July 18th, 2021

July 5th, 2021

June 15th, 2021

June 1st, 2021

May 15th, 2021

May 2nd, 2021

Newsletter Library

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

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

April 18th, 2021

April 18th, 2021 PDF Version

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

Or you can subscribe directly to our Mailchimp account by clicking on the subscriber link at the bottom of this latest newsletter.

July 17th, 2021

Texas Medicaid 1115 Transformation Waiver Extension

HHSC announces its submission of an extension application to the Centers for Medicare & Medicaid Services (CMS) for the Texas Healthcare Transformation Quality Improvement Program (THTQIP) waiver under section 1115 of the Social Security Act.

The extension request is for approximately 10 years, which will provide the 1115 waiver authority through 2030. The extension reflects the same terms and conditions agreed to and approved by CMS on Jan. 15, 2021.

The requested extension will allow Texas continued flexibility to pursue the goals of the existing 1115 waiver:

• Expand risk-based managed care to new populations and services.
• Support the development and maintenance of a coordinated care delivery system.
• Improve outcomes while containing cost growth.
• Transition to quality-based payment systems for managed care and providers.

Stakeholders may take part in a meeting regarding the waiver application next Tuesday:

July 20, 2021

11 a.m. Central time

Register for the webinar.

Stakeholders may review the final application posted here.

July 4th, 2021

Hurricane and Flooding Readiness Webinars for LTC Providers

Home & Community-based Services:

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

Intermediate Care Facilities:

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

July 2021 LTCR Provider Training Opportunities

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

Emergency Preparedness in Long-Term Care Facilities

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

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

July 3rd, 2021

CMS Provides Guidance on Full-Scale Emergency Preparedness Exercises

ICF Providers, please make sure you see this.

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

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

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

COVID-19 Resources

July 18th, 2021

August 2 ICF COVID-19 Webinar with HHSC LTCR

Long-term Care Regulation and the Department of State Health Services provide the latest information on the COVID-19 pandemic and take live questions from participants in this ICF provider webinar. Provider attendance is critical to staying current with COVID-19 requirements and guidance. ICF/IID providers are strongly encouraged to attend this and all COVID-19 webinars with LTCR and DSHS.

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

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

July 16th, 2021

July 6 ICF COVID-19 Webinar Recording Available

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

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

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

May 12th, 2021

Quality In LTC Conference Online

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

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

From HHSC May Newsletter

COVID-19 updated resources, see link below:

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

May 6th, 2021

APR 29 MCS COVID-19 Stakeholder Update

The audio from this session can be found here.

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

April 17th, 2021

March 18, 2021 MCS COVID-19 Stakeholder Information Session

Thank you for your interest in listening to the March 18 Texas Medicaid CHIP COVID-19 Information Session.

The audio from this session can be found here.

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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

April 17th, 2021

Reminder: Providers Can Request Free COVID-19 Testing Kits

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

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

March 28th, 2021

Free BinaxNOW COVID-19 POC Tests Available for LTC Providers

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

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

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

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

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

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

March 22 ICF COVID-19 Webinar with HHSC LTCR

Long-term Care Regulation and the Department of State Health Services provide the latest information on the COVID-19 pandemic and take live questions from participants in this ICF provider webinar. Provider attendance is critical to staying current with COVID-19 requirements and guidance. ICF/IID providers are strongly encouraged to attend this and all bi-weekly COVID-19 webinars with LTCR and DSHS.

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

ICF Provider Webinar

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

HHSC & DSHS Publish LTC COVID-19 Vaccination Options

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

The resource document provides COVID-19 vaccination options to:

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

Federal Pharmacy Partnership Program:

Contact Information for COVID-19 Vaccines

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

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

Walgreens:
Email Immunize ILTC.

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

These webinar meetings are held every Thursday

COVID-19 Provider Information

COVID-19 Client Information

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

The audio from this session can be found here.

• Email us for a transcript

The presentation can be found here.

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

Helpful Vaccination Information

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

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

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

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

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

CDC   Coronavirus Disease 2019 (COVID-19)

Resources For Posters For The Facility For Staff & Individuals

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

AADMD Webinar Series to Return in January 2021

https://open.texas.gov/

HHSC COVID-19 Provider Information

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

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

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

The webinar will review the November 2020 updates.

Long-term Care Facility Webinar

November 24, 2020

10:00 – 10:45 a.m. CST

See Recording below

Register for the Webinar.

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

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

View the video training.

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

ANCOR’s COVID-19 Resource Center

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

CDC information for persons with IDD

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

Resources from HRS

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

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

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

December 22, 2020

Risk/Benefit Return to Activity Form (Free from our friends at HRS) 

This could be very helpful for considerations for returning to work, Day Hab, Volunteer Jobs, etc…

https://hrstonline.com/download/risk-benefit-return-to-activity-form/?wpdmdl=3104&refresh=5fc779cf9f80e1606908367

Risk/Benefit Return to Activity Form

Employment Assistance & Supported Employment Training Options From HHSC

July 17th, 2021

June 28th, 2021

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

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

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

Each training has a corresponding quiz.

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

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

• Direct Service Workers Training
• Direct Service Workers Quiz

Rising To The Challenge!

PPAT Fall Conference

DoubleTree Hotel Austin, Tx 78752

More information and registration

PDF of the registration form

25th Annual Fall Conference -If you want to be a Sponsor, Vendor, Register for the Conference or Provide some of the items needed for Silent Auction & Goody Bags, please see the registration form above.  You may also contact the office at 512-452-8188.

PPAT also needs small items for the goody bags such as pens, pencils, notepads, etc. Goody bags will be given to each conference attendee. This is a great marketing opportunity for your company/agency. To assist us in raising needed dollars for the PPAT Political Action Committee (PAC), we request your consideration in donating an item or items to the silent auction. No item is too big or small! All contributors will receive recognition in the conference program and on PPAT’s website.

Deadline for inclusion of your name as a silent auction contributor in the final conference program is Monday, October 18, 2021. To donate items contact the PPAT Office at 512.452.8188 at your earliest convenience.

From our friends at PACSTX!

