resolutions regarding the most frequently reported issues may be found by reading the full alert

 

-Preventing claim denials for invalid date spans

Claims billed with date spans may deny with one of the following explanations of benefits (EOBs):

F0126: Claim line items cannot span current fiscal years.

The new state fiscal year (SFY) runs from September 1, 2022, through August 31, 2023. Claims will be denied with EOB F0126 if they are submitted with line item dates of service (DOS) spanning the previous SFY ending August 31, 2022, and the current SFY. Providers and LIDDAs submitting claims with DOS spanning the previous and current SFYs should submit separate claims for each SFY.

F0326: Incorrect number of days billed for this service.

Services that only allow billing for individual DOS may be denied with EOB F0326 if they are billed with date spans. These services should be billed as separate line items for each service date.

 


September 11th, 2022

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 8

-Termination Forms Submitted by LIDDAs

For clients who have CDS services only, termination forms are submitted by LIDDAs. After form submission, LIDDAs need to contact HHSC Program & Eligibility Support (PES) to acknowledge and review the forms. LIDDAs can contact HHCS PES by calling 512-438-2484, faxing 512-438-4249, or emailing enrollmenttransferdischargeinfo@hhs.texas.gov.

Read more on the following items:

Long-Term Care Online Portal Sessions Must Be Restarted Daily

Using the “Resubmit to SAS” Button

Access to Electronic R&S and PDF R&S Reports

 


August 31st, 2022

Migration Trending Issue Support Vol 7:  

Please see the most current resolutions to migration issues at the link below.
Dual Entry into CARE & TMHP Systems:  Though previously sent to members, please review if you have not already:  https://www.tmhp.com/news/2022-08-25-reminder-about-dual-entry-care-and-tmhp-systems

August 16th, 2022

HCS and TxHmL Waiver Programs:  Trending Issue Support Volume 6

Individual’s residential address in Individual Search

“Pending LA Review” status and action needed

Using the correct IMT Form to update the service coordinator (SC)

HCS and TxHmL call queue

For  info on these trending issues see the following link:

https://www.tmhp.com/news/2022-08-16-hcs-and-txhml-waiver-programs-trending-issue-support-volume-6


August 13th, 2022

HCS and TxHmL Waiver Programs: Trending Issue Support  Volume 5

Since May 2, 2022, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers, local intellectual and developmental disability authorities (LIDDAs), and financial management services agencies (FMSAs) that bill on behalf of consumer-directed services (CDS) have been submitting claims and forms to Texas Medicaid & Healthcare Partnership (TMHP). TMHP has received feedback from providers indicating that additional support is required.

Here are the latest resolutions to trending issues below:

HCS and TxHmL Call Queue

Status:  When contacting TMHP, providers need to select option 1 then option 7 to enter the HCS and TxHmL Waiver Programs queue.  The full number is 800-626-4117, Option 1, then Option 7.

Location Code Issue

Resolution:  LIDDAs submitting Individual Plan of Care (IPC) transfers for clients were receiving incorrect location codes. This issue has been resolved. Providers that received an incorrect location code need to resubmit the IPC transfer.


See previous Volumes and info below:

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 4

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 3

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 2

HCS and TxHmL Waiver Programs: Trending Issue Support

Important Claims Submission Information for HCS and TxHmL Programs

LTC Online Portal Dashboard Accessibility Issue Resolved

IPC Forms 3608 and 8582 Issue Resolved

HCS and TxHmL FAQ Updates Available May 9, 2022, and May 23, 2022

Individual Plan of Care (IPC) Training Materials for HCS and TxHmL Waiver Programs

Now Available: HCS and TxHmL Programs Forms and Claims Submissions to TMHP

EVV Updates for the HCS and TxHmL Transition to TMHP for Claims Submission

 


June 1st, 2002

Resolutions to the most frequently reported issues may be found at the following link for TMHP issues concerning entering IPC’s, dual entry into CARE, submitting claims, and more:   “Trending Issue Support” Table

 

In addition, please see helpful links below including recent HCS/TxHmL FAQ’s in May of 2022.

View previous postings:

Initial Critical Incident Management Services (CIMS) User Account Email

January 14th, 2023

Have You Signed Up For CIMS (Critical Incident Management System)Yet? 

There are still quite a few providers who have not done so.  HCS & TxHmL providers please do so right away.
TMHP has stated that FEI Systems sent emails to required users who had yet to log into CIMS.  Some providers have indicated that they did not receive an email.  According to HHSC FEI Systems did send emails out using a DONOTREPLY/FEI email address.  If you did not receive this email, please check your spam mailbox.
If you did not receive it, email the CIMS mailbox for assistance at: MCS_CIMS@hhs.texas.gov

August 31st, 2022

Initial CIMS User Account Email

On Monday, Aug. 29, FEI Systems sent another mass email to Critical Incident Management System (CIMS) users who have not logged into CIMS. It will provide your user ID and temporary password. The temporary password in the email will expire after seven days.

This applies to:

  • Community Living Assistance and Support Services providers and case management agencies
  • Deaf Blind with Multiple Disabilities providers
  • Home and Community-based Services providers
  • Texas Home Living providers
  • Local intellectual and developmental disability authorities

Please do not delay logging into your organization’s CIMS account. The account creation email will come from FEI Systems.

Providers are required to begin entering critical incidents into CIMS by Nov. 1. HHSC strongly encourages providers to become familiar with the system as soon as possible.

ISS (Individual Socialized Services) FAQ’s

January 13th, 2023

ISS FAQs:  Updated January 13th, 2023

HHSC posted updated FAQs for the new service. Read the FAQ here.

August 23rd, 2022

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

For further questions, contact:

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

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

AAIDD Texas Chapter: Link To Follow Bills During The Texas 88th Legislative Session

January 12th, 2022

From our good friends at the Texas Chapter of AAIDD, some important info about the Texas 88th Legislative Session

See actual TAAIDD link  

Dion White, Center for Life Resources
AAIDD Texas Chapter Board Member

“Texas is home to more than 500,000 adults and children with intellectual and developmental disabilities (IDD). This legislative session will be very important to address specific changes happening within the IDD systems of care across the State.

Our system of care specific to IDD is currently undergoing changes in its service delivery system. One aspect of this change deals with a transition of IDD long term services and supports going from a traditional Medicaid model to a managed care model. Currently there are plans to pilot test this transition starting in September 2023. This is major change because  it may impact the monitoring role of targeted case management. Through targeted case management, services are monitored to insure continuity over time. Currently the IDD local authorities are providing the TCM service.

As Texas continues to grow there is a concern if the entire system of care across the State will grow to meet the increased need of services.  Many providers are also dealing with staffing shortages across the State which is making the situation much more difficult.  There is a possibility this will be addressed either directly or indirectly during this session.

During this session there will be a-lot of discussion on addressing the IDD population in regard to the new programs starting such as Individualized Skills and Socialization services.  The session started on January 10 and will end on May 29th.   I encourage all stakeholders to follow legislation specific to IDD services and supports and contact your designated legislator with any concerns you may have. “

A good resource to follow bills online can be found at this link, https://capitol.texas.gov.

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

January 12th, 2023

 January 12 Texas Medicaid CHIP COVID-19 Information Session.

These sessions will continue to share information with stakeholders about the implementation of various Medicaid/CHIP flexibilities in response to the COVID-19 pandemic.

 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 1st, 2022

December 1 Texas Medicaid CHIP COVID-19 Information Session.

These sessions will continue to share information with stakeholders about the implementation of various Medicaid/CHIP flexibilities in response to the COVID-19 pandemic.

 

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.


November 8th, 2022

Medicaid and CHIP Services Has Updated Its Process of Sending Monthly COVID-19 Updates

In the past, these updates were sent via an email from Outlook. Beginning with the December update, the MCS COVID-19 Stakeholder Update will be sent via GovDelivery.

If you wish to be removed from the MCS COVID-19 Stakeholder Update distribution list and not receive anymore alerts, please reply with “OPT OUT”.

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


Sept. 7th, 2022

 September 1 Texas Medicaid CHIP COVID-19 Information Session

These sessions will continue to share information with stakeholders about the implementation of various Medicaid/CHIP flexibilities in response to the COVID-19 pandemic.

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 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.

Employment Assistance & Supported Employment Training Options From HHSC

Employment Assistance & Supported Employment Training Options From HHSC

 

January 12th, 2022

Please see notice below from Monty Chamberlain, HHSC.

“HHSC is pleased to announce the delivery of in-person Employment First / Employment Services training for the first time since 2019.  This free one-day training opportunity has proven to be a very valuable opportunity to various levels of staff involved in the support of individuals who set the goal of competitive and integrated employment in the community.  Various staff from the Local Authority, along with private providers in the area, as well as stakeholder groups will benefit from this training.

With the very high turnover rates the last several years, this training provides the opportunity to garner a basic understanding of Employment First, Employment Services, Benefits and Work Incentives, Job Coaching, Employment Readiness Skills, and Employer Relationships.  Service Coordinators will benefit tremendously from this training as they serve as the first line in service planning.  Additionally, a myriad of staff such as social workers, employment support staff, direct service staff, case managers, Qualified Intellectual Disability Professionals (QIDP), management staff and many others have found this training valuable. In short, anyone who has a role in supporting an individual directly or indirectly will benefit from the training.

This training will be offered at numerous locations in the state from February thru August 2023.  We are pleased to advise that the first two events will be in Houston on February 7th and 8th.  Each day will cover the same training, thus only one day should be chosen when registering. 

Training will be held at the Harris Center 9401 Southwest Freeway, Houston, Texas 77074 in Conference Room 104, 9am to 4pm.  Each event will have a max attendance limit of 70 people.  Thus, moving quickly to register will be important.  Please help us in getting the word out to your staff as well as sharing with others outside of your organization who can benefit.  Registration is easy. Registrants can use one of the two links below based on the best date for the registrant.”

Houston 02/07/23 Registration

Houston 02/08/23 Registration

Thank you and we look forward to seeing everyone on February 7th or February 8th!


August 1st, 2021

Live HHSC Training Workshop!

HHSC is announcing a free, one-day Employment First / Employment Services Training event to be offered in six cities from September 2021 thru December 2021. Employment promotes a more independent living setting and creates independence for a person in many ways. This training is another tool to increase the Employment First focus and provide better tools for providers to improve hands-on skills and increase job opportunities for people with intellectual and developmental disabilities.

Training includes:

·         Overview of Texas Employment First Policy

·         Employment services in Medicaid waivers

·         Basic facts on Social Security Administration disability benefits

·         Basic facts on developing an employment profile and vocational assessment

·         Building connections and working with families

·         Development of soft skills and job-readiness skills

·         Basic overview of applications and tablets for use as job coaches

·         Building and maintaining strong employer relationships

The training is specifically designed for any staff member who has a role in supporting people who set employment goals or people with direct, hands-on roles such as service coordinators, employment specialists, direct care staff, day habilitation staffjob coaches, supervisors and others who support individuals as they pursue competitive and integrated employment.

 

Registration Links for each event as follows:

*September 8, 2021 – Lubbock – MGM Elegante (801 Avenue Q, Lubbock, TX 79401)

https://survey.alchemer.com/s3/6395966/Registration-for-Employment-First-Training-Lubbock-TX-September-8-2021

*September 29, 2021 – Austin – Norris Conference Center (2525 W Anderson Ln #365, Austin, TX 78757)

https://survey.alchemer.com/s3/6395977/Registration-for-Employment-First-Training-Austin-TX-September-29-2021

*October 13, 2021 – McAllen – Cambria Hotel McAllen Convention Center (701 South Ware Road, McAllen, TX, 78501)

https://survey.alchemer.com/s3/6396028/Registration-for-Employment-First-Training-McAllen-TX-October-13-2021

*November 4, 2021 – San Antonio – Norris Conference Center (618 Northwest Loop 410 STE 207, San Antonio, TX 78216)

https://survey.alchemer.com/s3/6395989/Registration-for-Employment-First-Training-San-Antonio-TX-November-4-2021

*November 17, 2021 – Corpus Christi – Region 2 Education Center (209 N Water St, Corpus Christi, TX 78401)

https://survey.alchemer.com/s3/6396009/Registration-for-Employment-First-Training-Corpus-Christi-TX-November-17-2021

*December 1, 2021 – El Paso – Region 19 Education Center, (6611 Boeing Dr., El Paso, TX 79925)

https://survey.alchemer.com/s3/6396724/Registration-for-Employment-First-Training-El-Paso-TX-December-1-2021

Each event is limited to a maximum of 45 registrants.  HHSC highly encourages everyone to register early to make certain a space is reserved. HHSC will also offer a waiting list after they reach the maximum capacity for any event, which will be identified to anyone attempting to register once a given event is full.  Those on the waiting list will be contacted in the order received if they are notified of a cancellation.


