Twogether Updates
Letter To Providers From Twogether Consulting-December 1st, 2023
December 1st, 2023
From Twogether Consulting!
Implementation of the Personal Needs Allowance (PNA) Adjustment
December 1st, 2023
ICF/IID Providers:
Implementation of the Personal Needs Allowance (PNA) Adjustment
As required by House Bill 54 (88th Legislature, Regular Session, 2023), the Health and Human Services Commission (HHSC) is directed to increase the minimum monthly personal needs allowance (PNA) for Medicaid beneficiaries of a nursing facility (NF) or related institution licensed under Chapter 242, Health and Safety Code, assisted living facility, intermediate care facility for individuals with an intellectual disability or related condition (ICF/IID), or other similar long-term care facility who receives medical assistance. The monthly PNA would increase from $60 to $75 for a person and from $120 to $150 for a couple.
The increase in the minimum PNA requires the Centers for Medicare & Medicaid Services (CMS) approval of a Medicaid State Plan Amendment (SPA). Subject to CMS approval, HHSC anticipates the increase in the PNA will be effective Jan. 1, 2024.
HHSC will publish a Provider Information Letter with more detaied later.
Email ICF/IID with any ICF/IID questions.
Employment First Assessment Tool & Rules (HCS/TxHmL/CLASS/DBMD)
December 1st, 2023
As of Nov. 14, 2023, service coordinators and case managers in the CLASS, DBMD, HCS, TxHmL waiver programs and STAR+PLUS Home and Community-Based Services (HCBS) must use the Employment First Discovery Tool as part of the service planning process to explore an individual’s desire to work.
Review IL 2023-41 Employment First Discovery Tool for more information.
Be sure to sign up for :
Employment First Discover Tool Webinar
Jan. 10, 2024
10–11 a.m.
Register here to attend the webinar.
Email questions to John Huffine.
November 13th, 2023
HHSC publishes a newly, updated Employment First Discovery Tool (Form 8401) and accompanying instructions based on the rule implementation related to Senate Bill 50, 87th Legislature, Regular Session, 2021. Effective November 14, 2023, use of the tool is required to ensure that individuals who want to work receive employment services from the Texas Workforce Commission (TWC) or through the Medicaid waiver program in which the individual is enrolled.
Impacted programs:
- Community Living Assistance and Support Services (CLASS)
- Deaf-Blind with Multiple Disabilities (DBMD) programs
- Home and Community-Based Services (HCS)
- Texas Home Living (TxHmL)
- STAR+PLUS Home and Community-Based Services (HCBS)
HHSC has published IL 2023-41 Employment First Discovery Tool. Beginning on November 14, 2023, service coordinators and case managers in the CLASS, DBMD, HCS, TxHmL waiver programs, and STAR+PLUS Home and Community-Based Services (HCBS) must use the Employment First Discovery Tool as part of the service planning process to explore an individual’s desire to work.
The tool with instructions is located under the Forms section on the respective program areas HHSC webpage.
June 5th, 2023
IL 2023-22
Employment First Assessment Tool: Proposed Rules
Home and Community-Based Services (HCS) and Texas Home Living (TxHmL) – During the completion of the Service Coordination Assessment (Form 8647), the service coordinator asks the person about their desire to work. Document the person’s response on Form 8647.
If the individual indicates a desire to work, the service coordinator must complete the Employment First Uniform Assessment and make a referral to Texas Workforce Commission or refer the person for employment services through the waiver program where the person is enrolled.
Employment First Uniform Assessment Form 8401
Dr. Ollie Seay Knowledge Award For Excellence In Education or Research
November 25th, 2023
I am happy to announce that I was presented with the Dr. Ollie Seay Knowledge Award For Excellence In Education or Research. I was so honored to receive this award especially since I first met Dr. Seay when I first started working with IDD services at Austin Travis County MHMR (Now Austin Integral Care) in 1992 when she was head of the psychology department at our offices. We lost Dr. Seay earlier this year and she will be missed by all who knew her, especially for her many years with the Texas chapter of AAIDD and for her time teaching at Texas State.
Julie Andrews Blacklock
Family Caregivers: HHSC Offers Webinars
November 12th, 2023
Texas HHS Aging Services Coordinationor will be presenting a webinar series during National Family Caregivers Month in November.
This webinar series is for caregivers, people who work with caregivers and anyone interested in caregiving.
November Caregiver Webinar Series
November 15, noon-1 p.m.
Cultivating Community and Support for the Lifespan: Caregiving for Children with Disabilities
Register here.
November 29, noon-1 p.m.
Overview of supports for caregivers and care recipients
Register here.
Contact
For more information visit the HHS website or email the Age Well Live Well inbox.
HHSC IDD Operations Portal For Providers-2023 Update
November 12th, 2023
IDD Portal Information & Additional Training Resources
The Intellectual and Developmental Disabilities (IDD) Operations Portal is an online based application used by long-term care IDD providers and Local Intellectual Developmental Authorities (LIDDAs) to submit and receive documents to and from Texas Health and Human Services IDD Program Eligibility and Support (PES) and IDD Waivers Utilization Review (UR) sections. The portal is only meant to replace document submissions by fax and mail.
It does not replace the responsibility of providers or LIDDA’s to ensure accurate completion of documents, maintain signed paper copies of forms in individual records, and comply with HIPAA regulations when making submissions to the Health and Human Services Commission (HHSC). During initial account setup, the provider or LIDDA assigns a security authority who is responsible for managing their staff’s access to the portal. Providers and LIDDAs are responsible for ensuring procedures are in place to properly manage staff’s access to individual’s records inside and outside of the portal, just as they did prior to portal implementation.
Click on to see: IDD-operations-portal-user-guide
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.
From Our Friends at IntellectAbility: Clinical Pearls in IDD Healthcare that are Important Knowledge for DSPs
November 11th, 2023
I thought this was a great article for providers and their DSP’s. Please feel free to check out their other articles and resources and their training on person-centered practices!
Clinical Pearls in IDD Healthcare that are Important Knowledge for DSPs
As co-published by National Alliance for Direct Support Professionals (NADSP) and Research and Training Center on Community Living (RTC-CL) in the Frontline Initiative.