For more information click on this link to the newsletter

The American Rescue Plan Act (ARPA) of 2021 was signed into law on March 11, 2021. Section 9817 of ARPA provides states with a temporary ten (10) percentage point increase to the federal medical assistance percentage (FMAP) for Medicaid Home and Community-Based Services (HCBS), if certain federal requirements are met. States must use funds equivalent to the amount of federal funds attributable to the increased FMAP to implement activities that enhance or strengthen Medicaid HCBS. The Health and Human Services Commission (HHSC) submitted an initial spending plan to the Centers for Medicare and Medicaid Services (CMS) on July 12, 2021.

The plan Texas submitted is contingent upon federal clarification on outstanding questions.vTexas proposes to use state general revenue to fund projects to:

• Support providers of HCBS and community-based long-term services and supports (LTSS);
• Support recipients in HCBS programs; and
• Enhance and strengthen the HCBS infrastructure in Texas.

Please join HHSC on Thursday, July 15 at 10:00 a.m. for a webinar with stakeholders. HHSC staff will provide information about the contents of the plan, next steps, and answer stakeholder questions. Register here to join the webinar(link is external).

Read the ARPA HCS Funding Plan (PDF).

July 4th, 2021

EVV Visit Maintenance Policy Now Available

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

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

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

July 4th, 2021

HHSC EVV Webpage Updates Now Available

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

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

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

July 3rd, 2021

Revised EVV Visit Transaction Rejection Guide Now Available

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

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

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

Email TMHP with questions.

April 17th, 2021

EVV Policy Training for CDS Employers Now Available in Spanish

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

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

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

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

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

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

March 16th, 2021

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

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

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

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

For questions, email HCS Policy or CDS.

March 10th, 2021

Temporary EVV Policies for the Feb. 2021 Severe Winter Weather

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

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

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

Email questions to the HHSC EVV Mailbox.

February 7th, 2021

EVV Refresher Training on Feb. 19

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

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

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

Certificates of completion will not be issued.

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

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

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

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

Email HHSC EVV for questions.

Reminder:  Entering Schedules for EVV-Required Services

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

EVV is only required for the following services:

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

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

January 24th, 2021

EVV Portal and Training Updates for January

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

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

Email TMHP with questions about these updates.

January 24th, 2021

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

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

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

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

Email questions about EVV policy to HHSC EVV.

January 18th, 2021

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

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

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

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

Next Steps

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

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

January 10th, 2021

EVV Notification Requirement for HCS/TxHmL Program Providers 

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

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

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

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

January 4th, 2021

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

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

December 20th, 2020

Cures Act EVV:

Preparing for Jan. 1, 2021 Implementation

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

Beginning Jan. 1, 2021:

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

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

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

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

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

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

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

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

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

Visit the HHS EVV website for more information.

November 28, 2020

HCS and TxHmL CARE Service Authorization instructions for EVV

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

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

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

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

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

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

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

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

Best Practices for Temporary EVV Policies for COVID-19

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

Contact your payer for questions or email HHSC EVV.

Visit the HHS EVV webpage.

HCS and TxHmL Program Providers Required to Select an EVV Vendor

11/18/2020

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

Deadline Approaching Soon!!

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

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

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

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

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

Contact EVV if you have questions about EVV requirements.

Oct. 11th, 2020

EVV Revised Policies Effective Oct. 1

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

Claims Matching Policy (PDF)

The policy:

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

Claims Submission Policy (PDF)

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

Email HHSC EVV with your questions.

Oct. 11th, 2020

Updated EVV Service Bill Codes Table Effective Oct. 1

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

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

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

Units Matching

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

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

Home and Community-based Services and Texas Home Living Programs

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

Email HHSC EVV for questions.

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

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

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

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

EVV is only required for the following services:

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

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

Additional Guidance on Day Habilitation Services

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

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

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

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

August 20th, 2020

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

CURES Act EVV Training is Underway for HCS/TxHmL Providers

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

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

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

To register, click the links below:

FMSAs

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

HCS/TxHmL

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

Additional Training Opportunities

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

Email TMHP for questions about registration or the EVV Portal.

Email questions about EVV training requirements.

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

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

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

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

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

Updated Timeline for Cures Act EVV Expansion     

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

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

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

For questions, contact EVV.

• •  

     EVV Proprietary System page 

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

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

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

New EVV Proprietary System Onboarding Documents Available

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

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

Resources

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

Trainings Available:

• HHSC EVV Training webpage

EVV Policy Training (Provided by your payer)

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

EVV Aggregator and EVV Portal Training (Provided by TMHP)

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

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

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

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

Stakeholder Comments Requested for HCS, TxHmL Billing Guidelines, As Well As Proposed Billing Requirements, Provider Fiscal Compliance and TMHP Revisions

HCS and TxHmL Stakeholders can now comment to the HCS, TxHmL and CFC Billing Guidelines by July 18, 2021 about the proposed revisions:

• Proposed Billing Requirements
• Provider Fiscal Compliance
• TMHP revisions

The proposed billing guidelines revisions and a summary of changes were posted on June 18, 2021. They are located on the Long-term Care Providers page and are outlined below:

HCS

• Billing Guidelines (PDF)
• Summary of Billing Guidelines (PDF)

TxHmL

• Billing Guidelines (PDF)
• Summary of Billing Guidelines (PDF)

July 2nd, 2021

HHSC selected the Bexar service area as the primary service area in which to operate the STAR+PLUS Pilot Program

Yesterday members of the IDD SRAC and STAR+PLUS Pilot Program Workgroup were sent the notice below regarding selection of the STAR+PLUS Pilot site.   As the result of HB 4533 (Klick – 86th Session) Chapter 534, Government Code was amended and, among other changes, directs the pilot to assist in evaluating and developing a plan for the transition of all or some of the long term services and supports currently provided through the non-residential  services provided through the HCS, TxHmL, CLASS and DBMD waiver programs.  Chapter 534, Government Code calls for the pilot to start  9-1-2023 and conclude on 9-1-2025.