 

June 28th, 2021

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

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

Each training has a corresponding quiz.

 

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

EVV (Electronic Visit Verification) Updates

January 12th, 2023

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

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

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

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

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

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

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

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

IL-2023-03


January 2nd, 2023

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

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

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

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

HHSC will continue posting related updates.

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

For other EVV questions, email the EVV Operations inbox.

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


December 17th, 2022

EVV Training Updates

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

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

  • Español – EVV Compliance for CDS Employers (PDF) – Aug. 25 non-required training webinar
  • Annual EVV Policy Training for Program Providers and FMSAs – Sept. 30 and Oct. 27 webinars

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

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

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

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

Email EVV Operations for questions.


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

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

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


EVV Guidance on Program and Service Requirements for Schedules

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

Email HHSC EVV Operations for questions.


December 1st, 2022

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

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

  • STAR+PLUS
  • STAR Kids
  • STAR Health

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

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


December 1st, 2022

HCS and TxHmL Updates

The effective dates were updated for HCS and TxHmL services.

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

For questions, email EVV Operations.


October 16th, 2022

Potential Electronic Visit Verification Changes Coming in 2023

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

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

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

Notification of contract award is anticipated in March 2023.

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

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

Email questions about this solicitation to Andrick Reese.


September 25th, 2022

EVV Updates for HCS and TxHmL Program Providers and FMSAs

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

HHSC Notice

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

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

TMHP Notice

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

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

Email EVV Operations for questions.


September 25th, 2022

EVV Claims Matching Refresher for HCS and TxHmL

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

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

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

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

Click here for more information


September 18th, 2022

EVV Compliance Job Aids Updated

The Electronic Visit Verification Compliance Job Aids have been updated. They are in the compliance section on the EVV web page.

The job aids were simplified and provide updated information about the following EVV Compliance standards:

  • EVV Usage Scores and reviews
  • Required free text reviews
  • Landline phone verification reviews

August 31st, 2022

Annual EVV Policy Webinars for Program Providers & FMSAs

To view information about the upcoming webinars (September 30th and October 27th) and how to register go to:  https://www.tmhp.com/news/2022-08-30-annual-evv-policy-training-webinars-program-providers-and-fmsas
Both of the above-referenced webinars will cover the same information.  Information about the annual EVV policy webinars for CDS employers will be posted soon.

July 28th, 2022

EVV Portal and Training Updates

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

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

Email questions to TMHP.


July 5th, 2022

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

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

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

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

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

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

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

Email EVV Operations for questions.


July 1st, 2022

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

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

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

Email EVV Operations for questions.


June 12th, 2022

EVV Portal and Training Updates

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

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

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

Email questions to TMHP.


June 6th, 2022

EVV Policy Handbook Revision and Training Updates

The Electronic Visit Verification Policy Handbook has been revised.

Revisions include:

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

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

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

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

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

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

Email HHSC EVV Operations for questions about this notice.


May 30th, 2022

EVV Claims Matching for HCS and TxHmL Will Resume July 1

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

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

Email EVV Operations for questions about this notice.


May 8th, 2022

EVV Portal and Training Updates

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

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

Email TMHP EVV Operations with questions


March 7th, 2022

EVV Notice for HCS/TxHmL Program Providers

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

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

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

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

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

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

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


March 3rd, 2022

EVV Policy Handbook Revisions Now Available

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

The handbook includes EVV standards and policy requirements for:

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

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

Email HHSC EVV Operations with questions.


February 28th, 2022

EVV Portal and Training Updates

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

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

For questions, email TMHP EVV Operations.


January 8th, 2022

EVV Policy Handbook Revisions – Jan. 7th, 2022

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

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

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

For questions, email HHSC EVV Operations.


November 21st, 2021

EVV Portal and Training Updates for November 2021

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

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

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

Email TMHP with questions about these updates.


November 18th, 2021

Revised EVV Policy Handbook Now Available

The Electronic Visit Verification Policy Handbook was revised.

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

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

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

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

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

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

Email questions to HHSC EVV Operations.


November 17th, 2021

EVV Visit Maintenance Unlock Request Updates

HHSC published EVV Visit Maintenance Unlock Request spreadsheet updates.

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

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

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

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

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

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

    Review the instructions on the spreadsheets for more information.

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


July 4th, 2021

EVV Visit Maintenance Policy Now Available

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

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

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


July 4th, 2021

HHSC EVV Webpage Updates Now Available

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

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

Public Health Emergency (PHE) Renewed

January 11th, 2023

 

RENEWAL OF DETERMINATION THAT A PUBLIC HEALTH EMERGENCY EXISTS

 

“As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19)  pandemic, on this date and after consultation with public health officials as necessary, I, Xavier Becerra, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective January 11, 2023, the January 31, 2020, determination by former Secretary Alex M. Azar II, that he previously renewed on April 21, 2020, July 23, 2020, October 2, 2020, and January 7, 2021, and that I renewed on April 15, 2021, July 19, 2021, October 15, 2021, January 14, 2022, April 12, 2022, July 15, 2022, and October 13, 2022, that a public health emergency exists and has existed since January 27, 2020, nationwide.”

From the HHSC ASPR website page, this is the alert concerning continuing PHE.  At this time we have no further information on how long this will be ongoing.

https://aspr.hhs.gov/legal/PHE/Pages/covid19-11Jan23.aspx

ISS Rates

January 11th, 2023

 Revised Information Letter (IL) 2023-01 related to ISS Payment Rates (replaces IL 2022-56):  

HHSC has published Revised Information Letter (IL) 2023-01, which replaces 2022-56 related to payment rates for Individualized Skills and Socialization Services, effective January 1, 2023.

HHSC has also approved payment rates for the Individualized Skills and Socialization in the Deaf Blind with Multiple Disabilities waiver (DBMD), Home and Community-based Services waiver (HCS), and Texas Home Living waiver (TxHmL) programs, effective January 1, 2023.

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

HCS Rates Jan. 1st, 2023 including ISS services


December 06, 2022

Last Friday HHSC posted the ISS rates which may be viewed at the link below.

Please remember the following:
  • The on and off-site ISS rates are effective January 1, 2023. It appears to be unlikely any of the licenses for ISS will be approved by that time.
  • The current in and out-of home DH rates will remain effective through February 28, 2023.
  • ACRE will not be available for the ISS service.
  • This is because the current DH rate is a daily rate; the ISS rate is an hourly rate. 
  • Restructuring this component of ACRE will necessitate additional funds which HHSC will be requesting from the 88th Texas Legislature. Unfortunately, once received access to funds will not be available until September 1, 2023 and which providers choosing to participate in ACRE can request during the July, 2023 enrollment period.
  • Though the ISS rules have yet to be adopted (hopefully by no later than December 16th), the proposed rules allow persons with a medical or behavioral justification to receive in-home ISS.
  • proposed rules also state that if requested, a person who is 55 or older may also receive in-home ISS. 
  •  The provider of the in-home ISS service does not need to be a licensed ISS provider.
  • Note:  As proposed, the rules do not address whether persons with the aforementioned justification or request can also participate in community activities and bill for off-site ISS.  Though assumed this will not be permitted, we are still waiting for a response.
  • The off-site rates allow for two levels of enhanced staffing.  Though the proposed rules did not call for two levels of enhanced staffing, the adopted rules will.
  • The adopted rules will also change the ratios at least for the ‘LON 1 and LON 5 without enhanced staffing’ category.

September 27th, 2022

Please see the newly proposed ISS (Individualized Skills & Socialization) rates.  The proposed rates would be effective January 1st, 2023, if accepted, at the following link:  https://pfd.hhs.texas.gov/sites/rad/files/documents/2023/01-01-2023-pmnt-rates-individualized-skills-socialization-%20srvcs.pdf

Hearing:
The Texas Health and Human Services Commission (HHSC) will conduct an in-person public hearing to receive public comment on proposed Medicaid payment rates from 9:00 a.m. to 11:00 a.m. on October 11, 2022. The public hearing will be held in the Robert D. Moreton Building, Public Hearing Room M-100, First Floor, at 1100 West 49th Street, Austin, Texas 78751. Free parking is available in front of the building and in the adjacent parking garage. HHSC will consider feedback shared during the hearing prior to final rate approval. The hearing will be held in compliance with Texas Human Resources Code Section 32.0282, which requires public notice of hearings on proposed Medicaid reimbursements.
Should you have any questions regarding the information in this document, please contact: Provider Finance Department Long-Term Services and Supports Texas Health and Human Services Commission
E-mail: PFD-LTSS@hhs.texas.govHHSC will archive the recorded public hearing.

The recording can be accessed on-demand after the hearing at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings.

For HCS/TxHmL programs, HHSC is proposing rates that will vary by an individual’s Level of Need (LON). HHSC is also proposing a Level One Enhanced Staffing Rate and Level Two Enhanced Staffing Rate for off-site individualized skills and socialization. The Level One Enhanced Staffing Rate for off-site individualized skills and socialization is for certain individuals with LON 1 or LON 5 who need additional supports while in the community. The Level Two Enhanced Staffing Rate is for certain individuals with a LON 1, LON 5, LON 8, or LON 6 in the HCS Program, and any individual in the TxHmL Program regardless of LON who need additional staffing supports than supported by the Level One Enhanced Staffing Rate off-site for individualized skills and socialization.
*All proposed individualized skills and socialization rates are per hour.

STATUS OF HCS RATES!

Status of HCS Rates as of Jan. 1st, 2023 (includes new ISS rates)

HCS Rates Jan. 1st, 2023 including ISS services


Status of HCS Rates as of June 3rd  2022

Provider Rate Updates for HCS and TxHmL Providers

In early May, HHSC identified missing or incorrect rate keys for some Home and Community-based Services and Texas Home Living providers.

On May 11–12, HHSC completed updates to rate keys for these HCS and TxHmL providers based on rates published on the Provider Finance website.

Read the full alert.

After confirming rates with Provider Finance and paid claims on the R&S Report, contact the TMHP LTC Help Desk at 800-626-4117, Option 1, then Option 7, if you have additional questions.

https://pfd.hhs.texas.gov/sites/rad/files/documents/long-term-svcs/2022/2022-hcs-awards.pdf


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.

 

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.

Free Provider Resource Webinar Series

Free Webinars!!

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

January 2023 Webinars

 

Core-VA Solutions “Virtual Healthcare Assistants For LTC Programs”

Virtual Healthcare Assistants Services and Training for Long-Term Care Programs, including HCS, TxHmL, and ICF

Free Webinar Series Hosted By: Twogether Consulting (1/10/22 from noon-1pm)

 

Pre-Registration is required, click on the “Registration” button below to attend this free webinar and complete pre-survey questions!!

REGISTRATION

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

 

 

Twogether Consulting is happy to have Brittney Russo-COO (Chief Operations Officer) from Core-VA Solutions to discuss her company’s “virtual assistant” services.
Core-VA Solutions provides virtual assistance for any type of long-term healthcare setting, whether it be for a small medical office or therapy office or HCS provider. All of our virtual assistants have a degree in nursing and/or health-related fields.