By Craig Escudé, MD, FAAFP, FAADM, President of IntellectAbility
I started practicing in the field of healthcare for people with intellectual and developmental disabilities (IDD) in the 1990s. I very quickly realized how little I knew about this field. I found myself being responsible for the healthcare of hundreds of people with IDD without fully understanding many concepts that I later learned were important. Most health professional schools do not provide training about the healthcare needs of people with IDD. Click here to read more…
For more resources and articles from IntellectAbility, please go to: https://replacingrisk.com/idd-resources/
EVV HAAeXchange Townhall Meeting
November 11th, 2023
The Texas Health and Human Services Commission (HHSC), Texas Medicaid & Healthcare Partnership (TMHP), and HHAeXchange will have one last Town Hall webinar for all Electronic Visit Verification (EVV) stakeholders.
Attendees will have the opportunity to ask questions and provide input on the Texas EVV migration to HHAeXchange and the upcoming EVV expansion due to the Cures Act Home Health Care Services implementation.
Webinar Registration
Register ASAP! If you did not register before, this is your last chance to see scheduled webinars. Participation is optional but encouraged, so sign up today. Webinars are scheduled from 9-11 a.m. Central Time.
Contact HHSC EVV Operations with any questions.
Q&A’s & Helpful Information For EVV HAAeXchange (Regarding Previous Townhall Meetings)
EVV (Electronic Visit Verification) Updates
November 11th, 2023
Prepare for EVV Cures Act Home Health Care Services Implementation
HHSC will require Electronic Visit Verification (EVV) for Medicaid home health care services (HHCS) beginning Jan. 1, 2024, as listed in the Home Health Care Services required to use EVV (PDF). The 21st Century Cures Act is the federal law that requires states to implement EVV.
HHCS Claims for EVV Required Services Must be Submitted to TMHP Starting Dec. 1
- Program providers and financial management services agencies (FMSAs) must submit all HHCS EVV claims to Texas Medicaid & Healthcare Partnership (TMHP) using TexMedConnect, or through Electronic Data Interchange (EDI) using a Compass 21 (C21) Submitter ID starting with dates of service on or after Dec. 1, 2023.
- Managed care organizations (MCOs) will reject any HHCS managed care claims with EVV services and dates of service on or after Dec. 1, 2023, back to the program provider and FMSA, directing them to submit the claim to TMHP for EVV claims matching.
Register for TexMedConnect
- To access TexMedConnect through the TMHP website you must already have an account. If you don’t have an account, set one up using the information provided in the TMHP Website Security Provider Training Manual.
- Program providers and FMSAs that need help setting up C21 or CMS Submitter IDs should contact the EDI Help Desk at 888-863-3638, Option 4, or visit the TexMedConnect webpage for additional information.
Request EVV Portal Access
- To access the EVV Portal, program providers and FMSAs must have a TMHP User Account.
- Program providers and FMSA staff must contact their TMHP Provider Administrator to request EVV Portal access.
- For full instructions, review the EVV Portal job aids on the EVV Learning Management System (LMS).
Complete Onboarding and EVV Portal Training by Dec. 31
Program providers and FMSAs must complete the following before Dec. 31, to avoid impacts to EVV claims payment:
- Onboard with the state-funded EVV vendor system, HHAeXchange by submitting the HHAeXchange Provider Onboarding Form.
- Complete the TMHP Learning Management System (LMS) to complete annual EVV Portal training requirements.
Visit the TMHP EVV Training webpage for more information.
EVV Home Health Care Services Practice Period: Oct. 1 – Dec. 31
The practice period allows program providers and FMSAs, to practice using the EVV system, using the EVV Portal and submitting EVV claims before the Jan. 1, 2024, implementation date. EVV claims will be paid by the payers (HHSC or MCO) even if the EVV visit transactions do not match the EVV claims.
- Consumer Directed Services (CDS) employers can practice using the EVV system selected by their FMSA.
- Service providers and CDS employees can practice clocking in and clocking out using their program provider’s or FMSA’s selected EVV system, and the visit data will be transmitted to the EVV Aggregator.
EVV Claims Matching with Denials
Effective Jan. 1, 2024, and after, when an HHCS EVV claim is submitted without a matching EVV visit transaction, the EVV claim will be denied. This applies to all program providers and FMSAs required to use an EVV system. Program providers and FMSAs will be able to view EVV claim match results in the EVV Portal.
Resources:
- For questions about HHAeXchange onboarding, technical help with using the HHAeXchange Portal or issues related to data, contact HHAeXchange:
Email: TXsupport@hhaexchange.com
Phone: 833-430-1307 - Review FAQs about the EVV HHCS Implementation (PDF), found on the EVV 21st Century Cures Act webpage.
- For specific HHCS billing codes combinations, that require the use of EVV, refer to the EVV HHCS Service Bill Codes table in Excel or PDF formats.
- For more information about EVV, visit the HHS EVV webpage.
October 16th, 2023
IMPORTANT NOTICE: EVV Data Access & Conversion
For program providers transitioning to the new state-funded EVV vendor, HHAeXchange:
All visits in the EVV Aggregator will continue to be available and accessible for program providers. One year of historically accepted visits will be available in HHAeXchange as part of data conversion. This will be based on the data available in the EVV Aggregator.
For visit dates within the 95-day visit maintenance window, program providers should refer to the EVV Portal and perform visit maintenance in their legacy vendor system.
*If you rely on specific fields from EVV systems, DataLogic/Vesta and FirstData/AuthentiCare, this data may not be available after they are migrated to HHAeXchange.
Data Conversion
The following data will be transferred from your current EVV systems (AuthentiCare or Vesta) and uploaded to the new HHAeXchange system:
- Five years of profile data
- Direct service provider information
- Member information
- CDS employer information
- Service authorization information
- One year of accepted visit information (from the EVV Aggregator)
Data Availability
EVV visit data for dates of service Sept. 1, 2019, to present is available in the EVV Portal. Program providers or FMSAs needing access to data prior to Sept. 1, 2019, can email HHSC EVV Operations.
Program providers and FMSAs are encouraged to download and archive data in your current EVV systems that is not being converted as outlined above. For program providers and FMSAs that use the EVV systems or the paid for versions of AuthentiCare or Vesta to store or maintain non-EVV visit data, you should take steps now to maintain your non-EVV visit data. Access to the state provided AuthentiCare and Vesta systems will end on Dec. 22, 2023.