Notes:  i)  Prior to consideration of the transition of the residential services provided through the community-based ICF/IID program and the HCS and DBMD waivers, Chapter 534 calls for a separate pilot.  ii)  It is not known at this time how the STAR+PLUS procurement process will impact the number of and current MCOs in the Bexar STAR+PLUS service area.   The procurement is expected to be released in Q2 of FY 2022 with awards to be announced in Q3 of FY 2023 and an operational start date of Q1 of FY 2024.

Message to Members of the IDD SRAC and the STAR+PLUS Pilot program Workgroup:  Texas Government Code, Section 534.106(c) states the pilot program shall be conducted in a STAR+PLUS Medicaid managed care service area selected by the Health and Human Services Commission (HHSC).

HHSC has also identified two backup service areas if unforeseen circumstances prevent operation in the Bexar service area that are prioritized in the following order:

1.   MRSA Northeast

2.   Tarrant.

This link shows the Medicaid managed care service areas.

July 3rd, 2021

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.

Access recordings of previous webinars here.

March 6th, 2021

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

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

July 3rd, 2021

Update

COVID-19 Policy Extended for Service Providers of Respite and CFC PAS/HAB

HHSC has extended the lifted ban on service providers of respite and CFC PAS/HAB from living in the same home as the person receiving Home and Community-based Services and Texas Home Living program services.

This gives access to needed services for people living in their own or family’s home.

Due to guidelines a person’s spouse or a minor child’s parent still cannot be a paid service provider of the following services:

• HCS Billing Guidelines (PDF), 4691.7(1), 4660(1)
• TxHmL Billing Guidelines (PDF) Section 4660(1), 4691.8(1)
• CFC Billing Guidelines (PDF) Section 3700(a)(1)

This is a temporary policy change.

It is effective March 27, 2020 and is extended through July 31, 2021 unless the federal public health emergency ends sooner.

HHSC will provide updates if there are changes.

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

They must follow:

• The Texas Administrative Code, Title 40, Part 1, Subchapter D and N
• HCS and TxHmL Rules, Section 9.177 (n) and (o), and Sections 9.579 (r) and (s)
• HCS and TxHmL Billing Guidelines (PDF) Section 3400 for service provider qualifications

Email HCS program policy or  TxHmL program policy with questions.

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

July 3rd, 2021

Updates to HHSC EVV Mailboxes and Website

HHSC EVV Mailboxes

By June 28, HHSC EVV Operations will update their electronic mailboxes to the following email addresses:

• HHSC Electronic Visit Verification Mailbox: EVV@hhs.texas.gov
  • Previous email address: Electronic_Visit_Verification@hhsc.state.tx.us
• HHSC EVV Proprietary Systems Mailbox: EVVPSO@hhs.texas.gov
  • Previous email address: EVV_PSO@hhs.texas.gov

Additional Information

• Assess all personal materials, such as contact matrices, for any updates needed.
• Always refer to the HHSC EVV website for current information and resources.
• HHSC EVV Operations will continue receiving emails if a previous email address is used.

HHSC EVV Website

Throughout June and July, the HHSC EVV website and some of its webpages will have a new layout to reorganize resources and include updates related to the 21^st Century Cures Act, Section 12006.

Email the HHSC EVV Mailbox with any related inquiries.

February 7th, 2021

Electronic Visit Verification (EVV) Contact Information

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

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

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

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

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

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

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

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

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

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

or

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

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

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

or

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

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

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

Questions may include:
•
File Submission Errors.

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

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

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

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

or

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

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

EVV Vendor list

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

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

MCO EVV Contact Information/Contact Information for MCOs

Aetna
844-787-5437
evvmailbox@aetna.com

Amerigroup
800-454-3730
TXEVVSupport@amerigroup.com

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

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

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

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

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

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

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

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

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

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

Part I   Pre-recorded sessions available for purchase!

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

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

Part II   Pre-recorded sessions available for purchase!

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

Part III   Pre-recorded sessions available for purchase!

For HCS & TxHML Providers

“Developing The IP Using Person-Centered Practices”, on June 8th, 2021! This is part 3 of 5 of our Care Coordination series.

Part IV   Pre-recorded sessions available for purchase!

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

Part V  Coming Soon!

(Billable Services- HCS)  Moved to August.  This will be split up into 2 days!  August 3rd and 5th.

General Billable Services (Day 1 from 10 am -Noon) & then Adaptive Aids/Minor Home Mods/Dental (Day 2  10am-Noon)  as a separate webinar.

Register at:  www.twogetherconsulting.com.  Click on appropriate calendar to find information and register.  You may also click on the payment tabs below.

Day 1 Registration

Day 2 Registration: 

–Mention Us and Get Your Promotions for Becoming A New ADP Clients:

              – 2 months free for all PTA partners

              – 5 months free for the next 2 weeks!

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

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

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

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

Click here for ADP’s COVID-19 Resource Center

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

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

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

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

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

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

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

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

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

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

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

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

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

EVV 

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

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

Supercharge your ADP Time Cards with T-Sheets!

EVV (Electronic Visit Verification) Tracking

Manage Scheduling

Track Time By The Job

Easy Accurate Time Sheets

Mobile Time Tracking

Who’s Working Now and Where?

Alerts & Approvals

Reports

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

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

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

Some of The Helpful ADP Free Training Webinars & Recordings

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

Duration: 1 hour

Available On Demand

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

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

Duration: 1 hour, 3 minutes

Available On Demand

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

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

Duration: 1 hour, 1 minute

Available On Demand

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

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

Duration: 35 minutes

Available On Demand

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

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

Duration: 1 hour, 2 minutes

Available On Demand

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

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

Register

Cost Free

CPE Credits1.0 hour

CE Credits0.0 hours

Course Description

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

https://www.adp.com/

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

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

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

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

Julie Blacklock/ Owner

Current Job Postings (See below)

Turn of Events:  Good News For Providers

• Calls for an ICF/IID representative on the HHSC LTC Facilities Council,
• Caps the amount/$ of administrative penalties which may be imposed per each ICF/IID on-site regulatory visit or complaint investigation,
• Requires HHSC not to enforce an administrative penalty in the HCS or TxHmL waiver programs until interpretive guidelines are developed and adopted, and
• Requires that rules to implement the changes required by HB 3240 be adopted not later than December 1, 2021.