Core-VA is able to serve clients all over Texas and beyond. Some of the clients these virtual assistants work with are those in HCS, TxHmL, and also other IDD programs. This includes assisting with EVV and TMHP billing. Brittney’s team is able to provide appropriate training to her staff to cater to some of your specific needs, including persons with experience in the HCS/TxHmL programs providing some of that training and the IT solutions which they can learn to use using IT fundamentals here to learn for this. They have “virtual assistants” versed in the use of quite a few electronic health records software such as Taskmaster Pro, Focus, and other EHR and billing software. This is a wonderful resource for HCS/TxHmL providers for sure! This is especially true for some of you, who are brand-new HCS/TxHmL providers. Core-VA serves many different clients in other lines of Long-Term Health Services, but it is so nice to have help from a virtual assistant who understands the world of HCS/TxHmL!

-Core-VA team Solutions is part of our free webinar series for the month of January 2023!  Click on their postcard below for more information.  Services are available at $10/hr and no contracts.

core va post card

“Core-VA Solutions aims to positively change how your long-term healthcare facility operates with our virtual assistants with degrees in nursing and/or health-related fields. We understand that you may currently waste precious time and money completing tedious tasks such as medical reception, appointment scheduling, insurance authorization, receiving and submitting medical information, and so much more. Instead of hiring expensive employees to complete these much-needed tasks, hire our affordable virtual assistants instead, as we can provide you with the same level of service, at a fraction of the price. All you have to do is let us know how we can help, and our team will find the perfect assistant match for your facility!”

 

 “Support & Empowerment Program For Persons With IDD & Their Caregivers”

 

Twogether Consulting is happy to have Diana Chavarria from AACOG discuss an amazing program offered via a grant from TCDD (Texas Council For Developmental Disabilities).  This is a wonderful resource for IDD providers, Caregivers of persons with IDD and persons with IDD.  Dianne is part of our free webinar series for the month of January 2023!

Free Webinar Series Hosted By: Twogether Consulting (1/17/22 from noon-1pm)

Pre-Registration is required, click on the “Registration” button below to attend this free webinar and complete pre-survey questions!!

REGISTRATION

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

 

The Program Provides Support & Empowerment For Individuals and Their Caregivers Concerning The Following:
-General Health and Aging
-Aging With Specific Syndromes (i.e. Down Syndrome)
-Nutrition & Physical Fitness
-Financial Wellness
-Benefits and Employment
-Planning For The Future
-Mental Wellness
-Coping With A Diagnosis
-Crisis Management

 

 


Some Of Our Previously Recorded Free Webinars of Interest


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:

 

 

Letter From Twogether Consulting To Providers-January 2023 Update

January 1st, 2023

Update From Twogether Consulting!

     Happy New Year! 2022 was a pretty tough year personally for me and I know it has been difficult for many IDD providers as well.  Lots of new changes are coming in 2023, but let’s hope they will be for the better!
     So many changes are happening right now for LTC Providers, especially those in the HCS/TxHmL programs. HCS & Texas Billing Requirements were updated in 2022.  The Interpretive Guidance Booklet for HCS & TxHmL was released and hopefully has brought some clarity to survey team expectations.  ISS services will begin shortly and I hope to keep you up to date.  Don’t forget the new rules for ISS are now available and are on our “updates” post as well. Please remember the last day of billable Day Hab services will be Feb. 28th, 2023. We also expect to see a big change in the rules for HCS in the near future, so please be on the lookout.

 

The CIMS (Critical Incident Management Reporting System) is now in place as of Nov. 1st, 2023, so please let us know how this is going.  Current feedback from providers would imply that it is going well for those of you who have started using the reporting system.  We would encourage providers to take a look at the critical incident reporting form that your facility uses and ensure it captures elements that must be entered into CIMS monthly. Unfortunately, the transition from CARE to TMHP does not seem to have gone very well according to our provider feedback.  I would continue to encourage all providers for HCS and TxHmL to inform their provider associations (PPAT, PACSTX, etc..) and HHSC about their concerns.  Please continue to review the HCS & TxHmL Waiver Programs Trending Issues Volumes
put out regularly by TMHP, with recommendations and “fixes” as well as any current TMHP FAQ’s.

      2023 will also be a big 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 and expect to have some webinars in the near future for ICF including nursing.  We continue to provide requested on-site live training at this time and we will resume regular live training after March of 2023.
     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, 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. We do have some subcontracted persons that can help with these areas and we can recommend some other options as well, such as companies who can provide either software and/or billing services.  
FYI-We do still have “mentoring” assistance (especially great for new nurses) from our RN consultant on an as-needed basis.
     
     Twogether Consulting has a new IDD Consultant who has been with us since May of 2022, Sheila Hanson.  We are so happy to have Sheila join us.  She has been of great assistance with  POC’s (Plans of Correction)  and POR’s (Plans of Removal) for Immediate Threats/Jeopardy for HCS/TxHmL and ICF as well as Directive Inservice Training as needed. Sheila has also been helping us with survey prep and assisting providers ICAPs and ICAP scoring.  She is also an HCS provider herself in the San Antonio area, for the past 12 years or so and has been a much-needed member of the team this year.  We also want to thank Marcus Denman, who has been a member of our team for quite some time.  He continues to help us with so many needs of our providers.  Marcus has many years of experience in the HCS, TxHmL and ICF programs which is invaluable to Twogether Consulting. For many of you just starting out, he has been a  super resource for HR and New Hire practices, billing, budgeting, ppening a group home and staff training, etc…We would also like to give special thanks to our administrative assistant, Meghan Jones, without which I couldn’t function, lol. Many of you may know Meghan from registering for our classes and webinars. Meghan also assists me with the application process for many soon-to-be HCS & TxHmL providers.  Lastly, I would like to say our goodbyes to our dear departed colleague, Kim Littlejohn.  Kim worked for Twogether Consulting on and off over the years, primarily with HCS & TxHmL applicants and she assisted me with our conferences and workshops in the past. We recently lost Kim this December to cancer very suddenly.  She will be missed.
     
      Twogether Consulting will be posting more of our upcoming webinar classes for the rest of January and February very soon, 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 mid 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.  We also gladly accept Zelle.  You may just use our phone # for payment:  512-294-8032.  Please inform us before you do so, thanks.
5. 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”.
6.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.  

Currently, we do provide on-site (per request) and off-site training (webinars) but we are happy to announce that we have begun providing scheduled “live” training for small groups and on-site assistance to providers as well of course.  We hope to resume regular “live” sessions after March of 2023, so look for our website advertisements on social media-FB, Instagram, and Linkedin!

 

   

 Please see below for specific information for 2023 Services:

  • In-person group trainings/conferencesAvailable as requested. 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): 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, QIDP’s, 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:  Our current pricing will remain at $85/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.)  This will involve a formal contract
    • 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 as usually the time to complete them is limited and we are often booked already with appts. at such short notice, and most Regional Surveyors will accept a DIT via webinar, especially in these times. So please let us know.
  • Payments:  We prefer payment via Zelle or our PayPal Invoices, with Credit Card/Debit/ or PayPal or Venmo.  You are also welcome to pay via check,  e-check, or request to pay directly to 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

 

 

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

 

Starting Jan. 2023: New Application Process for the HCS and TXHML Waivers Contractors

Effective January 2023, the open enrollment application process to get a provisional contract to provide Home and Community-based Services (HCS) and Texas Home Living (TxHmL) services will change.

You must be enrolled as a Texas Medicaid provider through the Texas Medicaid & Healthcare Partnership (TMHP) Provider Enrollment System (PEMS) before applying.

To apply, you must complete the Provider Applicant Training (PAT). The PAT is now available on the HHS Learning Portal. Do not take the PAT if you aren’t applying for an HCS and TxHmL waiver contract.

  • You must get a score of 85% or higher to pass the exam. Lower scores will not be accepted.
  • After completing the PAT, you can apply using Form 5873 Waiver and Community-based Programs and Services. Your PAT exam certificate must be included with your application packet. Do not apply without a PAT exam certificate showing your passing score.

Mail Your Application to the Waiver Program Enrollment Team

Send to this address:

HHSC

Contract Administration and Provider Monitoring

Mail Code W-359 P.O. Box 149030

Austin, TX 78714-9030

Applicants can also submit applications by email: IDDWaiverContractEnrollment@hhsc.state.tx.us or fax: 512-206-3916.

More resources can be found on the HHSC website, including guidance on how to apply and manage your contracts. If you have any questions about the application process, please email us.

Expedited PPE Delivery for Long-Term Care Providers

January 2nd, 2023

HHSC published an alert on Dec. 21, 2022, informing long-term care providers that expedited delivery is available for a limited time for personal protective equipment through the Texas Division of Emergency Management.

This resource is available to all long-term care providers, including:

  • Nursing Facilities
  • Assisted Living Facilities
  • Intermediate Care Facilities
  • Home and Community-based Services
  • Home and Community Support Services Agencies, including Community Living Assistance and Support Services, Deaf Blind with Multiple Disabilities, and Medically Dependent Children Program
  • Texas Home Living
  • Prescribed Pediatric Extended Care Centers
  • Hospice
  • Day Activity Health Services

Long-term care providers who have a current need for these specific resources can submit requests by visiting star.tdem.texas.gov and selecting the “Expedited PPE” button. The generic passcode for the inventory listed above is: 112518.

Items are available on a first-come, first-served basis. This system is only to be used on a one-time basis for expedited PPE only. If a provider needs these resources, please include the amount needed in your request.

HCS & ICF Emergency & Disaster Preparation Updates

January 1st, 2023

LTC Winter and Extreme Freezing Weather Preparedness

HHSC encourages long-term care facilities and agencies to review and update emergency plans for freezing temperatures and snow. Emergency plans for extreme weather should include the provider’s plan to address:

  • Power loss
  • Water and food needs
  • Communication to families and staff
  • Staffing shortages
  • Sheltering in place and evacuation as applicable

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

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

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

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

 


May 26th, 2022

Guidance related to Emergency Preparedness- Exercise Exemption based on A Facility’s Activation of their Emergency Plan *** Revised to provide additional guidance and clarifications due to the ongoing COVID-19 public health emergency (PHE) REVISED 05.26.2022 ***

Memorandum Summary

• Emergency Preparedness Training and Testing Program Exemption -CMS regulations for Emergency Preparedness (EP) require facilities to conduct exercises to test the facility’s EP plan to ensure that it works and that staff are trained appropriately about their roles and the facility’s processes. During or after an actual emergency, the regulations allow for a one-year exemption from the requirement that the facility perform testing exercises.

• This worksheet presents guidance for surveyors, as well as providers and suppliers, with assessing a facility’s compliance with the EP requirements, in light of many of the response activities associated with the COVID-19 Public Health Emergency (PHE).

• As the PHE continues, many facilities continue to operate under their respective activated emergency plans. Therefore, CMS is providing additional guidance related to the exercise requirements (full-scale/functional drills and exercises) for inpatient and outpatient providers/suppliers.

• This exemption only applies to the next required full-scale exercise (not the exercise of choice), based on the facility’s 12-month exercise cycle. The cycle is determined by the facility (e.g. calendar, fiscal or another 12-month timeframe).

***All revisions are in red on this letter from CMS, click the link below for the complete document. 

Read more……

 


September 13th, 2021

Very Important Updates on Emergency & Disaster Preparedness During the Pandemic

Resources Listed Are From CMS & HHSC 

See Info For ICF Facilities Below

 

 

Life SafetyUpdated Guidance for Emergency Preparedness-Appendix Z of the State Operations Manual (SOM)

Emergency Preparedness Participant Workbook

 Interim Guidance for Hurricane Evacuation Transport to General Population Shelters during the COVID-19 Pandemic

Interim Guidance for General Population Disaster Shelters During the COVID-19 Pandemic

Screening Tool For COVID-19 During Pandemic For Arrival At General Population Shelters

 

“Moving Forward Together” 2022 Conference for ICF Surveyors and Providers- Dec. 1st, 2022

“Moving Forward Together” 2022 Conference for ICF Surveyors and Providers- Dec. 1st, 2022

Dec. 1 ICF Conference Recordings Available

The “Moving Forward Together” Intermediate Care Facilities Conference session recordings from Dec. 1 are available for viewing. Note that a certificate of completion will be generated upon completion, but no professional CE awards are available.