Once the data has been reviewed, users should contact HHAeXchange for any issues or concerns with their data.
Email HHAeXchange or call 833-430-1307.
August 20th, 2023
EVV Alternative Device Policy For New State EVV Vendor
HHSC has updated the alternative device policy notice posted on July 17.
In addition to allocating free alternative devices to 7.5% of the program providers or Financial Management Services Agencies (FMSAs) census (rounded to the nearest whole number), HHSC is allowing the purchase of additional alternative devices for qualifying members.
This policy applies to program providers and FMSAs who will use the new State EVV vendor, HHAeXchange.
Additional information will be forthcoming about the processes for providers and FMSAs to order alternative devices.
August 19th, 2023
Hurry Before It’s Too Late! EVV Onboard with HHAeXchange by Aug. 31
Begin the onboarding process with the new Electronic Visit Verification (EVV) vendor HHAeXchange.
Current Users
Program providers and financial management services agencies (FMSAs) who are transitioning to HHAeXchange, and are not in the proprietary system onboarding process, must submit the HHAeXchange Provider Onboarding Form by Aug. 31.
Application programming interfaces (APIs) can be used to exchange data between third-party software systems, such as payroll systems, electronic health records systems, and the HHAeXchange Portal (the new EVV vendor system).
Program provider and financial management services agencies, who want to integrate their third-party software systems with HHAeXchange, can refer to the specifications listed in the HHAeXchange Web Service API Guide (PDF).
APIs available to integrate with HHAeXchange include:
- Service Provider (Create, Update, Search, Get)
- Member (Create, Update, Search, Get)
- Schedule (Create, Update, Search, Get)
- Visit (Search, Get)
- Authorization (Create, Update)
To begin the integration process, submit a ticket through the HHAeXchange Client Support Portal.
Contact HHAeXchange for provider onboarding form questions.
June 13, 2023
Next Steps and Timeline for Transition to New Electronic Visit Verification State Vendor System
HHSC has posted the next steps and timeline to transition to the new, single and state-funded Electronic Visit Verification vendor system, the HHAeXchange Portal.
As stated in the EVV notice posted on May 5, users of the current EVV vendor systems (DataLogic/Vesta or First Data/AuthentiCare) must transition to HHAeXchange or receive approval as an EVV Proprietary System Operator by Oct. 1, 2023.
The following topics are listed in the notice, “Next Steps and Timeline for Transition to HHAeXchange” (PDF):
- EVV requirement
- Transition to HHAeXchange by Oct. 1, 2023
- Proprietary systems
- HHAeXchange Information Sessions
- HHAeXchange Provider Onboarding Form
- EVV Policy updates
- HHAeXchange System Training
- Access to the HHAeXchange Portal
- Contact information and other resources
*Training begins in August and access to the portal begins in September of 2023 for HHAeXchange.
HHSC has created a brief version of the notice that was posted on May 5 about the transition and changes related to the new, single and state-funded Electronic Visit Verification vendor system, HHAeXchange.
Program providers and financial management services agencies may provide the brief notice to their members, services providers and Consumer Directed Services employers. The brief notice is available in English (PDF) and Spanish (PDF).
HHSC will continue to post communications and resources throughout the transition.
June 10th, 2023
Registration Available for HHSC EVV Policy Training Webinars for Program Providers, FMSAs and CDS Employers
HHSC is hosting Electronic Visit Verification policy training webinars for program providers, financial management services agencies and Consumer Directed Services employers to complete the EVV policy training requirement. EVV policy training provides training on the EVV Policy Handbook.
Webinar agendas are included in the registration links below.
Webinar Registration
- Annual EVV Policy Training Webinars: For program providers, FMSAs and CDS employers using EVV for personal care services (PDF).
- Initial EVV Policy Training Webinars: For program providers, FMSAs and CDS employers new to EVV due to the EVV Cures Act Home Health Care Services implementation (PDF).
Program providers, FMSAs and CDS employers can also complete the EVV policy training requirement on the HHS Learning Portal.
The EVV Required Training Checklists (PDF) will help track completed EVV trainings.
Register for EVV GovDelivery to receive EVV notices by email, such as training updates and future webinar registrations.
June 2nd, 2023
EVV Resources Updates
HHSC has updated three Electronic Visit Verification resources that are located on the EVV webpage:
- EVV Training Requirements Checklists
- Getting Started with EVV
- Program and Service Requirements for Schedules
EVV Training Requirements Checklists
The EVV Required Training Checklists (PDF) is a resource for those required to use EVV due to all previous and upcoming EVV implementations (personal care services and home health care services). This resource was updated with the following:
- Aligns with EVV Policy Handbook revisions
- Lists training course names
- Describes required trainings
- Defines EVV Portal users, EVV system users and billing staff
- Includes link to sign up for GovDelivery
- Has interactive (fillable form) features to help document completed trainings
Getting Started with EVV
Getting Started with EVV is a guide that lists steps and resources to start using EVV. HHSC has created a single-page guide for each of the following stakeholders:
- Program providers (PDF)
- Financial management services agencies (PDF)
- Consumer Directed Services employers (PDF)
- Service providers (PDF)
- Consumer Directed Services employees (PDF)
Program and Service Requirements for Schedules
The document, Program and Service Requirements for Schedules (PDF), is a resource that describes requirements related to using schedules in the EVV system. HHSC added managed care organization programs to the document.
Email EVV Operations for questions.
May 13th, 2023
Reminder: EVV Claims Matching for HCS and TxHmL Will Begin for Dates of Service Starting May 1, 2023
This is a reminder that Electronic Visit Verification claims matching for Home and Community-based Services and Texas Home Living will begin on May 1, 2023. EVV claims with dates of service of May 1, 2023, and after that do not have an EVV visit match will deny.
For more information about billing updates for HCS and TxHmL, including resources to help avoid future payment denials or recoupments, reference the notice located on the EVV web page, “EVV Claims Matching for HCS and TxHmL Will Begin for Dates of Service Starting May 1, 2023”.
Email EVV Operations for questions.