May 25th, 2021

The Federal Communications Commission is offering an Emergency Broadband Benefit.

This new benefit will:

• Help families and households struggling to afford Internet service during the COVID-19 pandemic.
• Connect eligible households to jobs, critical health care services, virtual classrooms and more.

Read information about the benefit and eligibility requirements 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

Website Link:

For Previously Recorded Webinars & FAQ’s

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

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

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

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

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

Upcoming Webinar: How to Create a Culture of Data-Driven Decision Making!

“The Value of Data-Driven
Service Provision”

Date: June 11, 2021 

Time:  1:00 PM (EST)

Presenter: Jason Laws (Director of Quality & Data Initiatives)
jason.laws@therapservices.net

Are you looking to create a culture of data-driven decision-making at your organization?

Join us for an engaging webinar presentation to learn more about:

• Defining key metrics and indicators
• Identifying what data has meaning
• Tracking progress towards organizational goals

And More

To Register, please click on the link below.

REGISTRATION

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

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

 Here is her LinkedIn page

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

Data-Driven:

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

---

The University of North Texas Workplace Inclusion & Sustainable Employment (UNTWISE) is offering a free on-demand, prerecorded webinar called Ethics of Informed Choice, which is available through April 22, 2022. This training outlines informed choice and helps contractors, vendors, and Vocational Rehabilitation (VR) staff understand its importance in the VR process. Information on the training can be found on the UNTWISE web page.

“This training will define Informed Choice and help contracted providers and VR staff understand its importance in the VR process.  Laws related to informed choice as well as results from the Rehabilitation Council of Texas annual report will be discussed.  Best Practices, Ethics of Informed Choice, and Case Studies will be used to outline the role of VR staff and providers.”

Presenter: Lucy Gafford

May 16th, 2021

For those of you wanting a separate copy of the ANE TAC principles that were put into the HCS TAC in October of 2019, I have attached links to a few pdf versions for you to use at your facility.  These particular set of HCS principles are important to keep handy, especially concerning follow-up timelines as well as who to contact, when to contact and report and what to report. after an allegation.  

40 Tex. Admin. Code § 9.175
Certification Principles: Requirements Related to the Abuse, Neglect, and Exploitation of an Individual

or

HCS ANE Principles

May 16th, 2021

When to Call the IDD Ombudsman

The IDD Ombudsman receives complaints from individuals, family members, and the general public about the care, treatment, or services provided to an individual. Individuals receiving services or family members of the individual may prefer to call the IDD Ombudsman to assist in resolving an issue rather than speaking with their LIDDA service coordinator (SC) or HCS provider.

(In addition, if you are not sure where to make a complaint or who to make a complaint to, as it may not apply specifically to a specific individual in your program, the IDD Ombudsman will generally help you find out who you need to talk to.)

A complaint may be reported to the IDD Ombudsman by anyone by calling 1-800-252-8154 between 8 a.m. and 5 p.m. Monday through Friday.                                                                       A complaint may also be emailed to OmbudsmanIDD@hhsc.state.tx.us.  (I highly recommend email if you want something in writing)

Written complaints may be mailed to:

Texas Health and Human Services Commission
IDD Ombudsman
P.O. Box 13247
Austin, TX 78711-3247

.

For Your Information:  Rights Booklet and Handbook For Individuals In The HCS Program

The rights booklet, described in 40 Texas Administrative Code (TAC) §9.190(e)(2) and the rights handbook, described in 40 TAC §4.117(c) may be found on the HHSC website at https://hhs.texas.gov/about-hhs/your-rights/office-ombudsman/hhs-ombudsman-publications.

The booklet and handbook may also be obtained from HHSC by sending an email to OmbudsmanIDD@hhsc.state.tx.us.

Or click on the links below to download a copy

Resources for people with intellectual or developmental disabilities:

• Your Rights in the Home and Community-based Services Program (PDF)
• Your Rights in the Texas Home Living Program (PDF)
• Your Rights in Local Authority Services (PDF)

Resources for anyone looking for help resolving a problem concerning HHSC services:

• Have a question or problem with Texas Health and Human Services Office of the Ombudsman brochure (PDF)
• Office of the Ombudsman Reference Guide (PDF)

Attention: HCS, TxHmL, CDS, CLASS, DBMD, ICF/IID, SNF’s, and other HHSC programs

Providers can sign up to receive Gov Delivery, an electronic mailer from HHSC that includes current news and topics of interest for LTC providers.

Twogether Consulting Social Media pages.

Facebook page:   https://www.facebook.com/TwogetherConsultingIDDWaiverConsultants

Instagram Page:   https://www.instagram.com/twogetherconsulting/

May 3rd, 2021

Information Letter No. 2021-19

Termination of Waiver Services during the Public Health Emergency was on hold for eligibility issues, but that is now back in effect as of May 10th, 2021.

This information letter is to notify you that, starting May 10, 2021, HHSC will resume ending waiver services of an individual who is not eligible for CLASS, DBMD, HCS, or TxHmL. This is being done in accordance with a rule promulgated by the federal Centers for Medicare and Medicaid Services (CMS).
During the federal public health emergency (PHE), HHSC has not terminated individuals’ IDD waiver services for most reasons related to eligibility. The only service terminations processed during the PHE have been due to an individual dying, moving out of state, or voluntarily withdrawing from a program.
In accordance with CMS’s Interim Final Rule CMS-9912-IFC, starting May 10, 2021, HHSC will resume processing CLASS, DBMD, HCS, and TxHmL program terminations for individuals who do not meet a program’s eligibility. The rules for program eligibility are:
● §9.155 for HCS,
● §9.556 for TxHmL,
● §42.201 for DBMD, and
● §45.201 for CLASS.
Individuals no longer eligible for a waiver program will have waiver services terminated, but may continue to receive Medicaid state plan services, such as primary care and pharmacy benefits, until the end of the federal PHE.
If there are any additional changes to Medicaid coverage, HHSC will notify individuals at the appropriate time.