Listen to the ICF session recordings.

Email questions to LTCR Joint Training.

ICF COVID-19 Response & COVID-19 FAQs Retired By HHSC-Dec. 13th, 2022

December 18th, 2022

 HHSC Long-term Care (LTC) Regulation has retired the COVID-19 Response for ICF for Individuals with an Intellectual Disability or Related Conditions Response Plan and the ICF Frequently Asked Questions documents, effective Dec. 13, 2022.

Facilities can obtain guidance along with resources for infection prevention, control measures, and Personal Protective Equipment (PPE) through the Infection Prevention and Control Measures for Common Infections in LTC Facilities (PDF) and Infection Control Basics & Personal Protective Equipment for Essential Caregivers (PDF) documents published by HHSC.

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

Program providers may reach out to LTCR Policy with questions at LTCRPolicy@hhs.texas.gov.

ICF/IID Updates

December 15th, 2022

ICF Resources

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


September 25th, 2022

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

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

The letter provides guidelines to assisted living facilities,

intermediate care facilities for individuals with an intellectual

disability or related conditions, and nursing facilities about

the amelioration of administrative penalties assessed for state licensure

violations.

Read the provider letter details.


June 12th, 2022

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

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

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

The following rules expired June 6:

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

Here is a copy of the previous rule that expired:

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

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

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

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

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

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

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

Email questions to LTCR Policy.


April 29th, 2022

ICF Visitation Rules Update

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

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


April 10th, 2022

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

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

The revised rule:

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

April 10th, 2022

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

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

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

– New Requirements for Infection Prevention and Control Policies and Procedures

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

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

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

-ANE & Incident definitions

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

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


April 6th, 2022

COVID Screening in ICF’s

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

.ICFs must screen individuals:

•upon admission or readmission to the facility; and

•at least once a day.

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

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

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

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

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

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

Screening Criteria:

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

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

•other signs or symptoms of COVID-19, including

-chills,

-new or worsening cough,

-shortness of breath or difficulty breathing,

-fatigue,

-muscle or body aches,

-headache,

-new loss of taste or smell,

-sore throat,

-congestion or runny nose,

-nausea or vomiting,

-or diarrhea;

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

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

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


April 6th, 2022

Reporting Confirmed Case of  COVID-19 in ICF/IID

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

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

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


April 6th, 2022

COVID-19 Mitigation and Response Emergency Rule Updated

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

It became effective April 6, 2022.

The revised rule:

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

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

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

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


February 27th, 2022

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

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

Key changes to the rule are to:

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

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

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

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

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

Listen to the webinar recording.

Email LTCR Policy for the transcript.


February. 20th, 2022

Mar. 07 ICF COVID-19 Webinar with HHSC LTCR

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

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

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

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


February 13th, 2022

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

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

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

The rule requires ICF/IIDs to:

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

January 7th, 2022

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

Document   Version    Date    Change    Comments

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

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

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

Update your Infection Control Policies and other related policies accordingly. 

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


November 21st, 2021

HHSC Publishes PL 2021-38 Medicaid Bed Reallocation

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


November 4th, 2021

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

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

October 24th, 2021

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

Super important!!!!

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

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

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

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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

 

 

Joint Training From HHSC For Providers

Texas Health and Human Services

Dec. 13th, 2022

Joint Training Page Available for HCS and TxHmL Program Providers

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

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

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


Dec. 2022 HCS/TxHmL Provider Training Opportunities

Emergency Preparedness 101 for HCS and TxHmL Providers

Tuesday, Dec. 1311:30 a.m.–12:30 p.m.

Register here for webinar

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

Wednesday, Dec. 211–2 p.m.

Register here for webinar

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

9 a.m.–4 p.m.Nacogdoches, Texas

Register here for in-person class


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

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

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

Register for webinar

 

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

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

Register for webinar

 

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

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

Register for webinar

 

Emergency Preparedness 101 for HCS Program Providers (course description)

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

Register for webinar


July 2022 HCS/TxHmL Provider Training Opportunities

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

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

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

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

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

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

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

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

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


July 5th, 2022

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

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

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

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

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

HHSC Complaint and Incident Intake Voicemail Reporting Option Ends on Dec. 31 (ICF/IID)

December 11th, 2022

The provider self-reporting voicemail option will be transitioned out of service on Dec. 31, 2022. Effective Jan. 1, 2023, provider self-reported incidents must be submitted using one of the methods indicated below:

This does not apply to HCS or TxHmL, only ICF and other LTC programs such as ALF’s, SNF’s, DAH’s…

Please ensure that all initial self-reported incidents include the relevant information detailed in Provider Letter 18-20.

HHSC Retires LTCR Provider Investigations Policy Mailbox

December 11th, 2022

The Health and Human Services Commission (HHSC) created the Regulatory Services Division in 2017 as regulatory functions consolidated from the Department of Family and Protective Services, the Department of Aging and Disability Services and the Department of State Health Services. As part of this consolidation effort, effective Jan. 30, 2023, HHSC will retire the Provider Investigation policy mailbox at PIPolicy@hhs.texas.gov.

For questions about investigations, please use the Long-term Care Regulation Policy and Rules mailbox at LTCRPolicy@hhs.texas.gov.

IMPORTANT: Clarification on HCS/TxHmL IPC Status in “Pending DADS Review” 

December 06th, 2022

Please see this alert that was just sent to the 3 IDD associations from HHSC 

In an effort to identify potential IPC forms processing delays for Providers and LIDDAs, HHSC identified sixty-six (66)% of the form statuses on the portal are in a Pending DADS Review
Forms in this status typically require action to be taken by the submitter of the form per the attached HHSC clarification.   
Please share the attached alert document to your case managers, program managers, and appropriate persons, so that they can submit the appropriate documentation to process the forms and create a service authorization
 
The provider/submitter may need to submit a documentation packet for review in order to obtain approval for the IPC.  As many of you know, some of your major billing issues in TMHP have occurred, due to pending IPC’s. I urge you to sign up for for the December 8th webinar as well, see webinar registration information below

Upcoming Provider Webinar HHSC will discuss this topic during the December 8th, 2022,
TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar.
Please click on this link to register for this webinar.
If you are unable to attend the webinar, please click on this link to access the December 8th, 2022,
TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar recording.
Please note: this recording should be available by December 15th, 2022.


Packet/Documentation Submission Details
The most efficient mode of submission forHCS/TxHmL documentation is through the IDD Operations Portal.
To learn how to register and use the IDD Operations Portal or for answers to any questions, please
Packets may also be submitted via fax at 512-438-4249.
Questions
For questions about review packets, submitters can contact the HHSC UR department at 512-438-5055 or email deskURLONIPC@hhs.texas.gov
.For questions about enrollment or transfers, submitters can contact PES at 512-438-2484 or email enrollmenttransferdischargeinfo@hhs.texas.gov.

ISS (Individualized Skills & Socialization) Provider Webinar Recording

Recording of Individualized Skills and Socialization- Provider Licensing Application Process Webinar

December 06, 2022

If you were not able to listen to the November 30th webinar on navigating TULIP/applying for an ISS license, the recording of the webinar and the presentation are now posted.  See below for details.  Though assumed that persons who listen to the recording will also be able to download a certificate, HHSC has yet to confirm that

Listen to the webinar recording.

Read the Individualized Skills and Socialization webinar (PDF).

Any questions or requests for transcripts may be emailed to LTCR Policy.

Note:  According to HHSC it obtained over 400 questions related to the webinar.  Though anticipated that a large portion of those questions are duplicate in nature, HHSC will obtain answers and update the current FAQ posted on the ISS webpage discussed below.

Recording of Individualized Skills and Socialization Provider Webinar

August 13, 2022

HHSC hosted the Individualized Skills and Socialization Provider Webinar on July 19 and Aug. 22 for Home and Community-based Services, Texas Home Living, and Deaf Blind with Multiple Disabilities program providers.

This webinar — offered on Tuesday, July 19, from 2:30–4:30 p.m. and on Monday, Aug. 22, from 2–4 p.m. — provided information on the upcoming new service, individualized skills and socialization. Both webinars will provide the same information, so program providers can register for the time that works best for them.

Below are the links to the recorded sessions from July 19th and 22nd.  Please just click, register, and the presentation will begin.

Register now for the July 19 webinar.

Register now for the Aug. 22 webinar.

Handout:  Read the Individualized Skills and Socialization Provider Webinar (PDF).

Email HCS Policy and LTCR Policy for questions and to request a transcript of the webinar or ask questions.

Email questions about the webinar to your program policy inbox:


July 19 Individualized Skills and Socialization Provider Webinar Recording Available

August 3, 2022

A recording of the July 19 Individualized Skills and Socialization Provider Webinar with HHSC Long Term Care Regulation and HHSC Long Term Services and Supports is available for those who could not attend. The webinar recording and slides have been posted to the Individualized Skills and Socialization webpage, the HCS and TxHmL Webinars & FAQs webpage, and the DBMD Provider Training, Webinars and Podcasts webpage.

Listen to the Webinar here.

Read the Individualized Skills and Socialization Provider Webinar (PDF).

Email HCS Policy and LTCR Policy for questions and to request a transcript of the webinar.

Pre-enrollment Site Visit Required for HCS and TxHmL Providers That Enrolled Through PEMS

December 1st, 2022

Home and Community-based Services and Texas Home Living waiver program providers that enrolled through the Texas Medicaid and Healthcare Partnership Provider Enrollment and Management System will be subject to a pre-enrollment site visit from TMHP. Read the full alert.

Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver program providers that enrolled through the Texas Medicaid & Healthcare Partnership (TMHP) Provider Enrollment and Management System (PEMS) will be subject to a pre-enrollment site visit from TMHP.

The pre-enrollment site visit is required for enrollment in Texas Medicaid. The HCS program site visits will be conducted at the locations listed on the enrollment application, including the business office and any locations where clients receive residential assistance services.

A TMHP site visit coordinator will reach out through email or phone to schedule a visit. If the TMHP site visit coordinator is unable to reach the provider, then TMHP will conduct an unannounced site visit.

If providers have questions, contact the TMHP LTC Help Desk at 800-626-4117 (select option 1 and then option 7)

A few items I want to make you aware of if you are a new HCS/TxHmL Provider Applicant:

  1. They may want to know what services you intend to use to bill via TMHP.
    1.   i.e. TMHP billing specialist, or billing agency, someone at your agency using only TMHP or also specific outside software to make it easier to monitor and complete your billing (i.e. Millen Pro Billing services and/or software), or via Electronic Health Records for instance that have TMHP and EVV billing capabilities (TaskMaster Pro, TMHP, etc..)
  2. You do not have to have a group home when they visit before you have a contract.  You don’t have clients yet and HCS does not require you to purchase or rent a home prior to receiving your contract. (Adult Mental Health HCBS program does require you have a home)
  3. You do not have to have a rented business office or “storefront”.  You can use your “home office”.  But you may need to explain how you intend to see your clients, meet potential families and clients or do staff trainings and still maintain privacy.  Perhaps you can ask your local LIDDA’s if they have meeting spaces available to the providers, or you may use virtual office space, hotel conference/meeting rooms, and any staff training for group homes that will happen in the group home for example..
  4. Make sure if it is a home office, that it really is a delegated space for your office.
  5. They may want to know how you plan to maintain privacy and security with client records electronically stored, transferred, shared, or disposed of.

LTC Online Portal Enhancements for HCS and TxHmL Waiver Programs- Starting December 2022

December 1st, 2022

Overview of Upcoming LTC Online Portal Enhancements for HCS and TxHmL Waiver Programs

On December 12, 2022, the Texas Medicaid and Healthcare Partnership will implement several enhancements to the TMHP Long-Term Care Online Portal. After the enhancements are implemented, existing information and training materials will be updated. Read full alert.