April 3rd, 2023
Session 4 ORR Schedules Added to TMHP EVV Proprietary Systems Web Page
HHSC created the Session 4 Operational Readiness Review, which is a special abbreviated Electronic Visit Verification Proprietary System Operator onboarding path that supports additional PSO ORRs. This additional path allows program providers and financial management services agencies to onboard with a previously approved proprietary system or a proprietary system that is participating in the Session 3 Standard Path ORR.
The Texas Medicaid and Healthcare Partnership has updated the EVV ORR section of the EVV Proprietary Systems web page to include ORR schedules, requirements and information about the Session 4 ORR.
Email the TMHP EVV PSO inbox for questions.
January 12th, 2023
Electronic Visit Verification (EVV) for Individualized Skills and Socialization (ISS) IL-2023-03 alert letter
Electronic Visit Verification (EVV) for Individualized Skills and Socialization
Program providers must ensure EVV is used when delivering in-home individualized skills and socialization in an own home/family home (OHFH) setting. For dates of services on and after March 1, 2023,
HHSC will deny or recoup a claim for in-home individualized skills and socialization in the own home/family home setting without a matching EVV visit record. For more information about EVV claims matching, refer to the EVV notice, “EVV Claims Matching for HCS and TxHmL Starts March 1, 2023”.
Program providers must input the Texas EVV Attendant ID for in-home EVV individualized skills and socialization OHFH claims.
Email TMHP EVV Operations for questions or refer to the document, HCS and TxHmL Best Practices to Avoid EVV Claim Mismatches (PDF), for more information to help avoid EVV claim mismatches.
to the LTC Billing Crosswalk for more information about Staff ID requirements.
By January 13, 2023, HHSC will update the EVV Personal Care Services Bill Codes Table, located on the HHSC EVV web page, to include the specific Individualized Skills and Socialization billing codes which require EVV. Sign up for EVV GovDelivery to receive updates by email.
For EVV-related contact information, reference the EVV Contact Information Guide for Program Providers and FMSAs (PDF).
To read more, please click on link below, for Information Letter 2023-03 related to ISS automatic service authorizations and EVV
January 2nd, 2023
EVV Vendor Systems Will Display Individualized Skills and Socialization Services Starting 1/1/2023 Before New Authorizations Are Available
This notice is for Home and Community-based Services program providers, Texas Home Living program providers and financial management services agencies required to use Electronic Visit Verification.
As shared in the EVV notice published on Oct. 26, Individualized Skills and Socialization bill codes will replace day habilitation bill codes; therefore, the EVV vendor systems will display 1/1/23 as the effective date for these new services; however, HHSC has extended the date when the new authorizations for Individualized Skills and Socialization services will be available, which is the week of 1/9/23.
Program providers and FMSAs required to use EVV must continue to use EVV.
HHSC will continue posting related updates.
As a reminder, EVV claims matching for HCS and TxHmL starts March 1, 2023. EVV Operations will be posting the updated bill codes, including helpful information to avoid future payment denials or recoupments, following the publication of other HHSC materials.
For other EVV questions, email the EVV Operations inbox.
For questions about Individualized Skills and Socialization services, email the Long-Term Services and Supports Policy inbox.
December 17th, 2022
EVV Training Updates
This notice from HHSC lists Electronic Visit Verification training updates for program providers, financial management services agencies and Consumer Directed Services employers required to use EVV.
Resources from the following training webinars are now available in the HHS Learning Portal by selecting EVV Policy Training – Webinar Recordings FY23:
- Español – EVV Compliance for CDS Employers (PDF) – Aug. 25 non-required training webinar
- Annual EVV Policy Training for Program Providers and FMSAs – Sept. 30 and Oct. 27 webinars
If new to EVV and need to complete the EVV policy training requirement, complete one of the applicable computer-based training courses located in the HHS Learning Portal:
- EVV Policy Training for Program Providers and FMSAs FY23
- Initial EVV Policy Training for CDS Employers FY23
An account is required to access the training webinar resources and CBTs, including to obtain a certificate of completion. Note that a “non-required training” does not include a completion certificate because it is considered optional training. Reference the EVV HHS Learning Portal Guide (PDF) for instructions.
For more information on EVV training requirements, reference section 4200 from the EVV Policy Handbook.
Sign up for GovDelivery to receive EVV updates, such as training updates, by email.
Email EVV Operations for questions.
2023 EVV Operational Readiness Review Session & Business Rules for Proprietary Systems Version 3.0
EVV Operations has posted the following notice: Notice of 2023 EVV Operational Readiness Review Sessions and EVV Business Rules for Proprietary Systems Version 3.0 (PDF).
This notice is to inform program providers and financial management services agencies about the publication of the 2023 Operational Readiness Review Sessions, as well as the new EVV Business Rules for Proprietary Systems Version 3.0.
EVV Guidance on Program and Service Requirements for Schedules
HHSC has published the document, Program and Service Requirements for Schedules (PDF), under the Resources section on the Electronic Visit Verification web page. This document describes HHSC requirements related to using schedules in the EVV system.
Email HHSC EVV Operations for questions.
December 1st, 2022
Reminder for STAR+PLUS, STAR Kids and STAR Health: New EVV Bill Codes and Modifier Combinations Effective Dec. 1
As a reminder, starting Dec. 1, new Electronic Visit Verification personal care services Healthcare Common Procedure Coding System and modifier combinations will be effective for:
- STAR+PLUS
- STAR Kids
- STAR Health
Refer to HHSC’s Oct. 31 notice for more information.
Contact your managed care organization for questions about these updates. Refer to the last page of the EVV contact guide (PDF) for MCO contact information.
December 1st, 2022
HCS and TxHmL Updates
The effective dates were updated for HCS and TxHmL services.
Refer to the bill codes table’s revision history dated Dec. 1, 2022, for more information.
For questions, email EVV Operations.
October 16th, 2022
Potential Electronic Visit Verification Changes Coming in 2023
The purpose of this notice is to inform stakeholders that HHSC’s contract for the current Electronic Visit Verification vendor systems (AuthentiCare and Vesta EVV) is scheduled to expire on Aug. 31, 2023.
On April 26, 2022, HHSC posted a competitive solicitation on the Electronic State Business Daily for EVV System Management Services. Contractor responsibilities will include:
- Providing and managing a single EVV vendor system
- Review and approval of provider-operated EVV proprietary systems If you have an outside vendor (proprietary vendor), these will be reviewed as well.