To read more, here is Information Letter 2021-19

Contact the following with questions about termination of a person’s program:

HCS, TxHmL, CLASS Program Services:
IDD Program Enrollment and Support Message Line at 512-438-2484.

DBMD Program Services
IDD Utilization Review Message Line at 512-438-4896

May 3rd, 2021

HHSC Publishes In-Home Day Habilitation Information for Program Providers for COVID-19 (IL 2021-20)

The Texas HHSC is temporarily waiving certain requirements in Section 3710, 4381.3, 4381.7(6) and 4381.7(7) of the Home and Community-based Services Billing Guidelines and the Texas Home Living Billing Guidelines.

This is in response to COVID-19 and to provide access to needed day habilitation services.

HHSC has published a revision to this guidance IL 2021-20 In-Home Day Habilitation Information for Program Providers for COVID-19 (PDF) which replaces IL 2021-16. It extends the temporary guidance through
May 31, 2021.

Email questions to HCS Policy.

April 17th, 2021

Revisions to Guidance For Day Habilitation Providers Coming!

HHSC and DSHS are working on revisions to the DSHS Guidance for DHs.  Once revisions are finalized HHSC will notify providers.

March 25th, 2021

Program Provider Response to COVID-19 and Visitation Expansion-

Day Habilitation Off-Site

2.1.8 Day Habilitation and Outside Employment
Individuals receiving HCS or TxHmL services can choose to attend off-site day habilitation that is in compliance with DSHS Checklist for Day Habilitation Sites or outside employment with documented informed decision-making.
• The program provider’s infection control policy must include provisions specific to those attending off-site day habilitation, employment, or any other community activity to ensure the health and safety of individuals.
• The program provider must screen individuals for fever and other signs and symptoms of COVID-19 upon their return to the residence.
• If program provider staff does not provide transportation, the program provider should arrange for pick-up and drop-off to occur outside the residence when possible. If transportation staff must enter the residence to prepare individuals for transportation, they must be screened and wearing a face mask.
• Program providers must provide oversight of day habilitation settings to ensure compliance with their contract. They must request documentation (e.g., policies, plans, procedures) from the day habilitation site that demonstrates how it plans to comply with DSHS guidance. For outside employment, the program provider must request from the employer information on how the employer is responding to COVID-19 to protect its employees.
PL 21-09 March 25, 2021 Page 5 of 20

• The program provider must ensure individuals are supplied with masks or cloth face coverings and encourage their appropriate use, unless contraindicated. The provider cannot charge individuals for facemasks or face coverings.
Providers are responsible for ensuring the health and safety of the individuals in their care. In the context of deciding whether to attend outside day habilitation sites, the program provider fulfills this responsibility by participating in the informed decision-making process, which includes:
• Providing a full list of available options and alternatives, including in-home day habilitation, if available;
• Assessing the risks of attending day habilitation;
• Providing training on PPE, hygiene, and physical distancing;
• Except for individuals in host-home and own home/family home settings, ensuring that individuals have access to PPE.
For individuals in a host home and own home/family home settings, the program provider must encourage individuals to wear a facemask or face covering over the nose and mouth and use any other required PPE necessary to safely attend the day habilitation site.
The program provider must only contract with a day habilitation site that agrees to comply with DSHS guidance. As part of its contractual oversight of the day habilitation site, the HCS or TxHmL program provider should set up a system to monitor compliance with DSHS guidance.
In addition, the program provider must include in its contract a requirement for the day habilitation site to inform individuals, program providers, staff, and family when it is aware of probable or confirmed cases of COVID-19 among staff or the individuals it serves. However, a day habilitation site must not release personally-identifying information regarding confirmed or probable cases.

May 3rd, 2021

May 2021 HCS/TxHmL Provider Certification Principle Webinars

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

This webinar will give an overview of Texas Administrative Code §9.174 relating to service delivery requirements for HCS program providers.

Certification Principle 9.174-Service Delivery
May 11, 2021
10 – 11:30 a.m.

Register for the HCS provider webinar.

Email your questions to Shelley Gusky.

February 2021 HCS/TxHmL Provider Certification Principle Webinars

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

Certification Principle 9.177: Staff Member and Service Provider Requirements

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

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

Certification Principles 9.179 & 9.180: Restraints and Prohibitions

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

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

Certification Principle 9.178: Quality Assurance

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

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

Certification Principle 9.173: Rights of Individuals

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

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

Certification Principle 9.175/9.585: Abuse, Neglect and Exploitation

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

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

Certification Principle 9.174: Service Delivery

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

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

January 2021 HCS Provider Certification Principle Webinars

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

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

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

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

Comprehensive Nursing Assessment

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

PREVIOUSLY RECORDED WEBINARS

Dec 3rd, 2020 Recording of Certification Principles:

Quality Assurance– Webinar for HCS and TxHmL Providers Available

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

View the webinar recording here.

Dec 10th, 2020 Recording of Certification Principles:

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

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

View the webinar recording here.

Dec 15th, 2020 Recording of Certification Principles:

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

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

View the webinar recording here.

Dec 17th, 2020 Recording of Certification Principles:

Service Delivery– Webinar for HCS and TxHmL Providers Available

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

View the webinar recording here.

November 12th, 2020 Recording of Certification Principles:

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

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

View the webinar recording here.

November 19th, 2020 Recording of Certification Principles:

Restraints and Prohibitions Webinar for HCS and TxHmL Providers Available

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

View the webinar recording here.

March 29th, 2021

Program Provider Response to COVID-19 and Visitation Expansion for HCS (Replaces PLs 2020-22 and 2020-40)

The HCS/TxHmL provider letter 21-09 below spells out guidance to HCS/TxHmL providers that was adopted in COVID-19 Emergency Rules and Expansion of Visitation Emergency Rules.

PL 2021-09

March 25th, 2021

HHSC Adopts New HCS Program Provider Response to COVID-19 and Expansion of Reopening Visitation Emergency Rule!!!

HHSC has adopted new Home and Community-based Services (HCS) Program Provider Response to COVID-19 and Expansion of Reopening Visitation Emergency Rule that establish criteria for expanded indoor and outdoor visitation as well as essential caregiver visits. These rules are effective March 23, 2021.