-IPC Forms

-Termination Forms

-Pre-Enrollment Forms

-Individual Movement (IMT) Local Authority (LA) Reassignment Forms

-Provider Location Update (PLU) Forms

Other System and Form Enhancements

The Inactivate and Correct this Form buttons on the 8578 Intellectual Disability/Related Condition (ID/RC) Purpose Code (PC) 2 and Initial Enrollment IPC forms will be available only to HHSC staff.

This will decrease the potential for pre-enrollment and enrollment forms to get out of sync, as well as decreasing unnecessary form inactivations.

 

Account Preparation and Additional Resources

To prepare for these changes, HCS and TxHmL providers and LIDDAs that do not have an LTCOP account need to create an administrator or user account. Providers and LIDDAs can find instructions for creating an account in the TMHP Account Setup for HCS and TxHmL Waiver Programs Quick Reference Guide (QRG).

Additionally, providers and LIDDAs are encouraged to visit the TMHP 1915(c) Waiver Programs web page for recent news, reference materials, education, and bulletins.

For more information, contact the TMHP LTC Help Desk at 800-626-4117 (select option 1 and then option 7).


October 23rd, 2022

LTC Portal Enhancements: Coming Soon!

Beginning in December 2022, several enhancements will be implemented for the Texas Medicaid & Healthcare Partnership (TMHP) Long-Term Care (LTC) Online Portal. The enhancements will improve form submission and portal functionality. Information about these upcoming changes will be available in future articles on the TMHP 1915(c) Waiver Programs web page.

Account Preparation and Additional Resources

To prepare for these changes, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) providers and local intellectual and developmental disability authorities (LIDDAs) that do not have an LTC Online Portal account need to create an administrator or user account. Providers and LIDDAs can find instructions for creating an account in the TMHP Account Setup for HCS and TxHmL Waiver Programs Quick Reference Guide (QRG), which is available in the TMHP Learning Management System (LMS), and on the TMHP website.

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

(FYI-This includes HCS/TxHmL provider applicants who are going to have their contracts approved soon to begin services.  If you haven’t signed up for the LTC Portal yet, please do so!) 

Additionally, TMHP encourages providers and LIDDAs to visit the TMHP 1915(c) Waiver Programs web page for recent news, reference materials, education and bulletins.

For more information, contact the TMHP LTC Help Desk at 800-626-4117, option 1, then option 7.

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

November 14th, 2022

Don’t forget: HHSC has extended the time for any providers eligible for these ARPA payments to complete the attestation, so that the initial and final reports are not due, until 30 calendar days after the end of the COVID Public Health Emergency (PHE).

 Failure to submit the attestation and initial and final reports will result in recoupment of the funds.
There appear to be quite a few members who have yet to submit the attestation or even the initial report.  Don’t forget that the list is based on one’s NPI and legal name registered with CMS.  If you are not registered properly, perhaps you are not on the list.  Because of this, we would strongly encourage all providers eligible for these payments to review the current compliance list to ensure its accuracy and to see whether you have submitted or not submitted these required items.
If you have yet to complete the attestation and initial report, we strongly recommend you do so.

July 4th, 2022

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

Initial report is now due by August 15, 2022.

The Texas Health and Human Services Commission (HHSC) implements American Rescue Plan Act (ARPA) Home and Community-Based Services (HCBS) Provider Retention payments.

HHSC is providing funds to agency providers and consumer-directed services employers to support recruitment and retention efforts for direct care staff delivering HCBS services. 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-19 vaccination or to isolate after receiving a positive COVID-19 test.

Providers who may be eligible to receive funds are:

 

  • 1915 (c) Texas Home Living (TxHmL) Provider Agency
  • 1915 (c) Home and Community-Based Services (HCS) Provider Agency
  • 1915(i) Home and Community-Based Services – Adult Mental Health (HCBS – AMH) Provider Agency
  • 1915 (c) Home and Community-Based Services (HCS) CDS Employer
  • 1915 (c) Texas Home Living (TxHmL) CDS Employer
  • see the HHSC HCBS website for other types of additional information on ARPA funds.

HHSC is providing time-limited reimbursement increases to strengthen and stabilize the HCBS workforce. Temporary rate increases will be made on eligible HCBS service claims with dates of service between March 1, 2022, and August 31, 2022.

Providers receiving temporary rate increases must complete an attestation and complete an initial report by August 15, 2022.

HHSC will announce the due date for the final report in a follow-up notice. Providers will have at least 30 days to complete the final report.

Providers who fail to complete the required attestation and reporting will be subject to recoupment of HCBS ARPA funds.

Consumer Directed Services (CDS) Employers and Financial Management Services Agencies (FMSAs)

The CDS participant, as the employer of record, may choose to submit the required attestation and reports or work with the Financial Management Services Agency (FMSA) to submit the attestation and reports on the CDS participant’s behalf. FMSAs may also reach out to the CDS participants to offer assistance in submitting the attestation and reports. FMSAs can submit the required information for multiple CDS participants in the FMSA HCBS ARPA Attestation and Initial Report Template. Pursuant to Texas Administrative Code rule 1 TAC 355.207(c)(4), to be eligible for the temporary rate add-on, providers must submit required reports regarding the use of funds and provide data to document vacancy rates in direct care staff and other indicators. If completing the attestation and reports on behalf of a CDS participant, FMSAs should work with the CDS participant to collect all required data. The deadline for the attestation and initial reporting has been extended to August 15, 2022.

Information regarding ARPA HCBS Provider recruitment and retention payments is available on the HHSC Provider Finance website.


 

June 2nd, 2022

Don’t Forget!

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

Initial report is due by July 1, 2022.

The Texas Health and Human Services Commission (HHSC) implements American Rescue Plan Act (ARPA) Home and Community-Based Services (HCBS) Provider Retention payments.

HHSC is providing funds to agency providers and consumer-directed services employers to support recruitment and retention efforts for direct care staff delivering HCBS services. 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-19 vaccination or to isolate after receiving a positive COVID-19 test.

HHSC is providing time-limited reimbursement increases to strengthen and stabilize the HCBS workforce. Temporary rate increases will be made on eligible HCBS service claims with dates of service between March 1, 2022, and August 31, 2022.

Providers receiving temporary rate increases must complete an attestation and complete an initial report by July 1, 2022.

HHSC will announce the due date for the final report in a follow-up notice. Providers will have at least 30 days to complete the final report.

Providers who fail to complete the required attestation and reporting will be subject to recoupment of HCBS ARPA funds.

Information regarding ARPA HCBS Provider recruitment and retention payments is available on the HHSC Provider Finance website.


 

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.

TMHP Enhancements Release Dates

November 11th, 2022

TMHP Enhancements

According to HHSC the enhancements (improvements) planned for release this month will most likely be posted later this week or early next week.  These posted enhancements will not be effective until Dec. 12, 2022.

HHSC will go over these enhancements in depth at the December 8th, 2022 Migration Webinar


September 23rd, 2022
There are 2 sets of HHSC and TMHP ‘enhancements’ (or ‘fixes’ or ‘improvements’ to the system) to be released in the near future.  HHSC has said that the first set of ‘enhancements’ will be released November 4, 2022, and the second set will be released in June of 2023.

Public Health Emergency (PHE) Status

November 11th, 2022

At this time, according to HHSC the PHE is set to end on January 11, 2023.  Currently, it is not known whether it will be extended beyond January 11th, 2022.  It is possible providers will be notified this week in some alerts if PHE will be extended beyond January 11, 2023.

Why is this important?

*This is important as COVID-19 flexibilities may end and Medicaid status may be lost for those individuals in our waiver  and ICF programs where provider has not responded to previous warning letters from CMS that their Medicaid status will not automatically be renewed without reapplying.

THERAP Information and Resources

Therap services website

Previous Webinars Hosted ByTwogether Consulting:  Therap during our free resource webinar series below.  Just click on the links and register.

October 2022

https://attendee.gotowebinar.com/recording/2347988816141652494

 

August 2022

https://attendee.gotowebinar.com/recording/1388286687336697103



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

Calvin Christensen(Business Development Consultant at Therap Services, LLC)

 Here is his LinkedIn page

https://calendly.com/calvin-christensen/system-demonstration?back=1&month=2022-10

 


Other Resources

Overview of new pharmacy interface feature with orders, MARS, etc…

https://help.therapservices.net/app/pharmacy-interface

 

Overview of GER Reports (Incidents, Injuries, Med Errors…)

Comprehensive Documentation and Information Management System

Data-Driven:

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


 

 

HCS Provider Letters, Contacts and Resources

October 27th, 2022

Home and Community-based Services (HCS)

 

Provider Letters/Provider Communications!!!

Click here for news, information letters (ILs) & provider letters (PLs).


Receive Emails from HHS Every Sunday

The Texas Health and Human Services Commission contracts with a company called Granicus to provide email updates, called GovDelivery. In accordance with your contract, and contracting rules at 40 Texas Administrative Code §49.302(g), you must subscribe to receive HHSC email updates, using this GovDelivery signup, and select Information Letters, Provider Alerts and the contract program type(s).

When you sign up for email updates, you are giving your information to both HHSC and to Granicus. When HHSC has your information, it is subject to the HHSC privacy policy. When Granicus has your information, it is subject to the Granicus GovDelivery privacy policy.


Contact Program Staff


Resources

COVID FAQ’s & Guidance

Infection Control & Vaccine Resources

HB 3720
Surveyor Review Tools and Forms
Additional Resources

TaskMaster Pro Information & Resources

October 31st, 2022

Previous Webinars Hosted ByTwogether Consulting:  TaskMaster Pro (TMP) during our free resource webinar series below. 

Just click on the links and register.

October 20th, 2022

https://attendee.gotowebinar.com/recording/1488497278022599682


We couldn’t find an innovative IDD Practice Management software that focused on delivering better care, so we built one!

Software features for Service Providers

Our IDD software is designed by Service Providers and built for Service Providers. Every day we face the same challenges you do in providing care to the people in our IDD community. So that delivering the best care possible can be the focus, we designed TMP to be easy to use, intelligent, and robust.

Care professionals are led quickly through documentation processes with platform-assisted data completion. No repetitive entry of information, it’s fast and accurate. Compliance data is gathered and tracked simultaneously. This means compliance reporting can be completed at the push of a button. Thus, caregivers spend more time giving care and less time on paperwork.

Have more questions? Please schedule a free demo below.

And don’t forget to mention if you found out about us through Twogether Consulting! 

Monthly Webinars on Migration of CARE to TMHP

January 15th, 2023

Jan. 11th TMHP LTC Migration Webinar

Monthly Webinars:  See January 11th migration webinar.
I believe the next one will be February 6, 2022.
If you missed the January 11th webinar, a recording will be posted soon.  The February webinar will focus on cost reports.
R & S Reports and Other Notices:  Please see
  • R & S Video Series for LTC Providers & FMSAs: There are 3 videos related to this topic:.

October 23rd, 2022

Oct. 5 TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar Recording Available

A recording of the Oct. 5 TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar is available for those who could not attend.

The webinar recording and slides have been posted to the HCS and TxHmL Webinars & FAQs webpage.

Listen to the Webinar here.

For questions, email TxHmL Policy.


October 13th, 2022

Starting November 9th, 2022 monthly Migration Webinar, the next webinar will be extended 30 minutes to allow more time to answer questions, and the number of items reviewed will be limited so more time can be spent reviewing each topic/item. This is based on feedback previously received.

Monthly Meetings/Webinars On Migration To TMHP LTC Portal for HCS/TxHmL/FMSA’s 

Medicaid and CHIP Services (MCS) will begin hosting monthly meetings for Providers and Financial Management Services Agencies (FMSAs) who use the Long-Term Care (LTC) Online Portal for the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver programs, beginning in October will be held to discuss trending issues, share solutions established to address barriers providers and LIDDAs are experiencing, answer questions, etc.

Texas Medicaid & Healthcare Partnership (TMHP) and Health and Human Services Commission (HHSC) staff from the following departments will be available to provide information and answer questions:

  • Program Eligibility and Support (PES).
  • Utilization Review (UR).
  • Provider Claims Services (PCS).
  • Contract Administration & Provider Monitoring (CAPM).
  • Local Procedure Development and Support (LPDS).