- Coordinating EVV system integration with the EVV aggregator
- Providing operational and technical support for the functions listed above
Notification of contract award is anticipated in March 2023.
HHSC, at its sole discretion, may publish updates about the anticipated award date to the Procurement Forecast on the HHS Procurement Opportunities web page. Respondents are responsible for periodically checking the ESBD and the HHSC Procurement Forecast web page for updates.
HHSC must maintain the confidentiality and integrity of the procurement process; therefore, no additional information is available at this time. HHSC will provide more information in future announcements.
Email questions about this solicitation to Andrick Reese.
September 25th, 2022
EVV Updates for HCS and TxHmL Program Providers and FMSAs
HHSC and the Texas Medicaid and Healthcare Partnership posted helpful information for Home and Community-based Services program providers, Texas Home Living program providers and financial management services agencies required to use Electronic Visit Verification.
HHSC Notice
This notice is to help program providers and FMSAs that are receiving EVV mismatches for Day Habilitation services.
Refer to the Sept. 15 notice for information on billing requirements, such as which Day Habilitation bill codes to use.
TMHP Notice
This notice provides information about EVV requirements for In-Home Day Habilitation and about EVV claims matching starting Nov. 1 for HCS and TxHmL.
Refer to the Sept. 19 notice for more information and resources.
Email EVV Operations for questions.
September 25th, 2022
EVV Claims Matching Refresher for HCS and TxHmL
Electronic Visit Verification claims matching for Home and Community-based Services and Texas Home Living will begin for dates of service starting Nov. 1.
To help prepare, the Texas Medicaid and Healthcare Partnership will host a refresher webinar on Oct. 13, for:
- HCS program providers
- TxHmL program providers
- Financial management services agencies
Refer to TMHP’s Sept. 15 notice for more information and to registerl
Click here for more information
September 18th, 2022
EVV Compliance Job Aids Updated
The Electronic Visit Verification Compliance Job Aids have been updated. They are in the compliance section on the EVV web page.
The job aids were simplified and provide updated information about the following EVV Compliance standards:
- EVV Usage Scores and reviews
- Required free text reviews
- Landline phone verification reviews
August 31st, 2022
Annual EVV Policy Webinars for Program Providers & FMSAs
July 28th, 2022
EVV Portal and Training Updates
Texas Medicaid and Healthcare Partnership updated the Electronic Visit Verification Portal and related training materials on July 14.
Refer to the EVV Portal and Training Updates notice on TMHP’s EVV webpage for more information.
July 5th, 2022
EVV Claims for HCS and TxHmL Will Deny for Dates of Service Starting Sept. 1
HHSC has extended the start date when Electronic Visit Verification claims for Home and Community-based Services and Texas Home Living will deny for no matching EVV visit. This will begin for the dates of service of Sept. 1, 2022, and after.
The extension gives HCS and TxHmL program providers and financial management services agencies more time to improve their claims matching. Texas Medicaid and Healthcare Partnership will provide more outreach and training on this topic. Trainings will be announced at a future date.
Refer to the HCS and TxHmL Best Practices to Avoid EVV Claim Mismatches (PDF) for technical guidance.
HCS and TxHmL EVV claims must continue to be submitted through the Client Assignment and Registration System or TMHP.
- Submit EVV claims to CARE for dates of service before May 1, 2022.
- Submit EVV claims to TMHP for dates of service of May 1, 2022, and after.
Program providers, FMSAs and Consumer Directed Services employers must continue to use EVV during this period. However, HCS and TxHmL claims will not be denied for an EVV mismatch. HCS and TxHmL claims during this period are still subject to HHSC provider fiscal compliance reviews conducted by HHSC Provider Fiscal Compliance..
Email EVV Operations for questions.
July 1st, 2022
EVV Claims for HCS and TxHmL Will Deny for Mismatched Visits Starting July 1
Starting July 1, Electronic Visit Verification claims for Home and Community-based Services and Texas Home Living must have a matching EVV Visit, or claims will deny.
Refer to the June 20 notice for more information and resources.
Email EVV Operations for questions.
June 12th, 2022
EVV Portal and Training Updates
Texas Medicaid and Healthcare Partnership updated the Electronic Visit Verification Portal and related training materials on June 9.
There are also two new visit rejection codes related to EVV system transfers.
Refer to the EVV Portal and Training Updates notice on TMHP’s EVV webpage for more information.
June 6th, 2022
EVV Policy Handbook Revision and Training Updates
The Electronic Visit Verification Policy Handbook has been revised.
Revisions include:
- Adding new sections for the Consumer Directed Services option.
- Updating Schedules policy.
- Updating Visit Maintenance Reduction Features policy.
These revisions are effective June 1 and are outlined in the new revision log (PDF), located on the EVV webpage.
The handbook’s policies include EVV standards and policy requirements for:
- Program providers
- Financial Management Services Agencies
- Consumer Directed Services employers
- Payers, such as HHSC and managed care organizations
Computer-based training on the HHS Learning Portal were updated to include the policy revisions.
- EVV Policy Training for Program Providers and FMSAs CBT
- Initial EVV Policy Training for CDS Employers CBT
- Note: The updates to the Spanish CBT will publish in June.
Email HHSC EVV Operations for questions about this notice.
May 30th, 2022
EVV Claims Matching for HCS and TxHmL Will Resume July 1
Electronic Visit Verification claims matching will resume for all Home and Community-based Services and Texas Home Living billing code combinations with dates of service of July 1, 2022 or after.
HHSC will post another notice with more information and resources to avoid EVV claims mismatches before July 1, 2022.
Email EVV Operations for questions about this notice.
May 8th, 2022
EVV Portal and Training Updates
Texas Medicaid and Healthcare Partnership updated the Electronic Visit Verification Portal and related training materials on April 29.
Refer to the EVV Portal and Training Updates notice on TMHP’s EVV webpage for more information.
Email TMHP EVV Operations with questions
March 7th, 2022
EVV Notice for HCS/TxHmL Program Providers
The migration of Home and Community-based Services (HCS) and Texas Home Living (TxHmL) forms and claims entry to Texas Medicaid & Healthcare Partnership (TMHP) has been moved from March 1, 2022, to May 1, 2022. The postponement allows more time for program providers to set up the necessary TMHP accounts and take relevant training courses. HCS and TxHmL program providers must continue to use the Client Assignment and Registration (CARE) system to submit claims using existing billing code combinations for service groups 12 and 15 for dates of service prior to May 1, 2022.