Read the HCS COVID-19 Response Emergency Rules and Expansion of Reopening Visitation Emergency Rule (PDF).

Updated TxHmL Provider Response to COVID-19 – Mitigation Emergency Rules!!!

HHSC has issued updated COVID-19 emergency rules. The rules, in place to stop the spread of COVID-19, require actions by Texas Home Living (TxHmL) providers. The new screening criteria reflects current CDC recommendations and the definition of “providers of essential service” was expanded. These rules are effective March. 23, 2021.

Read the TxHmL COVID-19 Response Emergency Rules (PDF).

March 16th, 2021

COVID-19 Vaccine

Phase 1C

April 29th, 2021 MCS COVID-19 Stakeholder Information Session

Thank you for your interest in listening to the April 29 Texas Medicaid CHIP COVID-19 Information Session.

The audio from this session can be found here.

• Email us for transcript

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.

March 11, 2021 MCS COVID-19 Stakeholder Information Session

Thank you for your interest in listening to the March 11 Texas Medicaid CHIP COVID-19 Information Session.

The audio from this session can be found here.

• Email us for transcript

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.

February 22nd, 2021

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

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

January 24th, 2021

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

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

The following rules are extended:

• Home and Community-based Services rule 40 TAC §9.198 and 9.199 (PDF)
• Texas Home Living rule 40 TAC §9.597 (PDF)

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

January 10th, 2021

Federal Pharmacy Partnership Program:

Contact Information for COVID-19 Vaccines

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

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

Walgreens:
Email Immunize ILTC.

January 7 Texas Medicaid CHIP COVID-19 Information Session.

The audio from this session can be found here.

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

December 22, 2020

DSHS Issues Guidance About Moderna Vaccination Readiness for Vaccine Administrators

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

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

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

Helpful Vaccination Information

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

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

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

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

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

December 2, 2020

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

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

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

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

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

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

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

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

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

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

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

December 2, 2020

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

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

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

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

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

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

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

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

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

December 2, 2020

Risk/Benefit Return to Activity Form (Free from our friends at HRS) 

This could be very helpful for considerations for returning to work, Day Hab, Volunteer Jobs, etc…

https://hrstonline.com/download/risk-benefit-return-to-activity-form/?wpdmdl=3104&refresh=5fc779cf9f80e1606908367

Risk/Benefit Return to Activity Form

November 22, 2020

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

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

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

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

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

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

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

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

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

Reminder to LTC Facilities about Death Reporting Requirements

July 22, 2020

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

• Intermediate care facilities must report all deaths to Complaint and Incident Intake within one hour. See:
  • PL 17-02 (licensed facilities)
  • PL 17-03 (non-licensed facilities).
• Home and Community-based Services and Texas Home Living Program Providers must report all deaths of people receiving HCS or TxHmL services to HHSC by the end of the next business day following the death or the program provider’s learning of the death. See IL 12-28.

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

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

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

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

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

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

LTC Providers Required to Report COVID-19 to HHSC

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

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

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

FAQ’s For Covid-19

04/02/20

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

Contact Information For Other Questions:

• 512-438.5359
  schmidt@hhsc.tx.us.state
• 
  Policy Specialist for HCS/TxHmL
• hcspolicy@hhsc.state.tx.us

New Guidance for LTCR Providers on Coronavirus

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

• 888-963-7111
• 877-570-9779

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

From The CDC website:

            HHSC’s WS&C Portal

April 26th, 2021

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.

• A recorded session of The WSC portal training
  • https://register.gotowebinar.com/recording/recordingView?webinarKey=3385319749029434640&registrantEmail=javasbja%40gmail.com

Here are the handouts:

• Basics of portal
  • Provider letter 2021-13
    • PL-2021-13
  • WSC Portal Training Handout
    • WSC Portal Training Handout with links

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.

• Where do I find the page to create the portal?
  • Bookmark this link below, because that is where it will be and it will go live closer to the release of the portal.
  • https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/resources/waiver-survey-certification-wsc-provider-portal

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

June 20, 2020

Survey Process:  Timelines

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

.

• Table of Contents:      Page 1
• Rule Introduction (purpose, applications, definitions):      Pages 2 – 7
• ALFs:            Pages 8 – 11
• DAHS:           Pages 12 – 15
• HCSSAs:       Pages 16-24
• Prescribed Pediatric Extended Care Centers:    Pages 25 – 27
• Nursing Homes:             Pages 28-37
• ICFs/IID:                  Pages 38 – 41
• HCS:                        Pages 42 – 45
• TxHmL:                   Pages 46 – 47

April 17th, 2021

HCS Retainer Payments Status

We have been informed that CMS has finally approved retainer payments for HCS.  Certain provider associations will have the opportunity to review and provide feedback on the draft Information Letter related to the payments.  HHSC is also developing rules related to this initiative, but those associations will not be able to provide feedback on them.   HHSC  will conduct a webinar on the HCS retainer payments.

New Providers, Please Take These Trainings

HHSC Publishes HCS Expansion of Reopening Visitation Rules

Update:   April 17th, 2021

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

March 24th, 2021

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

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

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

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

March 22nd, 2021

ICF COVID-19 March 22 Webinar Recording Available

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

Listen to the COVID-19 Q&A recording.

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

March 11th, 2021

Recording of ICF COVID-19 March 8 Provider Webinar Available

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

Listen to the COVID-19 Q&A recording.

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

February 8th, 2021

Draft ICF/IID Rule Changes

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

February 7th, 2021

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

Reminder to Provide Letter to Families

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

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

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

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

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

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

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

January 19th, 2021

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

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

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

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

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

Read the updated ICF FAQs (PDF).

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

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

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

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

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

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

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

Listen to the COVID-19 Q&A recording.

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

January 10th, 2021

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

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

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

HHSC Publishes Revised Reporting Guidance for Long-Term Care Providers

(PL 20-37)

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

November 22nd, 2020

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

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

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

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

ICF Provider Webinar

November 30, 2020

11 a.m. – 12:30 p.m.

Register for the COVID-19 webinar.