Save the Dates

The webinars will be held on the following dates. We encourage Providers and FMSAs to invite staff who use the LTC Online Portal for HCS and TxHmL programs.

Standing Meeting Agenda

  • Trending issues – discuss trending issues and solutions to increase successful processing of forms.
  • Updates on LTC Online Portal for HCS and TxHmL – provide relevant updates.
  • Questions and Answers – HCS and TxHmL Providers and FMSAs will have the opportunity to ask questions* regarding LTC Online Portal for HCS and TxHmL.

*To comply with HIPAA requirements, questions that include any identifying information for a specific individual will not be allowed during the monthly meetings.

Email Questions to TxHmL Policy.

Don’t Forget To Get Ready For Flu Season!

October 17th, 2022

From HHSC:

LTC Providers Encouraged to Get Ready for Flu Season

CDC recommends everyone be vaccinated against the flu by the end of October to avoid peak flu season. Long-term care providers should review their program requirements for guidance related to vaccination requirements and infection control.

Some of the CDC’s recommendations for vaccinating patients in congregate healthcare settings are:

  • The CDC recommends that LTC facilities offer the flu vaccine to all residents and healthcare staff throughout the flu season.
  • Residents with close contact to someone with COVID-19 and asymptomatic and pre-symptomatic residents in isolation can be vaccinated.
  • For residents with suspected or confirmed COVID-19 who are symptomatic, healthcare personnel can postpone their vaccine until meeting the criteria for discontinuing isolation. The person should not be considered moderately or severely ill and should have fully recovered from acute illness as recommended by the CDC.

Administer COVID-19 vaccines without regard to the timing of other vaccines. This includes administering the COVID-19 and flu vaccines at the same time. Access the CDC’s COVID-19 vaccine and coadministration with other vaccines for more information.

Adhere to standard precautions. They are the foundation for preventing the transmission of infectious agents in all healthcare settings and help prevent the flu.

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

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

For more information, view:

Texas Culture Change Coalition Conference-“A Day Focused On Person-Centered Senior Care” Nov. 3rd, 2022-Austin, Tx

October 16th, 2022

Register for Texas Culture Change Coalition Conference

The Texas Culture Change Coalition will host their in-person fall 2022 conference, “Texans Coming Together for Residents, for Staff, for All!”

This year’s theme is “A Day Focused on Person-Centered Senior Care.”

Nov. 3
8 a.m.–5 p.m.
Commons Conference Center (J.J. Pickle Research Campus)
10100 Burnet Road, Bldg. 137
Austin, TX 78758

Continuing education credit for multiple disciplines will be provided for this event.

Register for the conference.

For more information, visit the Texas Culture Change Coalition website.

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

October 17th, 2022

HHSC HCS Program Provider Response to COVID-19 Emergency Rule Expired Oct. 14

The emergency rule for Home and Community-based Services waiver program providers that contain the HCS Program Provider Response to COVID-19 Emergency Rule expired Oct. 14.

The following rule expired Oct. 14:

  • 40 Texas Administrative Code Section 9.198 – Program Provider Response to COVID-19 Emergency Rule

HCS program providers must continue to comply with visitation requirements for essential caregivers and clergy in a disaster located in TAC Chapter 570 as well as all other applicable rules and certification principles.

See Section 9.198 below:

Section 9.198 – [Expired effective 10/14/2022] Program Provider Response to COVID-19 Emergency Rule
(a) Applicability. Based on state law and federal guidance, Texas Health and Human Services Commission (HHSC) finds COVID-19 to be a health and safety risk and requires a program provider to take the following measures. The screening required by this section does not apply to emergency services personnel entering the residence in an emergency situation.
(b) Definitions. The following words and terms, when used in this section, have the following meanings.

(1) Individual–A person enrolled in the Home and Community-based Services (HCS) program.
(2) Persons providing critical assistance–Providers of essential services, persons with legal authority to enter, and family members or friends of individuals at the end of life and designated essential caregivers as described in Title 26 Texas Administrative Code Chapter 570, Long-term Care Provider Rules During a Public Health Emergency or Disaster, Subchapter H, §570.711 (relating to Visitation).
(3) Persons with legal authority to enter–Law enforcement officers, representatives of Disability Rights Texas, and government personnel performing their official duties.
(4) Physical distancing–Maintaining a minimum distance between persons as recommended by the Centers for Disease Control and Prevention (CDC), avoiding gathering in groups in accordance with state and local orders, and avoiding unnecessary physical contact.
(5) Probable case of COVID-19–A case that meets the clinical criteria for epidemiologic evidence as defined and posted by the Council of State and Territorial Epidemiologists.
(6) Provider of essential services–Contract doctors or nurses, home health and hospice workers, health care professionals, contract professionals, clergy members and spiritual counselors, guardians, advocacy professionals, and individuals operating under the authority of a local intellectual and developmental disability authority (LIDDA) or a local mental health authority (LMHA), whose services are necessary to ensure individual health and safety.
(7) Residence–A host home/companion care, three-person, or four-person residence, as defined by the HCS Billing Guidelines, unless otherwise specified.
(c) Infection Control.

-(1) A program provider must develop and implement an infection control policy to prevent the spread of COVID-19 that:

(A) prescribes a cleaning and disinfecting schedule for the residence, including high-touch areas and any equipment used to care for more than one individual;
(B) is updated to reflect current CDC or Texas Department of State Health Services guidance;
(C) may include the use of face masks;
(D) includes screening procedures for staff, visitors, and individuals;
(E) includes strategies for staff to provide services to individuals who have tested positive for COVID-19;
(F) includes strategies for a service provider at a host home, three-person or four-person residence, or a staff member at a respite or Community First Choice Personal Assistance Services/Habilitation (CFC PAS/HAB) to return to work when they have a confirmed or probable COVID-19 diagnosis; and
(G) is revised if a shortcoming is identified.
-(2) A program provider must provide training to service providers on the infection control policy initially and upon updates.
-(3) A program provider must educate staff and individuals on infection prevention, including hand hygiene, physical distancing, and cough etiquette.
(d) A program provider must update the emergency plan developed in accordance with § 9.178(d) of this subchapter (relating to Certification Principles: Quality Assurance) to address COVID-19. The updated plan must include:

(1) a plan for maintaining infection control procedures during evacuation;
(2) a list of locations and alternate locations for evacuation for individuals with confirmed or probable COVID-19, and for individuals with negative or unknown COVID-19 status; and
(3) a list of supplies needed if required to shelter in place.
(e) A program provider may conduct the annual inspection required by § 9.178(c) of this subchapter by video conference. A program provider must conduct an on-site inspection required by § 9.178(c) of this subchapter within 30 days of the expiration or repeal of the public health emergency.
(f) Flexibilities in federal requirements granted by the Centers for Medicare and Medicaid Services during the COVID-19 pandemic, including waivers under the Social Security Act §1135, activation of Appendix K amending a 1915(c) home and community-based waiver, and other federal flexibilities or waivers are applied to corresponding state certification principles for HCS. HHSC will identify and describe federal flexibilities and flexibility in corresponding state certification principles in guidance issued through HCS provider letters.
(g) If this emergency rule is more restrictive than any minimum standard relating to the HCS program, this emergency rule will prevail so long as this emergency rule is in effect.

40 Tex. Admin. Code § 9.198

Adopted by Texas Register, Volume 45, Number 40, October 2, 2020, TexReg 6850, eff. 9/24/2020 and expired 1/21/2021; Amended by Texas Register, Volume 46, Number 06, February 5, 2021, TexReg 0895, eff. 9/24/2020 and expired 3/22/2021; Adopted by Texas Register, Volume 46, Number 14, April 2, 2021, TexReg 2122, eff. 3/23/2021and expired 7/20/2021; Adopted by Texas Register, Volume 46, Number 19, May 7, 2021, TexReg 2968, eff. 4/23/2021 and expired 8/20/2021; Amended by Texas Register, Volume 46, Number 36, September 3, 2021, TexReg 5486, eff. 8/21/2021 and expired 12/18/2021; Adopted by Texas Register, Volume 46, Number 53, December 31, 2021, TexReg 9137, eff. 8/21/2021 and expired 2/16/2022; Adopted by Texas Register, Volume 47, Number 09, March 4, 2022, TexReg 1038, eff. 2/17/2022 and expired 6/16/2022; Adopted by Texas Register, Volume 47, Number 26, July 1, 2022, TexReg 3769, eff. 6/17/2022, expired eff. 10/14/2022

July 11th, 2022

Provider Letter 2022-13, Version 2: Petition To Suspend Essential Caregiver Visits

HHSC issues PL 2022-13, Version 2 with additional information regarding how a facility or program provider may petition HHSC to suspend in-person essential caregiver visits. 

Read PL 2022-13, Version 2 here.

“A facility or program provider may petition HHSC to suspend in-person
essential caregiver visits for no more than 7 consecutive calendar days
if in-person visitation poses a serious community health risk. To
petition for a suspension of in-person essential caregiver visits, a
facility or program provider must submit a request to their Regional
Director (RD) by email. The contact information for each Regional
Director is available on the Long-term Care Regulatory Regional
Contact Numbers website. A facility or program provider may request
an extension from HHSC to suspend in-person essential caregiver
visitation beyond the original request, but HHSC may not approve an
extension that exceeds 7 days. HHSC may deny a petition to suspend
in-person essential caregiver visits if HHSC determines that in-person
essential caregiver visits does not pose a serious community health
risk.”


July 5th, 2022

 Updated HCS/TxHmL COVID-19 Response Plan, FAQ Documents- June 24th

HHSC Long-term Care Regulation updated the COVID-19 Response Plan and FAQ documents on June 24. 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).


May 7th, 2022

Updated HCS/TxHmL COVID-19 Response Plan, FAQ Documents-May 5th

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

Updated 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

New Critical Incident Management Reporting System: Updates

October 13th, 2022

Please Don’t Forget To Sign Up For CIMS Training

Only 200 of the 800 providers/users have completed the training and have signed in/register

Providers must start using CIMS by November 1st, 2022. If you are a member of one of the 3 IDD associations, HHSC will provide each of these associations with the names of those entities so each association can reach out to their respective IDD waiver members who are not on the list/have yet to complete these steps.


August 11th, 2022

Critical Incident Management System (CIMS) Now Live

HHSC announces the new Critical Incident Management System is now live. CIMS is a statewide tool for reporting critical incidents.

All providers must begin entering critical incidents into CIMS no later than Nov. 1.

See IL 2022-23 for more information about CIMS.

This alert applies to:

  • Community Living Assistance and Support Services providers
  • Deaf Blind with Multiple Disabilities providers
  • CLASS case management agencies
  • Home and Community-based Services providers
  • Texas Home Living providers
  • Local intellectual and developmental disability authorities

INSTRUCTIONS FROM HHSC FOR COMPLETING TRAINING AND CORRECTING/ADDING USERS:

“The provider administrator with the active user account created in CIMS is required to complete the training in the system. Once the provider administrator completes the training, provider administrators can begin adding new users to their organization and reassigning roles so other members of the organization can enter critical incidents into CIMS.

If the designated provider administrator still works for an organization, HHSC will not change the designated administrator for a provider organization. If the designated provider administrator no longer works for the organization, HHSC will work with the current designated employee to ensure that person is added as a user in CIMS. HHSC staff must verify the employee requesting CIMS access works for a contracted provider or a local intellectual and developmental disability authority before access can be granted.

Now that CIMS has gone live, providers can no longer change contact information in CARE or send provider administrator contact updates to HHSC if the provider administrator is employed with the organization.”

Providers are required to use current systems for entering critical incidents until they have completed CIMS registration and training and begin entering critical incidents into CIMS.

Email questions to the MCS-CIMS inbox.


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.