HHSC is aware that some program providers updated authorizations in the EVV systems to reflect the new billing code combinations for service groups 21 and 22 that were scheduled to take effect March 1. To avoid the re-entry of authorizations, HHSC and TMHP will take the following actions:
- By March 4, the EVV Aggregator will accept billing code combinations for service groups 12, 15, 21 and 22 on EVV visits for dates of service through April 30, 2022, to prevent visit rejections.
- For dates of service on or after May 1, 2022, the EVV Aggregator will only accept billing code combinations for service groups 21 and 22.
- Turn on the EVV07 claims matching bypass for all HCS and TxHmL billing code combinations to avoid claim denials through May 31, 2022.
- Claims matching for all HCS and TxHmL billing code combinations will resume June 1, 2022.
- Publish an updated EVV Service Bill Codes Table to reflect these changes.
HCS and TxHmL claims will not be denied for an EVV mismatch. HCS and TxHmL claims during this period are still subject to HHSC provider fiscal compliance reviews conducted by HHSC Provider Fiscal Compliance.
**For visits that have been rejected by the aggregator due to incorrect billing code combinations, program providers must re-export the visit and ensure it is accepted in the EVV aggregator prior to submitting claims.
Please refer to HHSC’s ‘Continue Submitting Claims and Forms Using CARE System Until May 1, 2022’ notice for more information.
For technical questions related to the EVV Aggregator, contact TMHP. For other general EVV inquiries, contact HHSC EVV Operations.
March 3rd, 2022
EVV Policy Handbook Revisions Now Available
HHSC revised sections and appendices of the Electronic Visit Verification Policy Handbook.
The handbook includes EVV standards and policy requirements for:
- Program providers.
- Financial Management Services Agencies.
- Consumer Directed Services employers.
- Payers, such as HHSC and managed care organizations.
The revisions are effective March 1 and are briefly described in the 22-2 notice. For more information about the policy changes, refer to the new revision log (PDF) located on the EVV webpage.
Email HHSC EVV Operations with questions.
February 28th, 2022
EVV Portal and Training Updates
Texas Medicaid and Healthcare Partnership updated the Electronic Visit Verification Portal and related training materials on Feb. 28.
For more information, refer to the EVV Portal and Training Updates article on TMHP’s EVV webpage.
For questions, email TMHP EVV Operations.
January 8th, 2022
EVV Policy Handbook Revisions – Jan. 7th, 2022
HHSC revised parts of the Electronic Visit Verification Policy Handbook. These revisions are effective Jan. 7 and are listed in Revision Notice 22-1.
The handbook’s policies include EVV standards and policy requirements for:
- Program providers.
- Financial Management Services Agencies.
- Consumer Directed Services employers.
- Payers, such as HHSC and managed care organizations.
For questions, email HHSC EVV Operations.
November 21st, 2021
EVV Portal and Training Updates for November 2021
Texas Medicaid and Healthcare Partnership made improvements to the EVV Portal and related training materials on Nov. 11.
For more information, access the November 2021 EVV Portal and Training Updates article on TMHP’s EVV webpage.
FYI- When you click on the link above for updates from HHSC, please be sure to scroll to the bottom and click on “accept” as this is a disclaimer page. You must do this 1st. I have received some comments that some providers get confused when they see this page on the EVV website first pop up and they think they are on the wrong page, or there is a problem with the website page, etc…
Email TMHP with questions about these updates.
November 18th, 2021
Revised EVV Policy Handbook Now Available
The Electronic Visit Verification Policy Handbook was revised.
The handbook’s policies are effective Nov. 1, 2021 and include EVV standards and policy requirements for:
- Program providers
- Financial Management Services Agencies
- Consumer Directed Services employers
- Payers such as HHSC and managed care organizations
The handbook replaces policies previously on the HHSC EVV webpage. See EVV Policy Handbook Revisions – November 2021 (PDF) for differences between previously published policies and the revised handbook.
The following computer-based training courses on the EVV Training page of the HHS Learning Portal now reflects the revised EVV Policy Handbook:
- Initial EVV Policy Training for CDS Employers
- EVV Policy Training for Program Providers and FMSAs
Use the applicable checklist within EVV Training Requirements Checklist (PDF) for EVV training requirements and completion options.
Email questions to HHSC EVV Operations.
November 17th, 2021
EVV Visit Maintenance Unlock Request Updates
HHSC published EVV Visit Maintenance Unlock Request spreadsheet updates.
These updates let the user request corrections to data element(s) on an EVV visit transaction(s) after the visit maintenance time frame has expired.
Program providers, Financial Management Services Agencies and Consumer Directed Services employers must use the request spreadsheets found on the EVV webpage.
The updates to the program provider and FMSA Request (Excel) include:
- New fields
- Added drop-down lists to applicable fields
- Updated and simplified field headers
- Revised instructions to:
- Reflect EVV policy updates
- List detailed steps and notes to complete the Request
The new Request for Consumer Directed Services employers (Excel) include:
- A new request spreadsheet for CDS employers who selected Option 1 on Form 1722, Employer’s Selection for EVV Responsibilities, to complete visit maintenance. This includes:
- Drop-down lists for applicable fields
- Sections for CDS employers and payers to complete
- Instructions reflect:
- EVV policy updates
- Detailed steps and notes to complete the request
Review the instructions on the spreadsheets for more information.
Email questions to your payer, either HHSC or a managed care organization
July 4th, 2021
EVV Visit Maintenance Policy Now Available
The Electronic Visit Verification Visit Maintenance Policy (PDF) is now available on the HHSC EVV webpage. The policy is effective July 1, 2021 and:
- Requires the program provider, Financial Management Services Agency or Consumer Directed Services employer to ensure each EVV visit transaction is complete, accurate and validated.
- Incorporates the Visit Maintenance: Last Visit Maintenance Date Policy.
- Incorporates the Visit Maintenance Unlock Request Policy.
- Includes the new visit maintenance time frame of 95 calendar days. (previously 60 calendar days) from the date of service delivery.
Email questions to HHSC EVV Operations at EVV@hhs.texas.gov.