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

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

View the COVID-19 Q&A recording.

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

10/16/20

Important Information!

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

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

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

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

• signs and symptoms of COVID-19;

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

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

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

or

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

LTCR Form 2195

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

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

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

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

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

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

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

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

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

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

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

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

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

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

10/05/20

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

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

10/03/20

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

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

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

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

Phase I Visitation Rules, no longer in effect!

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

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

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

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

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

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

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

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

FAQ’s (June 2020)

Survey Operations Resume as of June 15th, 2020

Providers Must Log Residents’ Leave

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

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

Provider Joint Training Opportunities

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

Survey Process for ICF Has Changed: Please Be Aware

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

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

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

Appendix Q of SOMA (Immediate Jeopardy) Changes

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

CMS clarifications letter

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

SOMA appendix Q Section  Immediate Jeopardy 

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

February 23rd, 2021

IDD Vaccine Plan Approved (HCS/TxHmL/ICF)

February 12th, 2021

HCS/TxHmL:  

Today DSHS reported it has finalized its presentation of the Tarrytown Expocare vaccine plan that the three IDD associations, Tarrytown and DSHS have been working on for many weeks.  DSHS says the plan will be presented to DSHS Vaccine Leadership and the Commissioner today and also the Expert Vaccine Allocation Panel (EVAP) at its next meeting Monday morning.  They expect to present this plan to the Governor’s Office Monday evening at which point DSHS feels it will have a final answer as to whether the plan is approved. Currently, we are not sure when it will be approved.

**This plan was developed using data the three IDD associations obtained from their respective members which include number of vaccines needed in both ICF/IID and HCS/TxHmL programs.  Thank you for all the work our IDD associations do for providers and individuals in the program!)

• HHSC has not made a decision whether this same reporting requirements ICF requires, will be established for the HCS/TxHmL program.

February 12th, 2021                                                                 

ICF/IID:

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

A stand-alone webinar on the requirement will also be held.  Here is the link to draft Provider Letter and draft emergency rules 

(So remember to update your policies and procedures for COVID-19 /infection control policies and procedures!!!)

ICF/IID providers will be required to complete a survey indicating how many residents and staff have received the vaccine (1st, 2nd, or both doses).  The survey will be open for at least the duration of the emergency rule, requiring providers to add any new information about the status of the vaccines given  This will allow providers to report 2nd doses given if such was not reflected in a provider’s first data entry (that is provided the individual received a 2-dose vaccine.  Some vaccines will only have 1 dose- i.e. Astrozenica), or to report receipt of newly first-doses given.

After this three week period, HHSC will reconcile the data to identify where gaps exist. This process will include contacting providers as needed to confirm the information reported through the survey.  HHSC anticipates the reconciliation process taking 2 or 3 days.

The data will then be sent to DSHS to be used to link providers still in need of the vaccine (whether 1st or 2nd dose) for the individuals they serve and their staff.  This process will take about 2 weeks.  The full process should take 5 weeks total, assuming HHSC completes its reconciliation process in a timely manner and DSHS is able to link providers to a vaccine entity in a speedy and efficient manner.

• Providers will not be cited on the rule, but it is possible to receive a citation from a desk audit (HHSC did not elaborate on this).
• The survey does not capture (and is not intended to capture) data on individuals who have opted not to receive the vaccine.
• Recognizing that not all providers are aware of or are tracking the vaccination status of their staff, providers only need only to report the number of staff of which they are aware have received the vaccine.

.

MEDICAID WAIVER PROGRAM WEB-BASED TRAINING FROM HHSC

Abuse Neglect and Exploitation Competency Training and Exam     

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

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

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

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

March 16th, 2021

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.

December 11, 2020

Plan of Removal

Plan of Removal 

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

Intermediate Care Facilities 

Writing Acceptable Plans of Correction for ICFs/IDD 

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

Scope and Severity Webinar Now Available

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

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

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

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

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

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

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

View the order at:  https://open.texas.gov/uploads/files/organization/opentexas/EO-GA-34-opening-Texas-response-to-COVID-disaster-IMAGE-03-02-2021.pdf

Tax Deadline Extensions for Individuals and Businesses

The IRS announced last week that because of last month’s winter storms, Texans will have until June 15, 2021, to file their individual and business tax returns and make tax payments.

This includes 2020 individual and business returns normally due on April 15, as well as various 2020 business returns due on March 15. Among other things, this also means that affected taxpayers will have until June 15 to make 2020 IRA contributions. The June 15 deadline also applies to quarterly estimated income tax payments due on April 15 and the quarterly payroll and excise tax returns normally due on April 30.

The IRS automatically provides filing and penalty relief to any taxpayer with an IRS address of record located in the disaster area, so taxpayers do not need to take any additional action to receive relief.

You can read the full announcement on the IRS website below:

https://www.irs.gov/newsroom/victims-of-texas-winter-storms-get-deadline-extensions-and-other-tax-relief

Topics:      

Description of HCS & TxHmL Waivers and Basic Terminology Needed

Tips for Preparing For The HCS Provider Certification Test.  

Important Sections of the HCS & TxHmL Handbook,

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

Frequently Cited TAC Codes  (HCS & TxHmL)

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

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

What Happens After I Pass My Test?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

New Revised TAC (Texas Administrative Code) for HCS

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

 Title 40 Part 1 Chapter 9 Subchapter D

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

Section 9.151 through 9.192.

New Revised TAC (Texas Administrative Code) for TxHmL

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

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

 Title 40 Part 1 Chapter 9 Subchapter N 

Section 9.551 through 9.587

See link to February 2021 edition below:

https://www.tmhp.com/sites/default/files/file-library/ltc/bulletins/February%202021%20LTC%20Bulletin%20No.%2085_Final%20for%20Web.pdf

See link to November 2020 edition below:

https://www.tmhp.com/sites/default/files/file-library/ltc/November%202020%20Long-Term%20Care%20Provider%20Bulletin%20No.%2084.pdf

HCS/TxHmL & CLASS Programs

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

ICF/IID

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

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

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

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

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

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

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

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

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

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

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

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

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

February 7th, 2021

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

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

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

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

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

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

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

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

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

April 15th, 2019

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

Who Can Use the Portal?