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:

 

CARE Migration To TMHP HCS &TxHmL: Updates

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October 13th, 2022

Update on Some Migration Issues

 Enhancements planned for release in November will now not be released until December; the 2nd set of enhancements will be released in June, 2023.  A notice about the enhancements will be posted in the next few weeks.
HHSC will post recordings of their monthly TMHP Migration webinars, but not sure where they could be accessed. Sometimes the original registration links end up leading to the recordings, but we will keep you posted when there is an update from HHSC on this issue.
 HHSC will not create a FAQ related to the questions asked during each webinar.  Instead, they will use the questions asked and comments included in the evaluation survey of each webinar in determining future webinar topics.
There have been some suggestions to revise the “caps” and also that one of the enhancements should be to allow LIDDAs and providers to make corrections to their own data entries. This would be incredibly helpful to providers and stop the slowdown for IPCs and IDRCs to be approved as well hopefully if this is part of those allowed corrections.

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:

Reminder: Avoiding HCS and TxHmL Overpayment of Services Effective Jan. 2, 2023

October 10th, 2022

Texas Medicaid and Healthcare Partnership (TMHP) will perform monthly calculations on services for the Individual Plan of Care that overlaps the May 1, 2022 implementation of the new process for submitting Home and Community-based Services and Texas Home Living forms and claims.

On a quarterly basis, TMHP will calculate all services that have been paid through (CARE) Client Assignment and Registration System and TMHP and will recoup services that exceed the authorized IPC amount. Read the full alert.

WS&C Mailbox for HHSC To Be Discontinued As of Oct. 31st, 2022

October 10th, 2022

As part of the on-going transformation efforts, HHSC will no longer use the following mailbox, effective Oct. 31, 2022:

For a complete list of current contact information, program providers should refer to PL 2021-26 or e-mail Survey Operations at LTCRSurveyOperation@hhs.texas.gov.

For policy questions related to HCS and TxHmL, providers should e-mail LTCRPolicy@hhs.texas.gov.

IPC Renewals Submissions, Transfers, How To Submit IPC into LTCOP

Timely Submission of IPC Renewals

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

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

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


Important note for individuals transferring:

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


Guidance on HCS and TxHmL IPC submissions:

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

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


Questions:

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

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

Important Reminder: HCS/TxHmL Webinar-October 13th, 2022

October 6th, 2022

 

In case you forgot, please register for this session. It is very important!

HHSC will be hosting HCS & TxHmL Updates Provider Webinar on Oct. 13

For:  HCS/TxHmL program providers, LIDDA’s, and other interested parties

This webinar will provide information on the following:

  • Substantial changes being made to the HCS and TxHmL Program rules.
  • IL 2022-49, assessments of HCS three-person residences, four-person residences and host home/companion care settings for compliance with the federal HCS settings rules.

HCS and TxHmL Program Updates Provider Webinar

Oct. 13

1–3 p.m.

Register for the Oct. 13 webinar.

From Our Friends at IntellectAbility: Health Risk Mitigation Tools &Training

October 6th, 2022

From our friends at IntellectAbility. Apologies, I have been meaning to post this for some of those of you who asked about this tool (Mostly nurses, lol).  Previously this tool was under a different company name.  There was a change sometime back in the name of the company.

For those of you who want to learn more about IntellectAbility’s health risk mitigation tools and training by visiting ReplacingRisk.com

Feel free to call us at 727-437-3201 or email us at Inquiries@ReplacingRisk.com

They can provide a demo to help you detect health risks in at-risk populations and check out their helpful video about the screening tool by clicking on link below

Health Risk Screening Tool

ANCHOR/IntellectAbility Webinars Concerning Individuals With IDD

October 6th, 2022

In partnership with ANCOR, IntellectAbility is hosting the following 2 webinars.

This webinar I believe is for all HCS Providers, not just in Texas

  • October 6, 2022 at 2PM | “Leveraging Home and Community-Based Services (HCBS) American Rescue Plan Act (ARPA) funds to Address Health Disparities for People with IDD”
    Click here to register

 

This webinar would be helpful for all IDD Providers and Individuals with IDD and their families

  • October 27, 2022 at 2PM | “Health Risk-Informed Telemedicine: A Model for Improving Health Equity for People with IDD”
    Click here to register

Reminder-HCS Provider Applicants: LTC Providers Must Enroll in Texas Medicaid Before They Can Get Their Contract

August 4th, 2022

All New LTC Providers must Enroll in Texas Medicaid.  (So, this means even HCS provider applicants, at least once they are nearing the stage of having their application approved and/or at the latest, prior to receiving their contract/s.  Remember, you can’t start providing services and accepting clients to your HCS program until you get your letter with the approved contract/s.

LTC-only Providers Enrolling Through Provider Enrollment and Management System (PEMS)
“A new applicant that wants to obtain a contract to provide Texas Health and Human Services LTC Medicaid services must enroll in Texas Medicaid.”
  • Applicants that intend to bill through TMHP for acute care or long-term care only services must enroll through TMHP.
For more information about Medicaid enrollment, visit www.tmhp.com or call the TMHP Contact Center at 800-925-9126

FYI-New HCS Provider applicants, I would recommend utilizing the “walkthrough assistance” for enrollment.

 

TMHP offers hands-on assistance with completing and submitting the TMHP enrollment application.

 

For enrollment walkthrough assistance please contact the TMHP Contact Center (800-925-9126) or TMHP-CSHCN Services Program Contact Center (800-568-2413) or send an email to provider.relations@tmhp.com to request assistance with enrollment questions


PROOF OF ENROLLMENT IN TMHP MUST BE SENT TO HHSC:  IDD WAIVER CONTRACTS ENROLLMENT DEPARTMENT
Applicants must enroll in Texas Medicaid through TMHP and do not have to enroll through HHSC;
 -however, these applicants must mail HHSC a copy of TMHP’s notification letter as proof of enrollment.
The notification letter must state HHSC has approved the application to become a Texas State Health-Care Programs provider and the enrollment term must be current. 
Applicants should retain the original notification letter for their records.
If you are applying for a contract for any of the following programs
1.     Home and Community-based Services (HCS)
2.     Texas Home Living (TxHmL)
3.     Hospice
4.     Community Living Assistance and Support Services (CLASS)
5.     Consumer Directed Services (CDS)
6.     Deaf-Blind with Multiple Disabilities (DBMD)
7.     Transition Assistance Services (TAS)
send a copy of the TMHP notification letter to:
Texas Health and Human Services Commission
Contact Administration and Provider Monitoring
Mail Code W-359
P.O. Box 149030
Austin, TX 78714-9030
For more information about the Medicaid Provider Enrollment Process for LTC-only Billing, please click here.

If you are already a current LTC Provider, they must Re-Enroll or Revalidate in Texas Medicaid through TMHP

2022 IDEA (Individuals With Disabilities Education Act) Manual

October 5th, 2022

Updated 2022 IDEA Manual

The updated 2022-2023 IDEA Manual is now available in both English and Spanish on the Disability Rights Texas website.

Created in partnership with The Arc of Texas, this manual is designed to help you understand the requirements of the federal Individuals with Disabilities Education Act (IDEA) and Texas law so you can act as an equal partner in planning your child’s education.

 

Learn more on our Resources for Families page

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

October 4th, 2022

COVID-19: HHSC Publishes In-Home Day Habilitation Information for Program Providers (Replaces IL 2022-48)

IL 2022-51 is posted on the HHS webpage for Home and Community-based Services, Texas Home Living, local intellectual and developmental disability authority, and financial management services agency program providers.

HHSC is temporarily waiving certain requirements in Section 3710, 4381.3, 4381.7(6) and 4381.7(7) of the HCS Billing Guidelines and TxHmL 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 2022-51 In-Home Day Habilitation Information for Program Providers for COVID-19 (PDF). This replaces IL 2022-48.

It extends the temporary guidance through October 31st, 2022, unless the COVID-19 public health emergency ends sooner. HHSC will provide guidance if there are any changes.

Email questions to HCS Policy.


May 30, 2022

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

In March 2020, HHSC implemented a temporary policy change for respite and Community First Choice Personal Assistance Services/Habilitation. This change allows service providers of respite and CFC PAS/HAB to live in the same home as the person receiving Home and Community-based Services or Texas Home Living program services.

This change has given access to needed services for people living in their own or family’s home. A person’s spouse or a 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 temporary policy change is effective March 27, 2020 through October 31st, 2022, unless the COVID-19 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.

Awarded Levels for the Attendant Compensation &DCS Enhancement Programs-2023

October 2nd, 2022

Texas HHSC has posted awarded levels for Long-term Services and Supports (LTSS) providers participating in the Attendant Compensation and Direct Care Staff enhancement programs for state fiscal year (FY) 2023 for the following programs:

Attendant Compensation Rate Enhancement Program for:

  • Community Living Assistance and Support Services (CLASS) – Direct Service Agency (DSA);
  • Day Activity and Health Services (DAHS);
  • Deaf-Blind with Multiple Disabilities Waiver (DBMD);
  • Home and Community-based Services (HCBS);
  • Primary Home Care (PHC);
  • Residential Care (RC);
  • Texas Home Living (TxHmL); and
  • Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID).

To view the FY2023 enrollment awarded levels list, please visit the PFD website. If you have questions regarding your FY2023 enrollment status, please contact the LTSS Center for Information and Training (CIT) by phone at (737) 867-7817 or by email

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


September 25th, 2022

TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar

Medicaid and CHIP Services (MCS) will begin hosting monthly meetings for Providers and Financial Management Services Agencies (FMSAs) who use the Long-Term Care (LTC) Online Portal for the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver programs.

Texas Medicaid & Healthcare Partnership (TMHP) and Health and Human Services Commission (HHSC) staff from the following departments will be available to provide information and answer questions:

  • Program Eligibility and Support (PES).
  • Utilization Review (UR).
  • Provider Claims Services (PCS).
  • Contract Administration & Provider Monitoring (CAPM).
  • Local Procedure Development and Support (LPDS).

Save the Dates

The webinars will be held on the following dates. We encourage Providers and FMSAs to invite staff who use the LTC Online Portal for HCS and TxHmL programs.

Standing Meeting Agenda

  • Trending issues – discuss trending issues and solutions to increase successful processing of forms.
  • Updates on LTC Online Portal for HCS and TxHmL – provide relevant updates.
  • Questions and Answers – HCS and TxHmL Providers and FMSAs will have the opportunity to ask questions* regarding LTC Online Portal for HCS and TxHmL.

*To comply with HIPAA requirements, questions that include any identifying information for a specific individual will not be allowed during the monthly meetings.

Email Questions to TxHmL Policy.


September 25th, 2022

HCS and TxHmL Updates Provider Webinar

HHSC will host the HCS and TxHmL Services Program Updates Provider Webinar on Oct. 13 for HCS and TxHmL program providers, local intellectual and developmental disability authorities, and other interested parties.

This webinar — offered on Thursday, Oct. 13, from 1–3 p.m. — will provide information on the substantive changes made to the HCS and TxHmL Program rules. Both webinars will provide the same information, so program providers and LIDDAs can register for the time that works best for them.

Email questions about the webinar to your program policy inbox:

HCS Policy

TxHmL Policy


September 12th, 2022

Updated HCS and TxHmL Waiver Programs FAQ Document Now Available- Sept. 2022

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

Read the full alert.


July 15th, 2022

HCS and TxHmL Webinar Recorded From July 14th, 2022

July 12, 2022

Webinar topic includes:

  • Forms Submission and Processing in TMHP LTCOP

HCS and TxHmL Webinar
July 14, 2022
2:30 – 4 p.m.

Click link below to register to watch recording of this session.
Register for the webinar

Email questions about the webinar to your program policy mailbox:


 

July 13th, 2022

IDD and PI Quarterly Webinars

 


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.


Updated HCS and TxHmL COVID-19 FAQ

May 6th, 2022 

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


September 1st, 2022

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

October 27th IDD and PI Webinar with HHSC LTCR

September 24th, 2022

IDD & PI Webinar October 27th, 2022

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

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

Oct. 27, 2022
10–11 a.m.