July 4th, 2021
HHSC EVV Webpage Updates Now Available
The Texas Health and Human Services Commission updated and archived web sections and content, updated and added additional information related to the 21st Century Cures Act (Section 12006) and added new resources for the following Electronic Visit Verification webpages:
- EVV Home page,
- EVV Consumer Directed Services Option,
- EVV Cures Act,
- EVV Training and
- EVV Proprietary Systems.
Email questions to HHSC EVV Operations at EVV@hhs.texas.gov.
July 3rd, 2021
Revised EVV Visit Transaction Rejection Guide Now Available
The Electronic Visit Verification Visit Transaction Rejection Guide (PDF) was revised and is now available.
The guide provides step-by-step instructions for program providers and Financial Management Services Agencies to identify and correct issues that result in transaction rejections in the EVV system.
The guide is published on TMHP’s EVV Training webpage.
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.
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:
- HHSC EVV Operations and TMHP have developed two Contact Guides:
- To assist program providers and FMSAs identify and correct EVV visit transaction rejections, TMHP created the EVV Visit Transaction Rejection Guide (PDF).
- Email HHSC EVV Operations, Electronic_Visit_Verification@hhsc.state.tx.us, regarding:
- EVV Policy and Compliance Questions
- General EVV Inquiries and Complaints
- Good idea to CC your provider association, if you are a member (PPAT, PACSTX..)
- Email TMHP, EVV@tmhp.com, regarding TMHP issues and EVV vendor complaints/issues.
- Copy Evan Wilkerson on urgent TMHP or EVV vendor issues.
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:
- The EVV visit transaction that supports the claim is accepted into the EVV Portal before claim submission.
- 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.
| HCS and TxHmL Program Providers Required to Select an EVV Vendor | ||||||||
| 11/18/2020 | ||||||||
|
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.
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.
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:
- Register for Session 1.
- Register for Session 2.
- 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
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.
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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
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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:
EVV Policy Training (Provided by your payer)
- The HHSC EVV Policy computer-based training (CBT).
- The MCO Policy training. Contact your MCO for EVV Policy training opportunities.
EVV Aggregator and EVV Portal Training (Provided by TMHP)
There will also be instructor-led trainings (EVV Roadshow) in October. Find the schedule and register on the HHS Learning Portal.
Additional training resources are available on the HHSC EVV website and the TMHP EVV Provider Training webpage.
For questions about this alert, email Electronic_Visit_Verification@hhsc.state.tx.us.
Online, interactive EVV training courses are available
in the HHS Learning Portal and TMHP Learning Management System. Completing these courses help program providers meet EVV training requirements.
The HHS Learning Portal includes training about HHSC EVV Policy.
The TMHP Learning Management System includes training about:
- EVV Vendor Selection
- EVV Portal
- EVV Portal Standard Reports and Search Tools
- EVV Claims Submission and Billing
TMHP Portal Town Hall Webinars And FAQ’s
HCS and TxHmL Town Hall Webinars and FAQs
November 10th, 2023
Register for November TMHP LTC Town Hall for HCS and TxHmL Providers and FMSAs
TMHP and HHSC staff from the following departments will be available to provide information and answer questions:
- Program Eligibility and Support
- Utilization Review
- Provider Claims Services
- Local Procedure Development and Support
November webinar will be held on:
- Wednesday, Nov. 15, 2023, from 10 a.m.–noon
Register for the webinar.
We encourage Providers and FMSAs to invite staff who use the LTC Online Portal for HCS and TxHmL programs.
Standing Meeting Agenda
- Training and Information Sharing — provide relevant training and updates.
- November topics include:
- Appendix A Scenario
- Using “Submit Form” on IPC Renewals*
- November topics include:
Question and Answer — HCS and TxHmL Providers and FMSAs will have the opportunity to ask questions** regarding the LTC Online Portal for HCS and TxHmL.
*Providers, please view the notice “Using Submit Form and Use as Template Options on IPC Renewals” prior to Town Hall.
September 13th, 2023
In case you missed the Town Hall Webinar from Sept. 13th, here are the links to the handouts
Provider Quick Reference Contact List (HCS/TxHmL) Update 091323
- Recording For Wednesday, Sept. 13, 2023, from 10 a.m. – noon (To Watch It, Please Register Below)
Panelists: • Ashley Wechsler –Program Eligibility and Support (PES) •Holly Lindsey –Utilization Review (UR) •Marie Redman –Provider Claims Services (PCS) • Rhonda Kay Richie –Local Procedure Development and Support (LPDS) • Kali Schmidt –Contract Administration & Provider Monitoring (CAPM) • Rick Bishop –Claims Management • Amy Aubin –Long-Term Services and Supports (LTSS) Policy Unit • Joan Workman –HHSC Information Technology (IT) •Depesh Shah -Texas Medicaid & Healthcare Partnership (TMHP)
Some of The Topics Discussed Included:
-Fiscal Year 2023 Year-End Closeout Process (CARE) & The Process For Closeout in LTC
-Claims Processing Update and Claims Overlapping With IPC’s
-Claims Data Export: How to Remove Duplicate Lines
-Suspensions, Terminations (In particular- screens/forms in TMHP for LIDDA and the Provider that need to be completed)
-How to Use Pivot Tables in Excel (There are training videos on Youtube for Pivot Tables and it is suggested that providers watch these videos. My understanding is that these tables may help some with cost reporting data that is needed)
-Requesting Inactivation
-Improvements to the phone system, including the Automated Inquiry System(AIS) as of Sept. 5th, 2023 and updated Contact List For TMHP
FYI- Trending Issues: Upcoming YoutubeTraining Video –Claims DATA Export will come out on September 18th, 2023
Some of the things that will be covered are: •How to convert the Claims Data Export file to a workable file. •Highlight some of the relevant data you can use. •Show how to work with the data.
August 24th, 2023
Medicaid and CHIP Services (MCS) is hosting monthly meetings for Providers and Financial Management Services Agencies (FMSAs), who use the Long-term Care (LTC) Online Portal for the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver programs.