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

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

What Are the Benefits?

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

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

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

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

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

Certain Medicaid Waiver Payments May Be Excludable From Income

See the following IRS page for the full FAQ

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

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

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

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

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

Individual Care Provider Questions

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

OFF-SITE CONSULTATION:  $75/hr

You can purchase 1, 3, 6, 9 or 12 hrs of off-site consultationfor assistance with HCS, TxHmL, or ICF and Additional IDD Waiver Programs.

This includes: research, phone calls, video chats, webinars, emails and texts. 

You may use this off-site consultation time as needed or all at once.  You can schedule a conference call, video chat or short training webinar with us, depending on your needs or contact us via email or text for questions you might have.  We bill a minimum of 15 mins. per contact.

After you make payment for a service, someone will contact you to schedule an appt. as soon as possible to set up initial services.  Please be sure to email us with your basic contact information and purpose for services at:

https://twogetherconsulting.com/contact-us/  

or info@twogetherconsulting.com

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

 OFF-SITE NURSING CONSULTATION:  $75/hr

There is a separate 1-hour payment tab for nursing consultation.  You may add on as many nursing hours as you want to the payment tab!

If you would like to schedule a teleconference or video conference with our RN Consultant and your nursing department or other members of your team, please contact us at info@twogetherconsulting.com  

This is a great way to prepare for a survey, discuss post-survey concerns, develop ideas for plans of correction, discuss nursing concerns about an individual prior to admission, or assist nurses with new admissions to the program.  

This service does not include the actual development of policy & procedure or assistance with writing plans of correction/corrective action plans..

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

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

HCS/TxHmL IDR Process Coming Soon!  

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

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

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

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

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

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

Request Forms

• IDR Request Form for NFs, ALFs, and ICFs (PDF)

Due Dates

Supporting documentation due dates are as follows:

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

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

Where to Submit Your Supporting Documentation

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

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

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

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

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

Email: iidrgroup@mpro.org

Texas Administrative Code rules for IDR

• SNFs/NFs and ICF/IIDs

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

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

12/28/20

IMPORTANT REMINDER!

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

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

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

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

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

10/29/20

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

This information letter (IL)explains:

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

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

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

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

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

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

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

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

In this webinar, we will review:

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

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

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

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

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

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

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

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

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

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

NCD Opportunity

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

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

AADMD’s Joint Position Statement

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

Read more, click on link below:

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

Twogether Consulting has added some new services to include:

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

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

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

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

Appendix K-Emergency Preparedness and Response-COVID-19

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

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

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

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

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

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

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

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

 [NPR §303.0015 ]

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

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

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

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

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

There are two kinds of nursing peer review:

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

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

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

 Provider Specific Training offered by Twogether Consulting

• Training (Off-site) to Providers concerning Direct Care staff’s interaction with Surveyors during interviews and how this can affect the provider, particularly the nursing department, as well as preparing for the survey in general.  (HCS, TXHmL, and ICF)
• Training (Off-site) to Providers concerning “Expectations of The Nurse Part I and II”  (HCS, TXHmL, and ICF)
• Training (Off-site) to Providers concerning Nursing Staff’s interaction with the Surveyors, particularly during the interview process with the nurse.  (HCS, TXHmL, and ICF)
• Training (Off-site) Other Direct Care staff training such as Abuse Neglect & Exploitation Reporting and Follow-Up for HCS/ICF, including PPT handouts,  Quiz and Inservice Sheet for your records or Certificates of Completion. This training does meet the new requirements listed in the current HCS TAC Code 9.175     Geared towards CM’s, QIDP’s, Nurses, Quality Assurance, Program Managers and  other Administrative Staff                                                   

• ---

• Other Direct Support Staff Training Webinars:  We continue to offer DIT’s (Directive Inservice Trainings) for ICF as well as General Direct Support Training for HCS/TxHmL/ICF providers.  Here are just some of our training webinars currently available live and/or via pre-recorded sessions:
• Abuse/Neglect/Exploitation-specific to Direct Support Staff
• Direct Support Documentation (Service Delivery Logs/Residential Notes, Incident Reports, Behavioral Support Documentation and Data Collection, and Training Data Collection),
• Elements of the Behavior Support Plan & The Importance of Your Documentation,
• Expectations From the Nurse of The DSP (Includes discussion of Medical Documentation as well-MARS, Medication Errors, Treatment Sheets, Significant Observations), 
• When and What to Report To The Nurse,
• SAM’s Training (Self-Administration of Medications Training To Staff-General Routes, Tasks, documenting), ,
• Host Home/Companion Care Service Provider Responsibilities,
• What The Nurse Expects from the HH/CC Provider and/or CRA, and many other training webinars.

Guest presenter:

Hillary Gaytan  (Business Development Representative)

From:  HRS

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.

Pre-Webinar Survey

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

We did not get to at least 4 of our questions primarily on COVID during the 1st Round Table Discussion on 11/5/20.  We still have some questions on RN Delegations that we need feedback on for future sessions and COVID-19.  We felt they were very important and did not want to wait until the Feb. quarterly session.  Thanks.

Please print out this page and document your answers and responses to help us to develop topics of discussion during our 1st session as well as future round table sessions.

You will need to scan your completed survey and email them as soon as possible, but by no later than 12/08/20, to info@twogetherconsulting.com or you may also submit them when you complete your registration prior to 11/1/20 to Meghan Jones.  Her email is:  meghanjones.tx@gmail.com if you prefer.  You do not have to put your name on the survey!   You can also fax them to 512-291-9075

Survey:

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

Survey Questions:  

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

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

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

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

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

c. N/A  (Not an RN)

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

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

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

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

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

a. Yes    b. No

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

Comment:

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

a. Yes    b. No

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

Comment:  

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

Comment:

Check out our page at “Gotostage” where we are providing  recordings of our free webinar sessions and other education For HCS, TxHmL, and ICF Providers

https://www.gotostage.com/channel/3b0bd3b1a47c4e80be974f4bcfa54d7b

September 15th, 2020