Register for the IDD/PI Webinar

Deadline Coming Up Soon For Comments on HHSC Proposed TAC Rules

September 24th, 2022

Deadline for Comments on HHS Proposed Rules Due Oct. 17

Texas HHSC is accepting comments from stakeholders on the following proposed rules, which are now posted in the Texas Register. The comment period ends Oct. 17, 2022.

  • Texas Administrative Code,
    • Title 40, Part 1, Chapter 9, Subchapter N, repeal of Sections 9.551, 9.552, 9.554, 9.556, 9.558, 9.560 – 9.563, 9.566 – 9.568, 9.570, 9.571, 9.573 – 9.575, 9.582, 9.583, concerning Home and Community-based Services (HCS) Program and Community First Choice (CFC); and
    • Title 26, Part 1, new Chapter 262, Texas Home Living (TxHmL) Program and Community First Choice (CFC). Comments can be emailed to HHS Rules Coordination Office.
  • Texas Administrative Code,
    • Title 40, Part 1, repeal of Chapter 9, Subchapter D, Sections 9.151, 9.152, 9.154 – 9.170, 9.186, 9.189 – 9.192, concerning Home and Community-based Services (HCS) Program and Community First Choice (CFC); and
    • Title 26, Part 1, new Chapter 263, Home and Community-based Services (HCS) Program and Community First Choice (CFC). Comments can be emailed to HHS Rules Coordination Office.

Questions can be emailed to HHS Rules Coordination Office.

Updated LTC Online Portal User Guides for HCS and TxHmL Waiver Programs Now Available

Updated LTC Online Portal User Guides for HCS and TxHmL Waiver Programs Now Available

The Long-term Care Online Portal User Guides for Home and Community-based Services and Texas Home Living Waiver Programs have been updated.

The learning path has been updated to include detailed instructions for entering Consumer Directed Services services in dollars instead of units, which were added to the 3608 and 8582 Individual Plan of Care Item-by-Item guides.

Read the full alert.

Crosswalk Billing Codes For DH -Sept. 2022 Update

September 17th, 2022

EVV Mismatches For DH

Providers Must Use Bill Codes Listed in the HCS and TxHmL Bill Code Crosswalk for Claims Submission

Concern and Issue

HCS and TxHmL providers are receiving unnecessary electronic visit verification (EVV) mismatches for Day Habilitation services due to providers not using proper bill code and modifier combinations based on where services are delivered.

Which day habilitation bill codes do I use?

In-Home Day Habilitation services delivered in an own home or family home setting require EVV visits before billing and must be billed using the following bill codes:

  • M0115 – DAY HABILITATION – LN 1 – IN-HOME
  • M0116 – DAY HABILITATION – LN 5 – IN-HOME
  • M0117 – DAY HABILITATION – LN 6 – IN-HOME
  • M0118 – DAY HABILITATION – LN 8 – IN-HOME
  • M0119 – DAY HABILITATION – LN 9 – IN-HOME
  • M0201 – DAY HABILITATION – LC 1 – IN-HOME
  • M0202 – CDS DAY HABILITATION – LC 1 – IN-HOME – Modifier 1 Position UC

In-Home Day Habilitation delivered in a host home or companion care setting, three-person or four-person residence, and Day Habilitation provided outside of the home do not require EVV visits and must be billed using the following bill code and modifier combinations:

  • M0421 – DAY HABILITATION – LN 1 – OUT-OF-HOME – Modifier 1 Position – KX
  • M0422 – DAY HABILITATION – LN 5 – OUT-OF-HOME – Modifier 1 Position – KX
  • M0423 – DAY HABILITATION – LN 6 – OUT-OF-HOME – Modifier 1 Position – KX
  • M0424 – DAY HABILITATION – LN 8 – OUT-OF-HOME – Modifier 1 Position – KX
  • M0425 – DAY HABILITATION – LN 9 – OUT-OF-HOME – Modifier 1 Position – KX
  • M0460 – DAY HABILITATION – LC 1 – OUT-OF-HOME – Modifier 1 Position – KX
  • M0461 – CDS DAY HABILITATION – LC 1 – OUT-OF-HOME – Modifier 1 Position – TG

September 17th, 2022

For HCS and TxHmL providers participating in the COVID add-on program, follow the instructions below.

Note: Only program providers delivering in-home Day Habilitation services in a three-person or four-person residence qualify for the COVID add-on program.

In-Home Day Habilitation services delivered in a three-person, or four-person residence do not require EVV visits and must be billed using the following bill code and modifier combinations:

  • M0944 – DAY HABILITATION – LN 1 – OUT-OF-HOME W/ COVID ADDON – Modifier 1 Position – KX – Modifier 2 Position – CR
  • M0945 – DAY HABILITATION – LN 5 – OUT-OF-HOME W/ COVID ADDON – Modifier 1 Position – KX – Modifier 2 Position – CR
  • M0946 – DAY HABILITATION – LN 6 – OUT-OF-HOME W/ COVID ADDON – Modifier 1 Position – KX – Modifier 2 Position – CR
  • M0947 – DAY HABILITATION – LN 8 – OUT-OF-HOME W/ COVID ADDON – Modifier 1 Position – KX – Modifier 2 Position – CR
  • M0948 – DAY HABILITATION – LN 9 – OUT-OF-HOME W/ COVID ADDON – Modifier 1 Position – KX – Modifier 2 Position – CR

Resources

EVV PCS Service Bill Codes Table
HCS and TxHmL Bill Code Crosswalk (for claims with dates of service beginning 05-01-2022)


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.

HCS Administrative Penalties, Survey, & Billing Requirement Updates

September 17th, 2022

HHSC publishes revised PL 20-55

HHSC Long-term Care Regulation updated Provider Letter 20-55 to include an updated link to the new amelioration form for HCS and TxHmL program providers.

The form is entitled 3708-A HCS and TxHmL Amelioration Request.


May 30th, 2022

HHSC has revised HCS and TxHmL Survey Operations Transformation (PL 21-26)

HHSC revised PL 2021-26 to reflect updates to the HCS or TxHmL Program Manager and Assistant Regional Director contact list.

Read PL 2021-26 here.


 

September 5th, 2021

Now Called Billing Requirements Not Billing Guidelines!!!!

HHSC Publishes Revision 21-3 of the HCS and TxHmL Program Billing Requirements and CFC Billing Requirements

HHSC Publishes Revision 21-3 of the HCS and TxHmL Program Billing Requirements and CFC Billing Requirements

This revision, effective Sept. 1, changes the name from Billing Guidelines to Billing Requirements, and all revisions are outlined in the 21-3 Revision 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.


September 5th, 2021

Very Important!!!  HHSC Releases Guidance Booklet for HCS/TxHmL Providers

Section 4 of House Bill 3720, 87th Legislature, Regular Session, 2021, requires HHSC to develop guidelines for regulatory staff and providers regarding the imposition of administrative penalties. To implement this provision, HHSC is offering training to regulatory staff and providers regarding the certification principles and the administrative penalty criteria and process. In conjunction with these training opportunities, HHSC has developed a comprehensive guidance booklet (PDF) that captures the training content in a user-friendly format. This booklet is available to training participants and on the HCS and TxHmL provider portals.  See the registration link below for training webinar presented on September 9th, 2021.

Register for HCS/TxHmL training here.


September 5th, 2021

HHSC Publishes Revised Informal Dispute Resolution (PL 2021-07)

HHSC published a revised version of Provider Letter 2021-07, Informal Dispute Resolution (PDF). A revision was made to update the contact phone number.


August 15th, 2021

HHSC Publishes Revised Guidance for HCS/TxHmL Providers Regarding:             How to File a Survey Complaint (PL 20-21)

HHSC has updated PL 2020-01, How to File a Complaint Regarding a Surveyor and Report Survey Inconsistencies (PDF).

The letter has been revised to include information for how HCS and TxHmL program providers can file a complaint regarding a surveyor, how to report survey inconsistencies related to the interpretation and application of regulations and rules, and to provide updated contact information for Long-term Care Regulatory HCS and TxHmL regional program staff.


April 26th, 2021

            HHSC’s WS&C Portal

 

Additional changes are coming to address Surveys and violations received from surveyors.  These include contacting WSC staff concerning violations and submitting EOC’s and POC’s to WSC through the WSC Portal!

On April 27th and 29th 2021:  HHSC hosted a webinar on WSC Portal Training for HCS/TxHmL providers.

Here are the handouts:

This portal will only be used to enter final PIR Reports, Submit EOC’s (Evidence of Correction), Submit POC’s (Plans of Correction) as well as communicate with WSC staff about POC’s/EOC’s, and Report a Death of an Individual in the program.


 

March 29th, 2021

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 28th, 2021

March 16 Recording of Clarification of Administrative Penalties and Related Processes Webinar Available

A recording of the March 16, 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.

January 10th, 2021


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

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

Listen to the webinar recording here.


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

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

Listen to the webinar recording here.


December 28th, 2020

Letter: PL 20-55  Administrative Penalties HCS & TxHmL

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


December 23rd, 2020

Upcoming HCS and TXHmL Webinars For:

“Hold Harmless” Period & Administrative Penalties & Amelioration

Hold Harmless Period Overview

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

Jan 5, 2021
2 p.m. – 4 p.m.

Here’s the link to record session:

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

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

Administrative Penalties and Amelioration

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

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


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

November 25, 2020

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


 Billing Guideline Changes

September 1, 2020

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

 


June 20, 2020

Survey Process:  Timelines

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

HHSC Provider User Guide (CARE)       

Please go to the following link:

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

.

Updated Webinar Resource Document & TMHP Account Setup Quick Reference Guide 

September 15th, 2022

Updated Webinar Resource Document and TMHP Account Setup Quick Reference Guide 

(HCS and TxHmL Waiver Program Providers)

From HHSC Alert September 12th, 2022

The Webinar Resource document that accompanied the Long-Term Care (LTC) Online Portal Training for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs webinar and the TMHP Account Setup for HCS and TxHmL Waiver Programs Quick Reference Guide have been updated. Read the full alert at Webinar Resource Document and TMHP Account Setup Quick Reference Guide.

Important! (Avoiding HCS and TxHmL Overpayment of Services)

September 12th, 2022

Avoiding HCS and TxHmL Overpayment of Services

Effective Jan. 2, 2023 Texas Medicaid and Healthcare Partnership (TMHP) will perform monthly calculations on services for the Individual Plan of Care that overlaps the May 1, 2022 implementation of the new process for submitting Home and Community-based Services and Texas Home Living forms and claims.

On a quarterly basis, TMHP will calculate all services that have been paid through Client Assignment and Registration System and TMHP and will recoup services that exceed the authorized IPC amount.

Read the full alert.

Read More Button

Revision To Billing Requirements

September 11th, 2022

HHSC Publishes Revision 22-2 of the HCS and TxHmL Program Billing Requirements, CFC Billing Requirements

Revision 22-2 is effective Sept. 1. All revisions are outlined in the Revision 22-2 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.


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.

PPAT Fall Conference For September 14th-16th, 2022

September 1st, 2022

Rising To The Challenge!

PPAT Fall Conference

DoubleTree Hotel Austin
6505 IH 35 North  Austin, 78752
Please click on below for session info:

 

The Association’s 25th Annual Conference is just around the corner. And, of course, a conference is not a conference without the help of many wonderful people like you and your colleagues. To ensure success we need your help. There are several ways to demonstrate your support and at the same time promote your company/agency.

They are:

 Sponsoring our reception, breakfast, happy hour, and/or breaks

 Advertising in the Conference Program

 Marketing your services in the Exhibit Hall

 Donating to the Silent Auction – all proceeds from the Auction go to PPAT’s Political Action Committee (PAC).

***We also need small items for the Goody Bags such as pens, pencils, notepads, etc.

 

It’s finally here, PPAT’s online registration option.  Click here:  REGISTRATION

Read more…

Other Registration Options

Conference forms in pdf

Registration form in pdf

If you signed up as a Sponsor, Vendor, or Registered for the Conference please contact PPAT for more information. You may contact the office at 512-452-8188.