TMHP and HHSC staff from the following departments will be available to provide information and answer questions:
- Program Eligibility and Support
- Utilization Review
- Provider Claims Services
- Local Procedure Development and Support
- Wednesday, Sept. 13, 2023, from 10 a.m. – noon
Standing Meeting Agenda: Trending Issues, Training & Information Sharing
Question and Answer – HCS and TxHmL Providers and FMSAs will have the opportunity to ask questions* regarding LTC Online Portal for HCS and TxHmL.
*To comply with HIPAA requirements, questions that include any identifying information for a specific individual will not be allowed during the monthly meetings.
We encourage Providers and FMSAs to submit questions they would like addressed during the webinar as part of the registration process. All questions must be submitted by Sept. 8, 2023.
August 17th, 2023
August Webinar 2023
A recording of the Aug. 9 TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs webinar is available for those who could not attend. The webinar recording and slides have been posted to the HCS and TxHmL Webinars & FAQs webpage.
Email TxHmL Policy for questions.
July 24th, 2023
Next TMHP LTC Portal Town Hall Webinar is on Aug. 9th, 2023
Medicaid and CHIP Services is hosting monthly meetings for Providers and Financial Management Services Agencies (FMSAs), who use the Long-term Care (LTC) Online Portal for the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver programs.
Register now to attend the TMHP LTC Online Portal Town Hall Webinar scheduled for Wednesday, August 9 at 10 a.m. Topics will include:
- Revisions of the Individual Plan of Care (IPC)
- Renewals of the Individual Plan of Care (IPC)
The July 12 recording of the TMHP LTC Portal Town Hall Webinar for HCS Providers, TxHmL Providers and FMSAs is now available. Topics included:
- Trending Issues
- Individual Movement Forms
- Provider Location Updates
- IPC Transfers
The June 14 recording of the TMHP LTC Portal Town Hall Webinar is also available. Topics included:
- Trending Issues
- Release 2 Enhancements
- Navigating the TMHP website
- Entering PC3s
- Adding and Removing CDS Services
Visit HCS/TxHmL Webinars and FAQs for more details.
Contact HCS and TxHmL with any questions.
June 14th, 2023
May Webinar 2023
- May 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
- May 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Pending DADS review for IPC forms
- EVV Claims Matching
- TMHP MESAV video (YouTube)
- Best Practice for IMT form
- Enrollment form sequence
- Location code issues
- Claim Adjustments recap
- TP2 Holds
April Webinar 2023
- April 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
- April 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- 2022 Cost reporting information
- Submitting multiple forms
- Accessing and Using R&S reports
- Purpose of a Provider Location Update Form
- Viewing Provider Locations on the Dashboard
- Billing for Individualized Skills and Socialization
March Webinar 2023
- March 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
- March 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Joint Training Provider Opportunities
- Trending Issue Support Volume 18
- Appendix A and Dashboard YouTube Videos
- Updated Quick Reference Guide
- Suspension Discussion and Training
- Placeholder/Admin Locations
February Webinar 2023
- February 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
- February 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- IPC Template and Location Code Field
- Cost Reporting Training
- Claims Adjustment follow-up
January Webinar 2023
- January 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
- January 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Enhancements to Individual Plan of Care (IPC) revisions and corrections, Individual Movement (IMT) correction forms have now been implemented.
- Trending Issue Support Volume 14 and 15 are now published.
- YouTube videos on the TMHP Remittance and Status (R&S) has now been published.
December Webinar 2022
- December 2022 – TMHP LTC Portal for HCS and TxHmL Providers and FMSAs (PDF)
- December 2022 – TMHP LTC Portal for HCS and TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Enhancements to 3608/8582, 3616, Individual Movement form (IMT) (Suspension), 3615 and Provider Location Update (PLU) forms will be available on the TMHP LTCOP on 12/12/22.
- Appendix B updated to include applicable action required when in specific statuses.
- YouTube videos on the TMHP Remittance and Status (R&S) will be published on 12/8.
- ID/RC purpose code 3 forms
- Suspension Reviews
- Renewal and Revision IPCs
- How to do batch billing using TexMedConnect (TMC)
- How to do claim adjustments
November Webinar 2022
- November 2022 – TMHP LTC Portal for HCS and TxHmL Providers and FMSAs (PDF)
- November 2022 – TMHP LTC Portal for HCS and TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Forms Sequencing
- Claims Submission (Rejected and Denied Claims)
- Changes to Service Coordinator ID
- Accessing the Dashboard
- Accessing the Individual Search Page
- What is MESAV?
HCS and TxHmL Rules Update and Site Assessments of 3-Person Residences, 4-Person Residences, and Host Home/Companion Care Settings Webinar
- October 2022 – HCS and TxHmL Rules Update and Site Assessment Webinar (PDF)
- October 2022 – HCS and TxHmL Rules Update and Site Assessment Webinar Recording
October Webinar 2022
- October 2022 – TMHP LTC Portal for HCS and TxHmL Providers and FMSAs (PDF)
- October 2022 – TMHP LTC Portal for HCS and TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- How is data updated in TMHP?
- Where can I find cost reporting data?
- What to do if you cannot access the dashboard.
- What is MESAV and how do access it.
- Creating a MESAV group template.
- Viewing a MESAV batch history
- Claims Status Inquiry
Provider Quick Reference Contact List (Updated 6/14/23)
** Don’t forget also the TMHP Help Desk 1-800-626-4117 option 1 and then option 7
January 16th, 2023
Helpful Information: From TMHP Portal Town Hall Meeting on 1/11/23
-A representative from one of the LIDDAs (Alamo Area Council of Governments) relayed the following information:
- If an individual moves from one LIDDA to another (LIDDA to LIDDA transfer) and they are going to new HCS or TxHmL provider, the old LIDDA has to do INT form 1st and then the new LIDDA has to do the transfer to the new provider. These things must happen in this order, or it will hold things up in your transfer.
- One of the major problems the LIDDA’s have is that the LOCATION code is being changed by the system (a glitch of some sort in TMHP) and then it is greyed out by the system so they can’t put anything in that spot where location code goes. They can’t edit it to correct it. This has caused many of the delays in transfers and this is why alot of providers might be thinking the LIDDA is causing the delay. However, that may not be the case because of this issue. Good news: Enhancement to allow the LIDDA to type in location code instead of grey out barrier. This is happening Friday Jan. the 13th. This should provide a resolution to this “glitch” in the system. Hopefully, it will allow a lot of transfers to go through. This problem has been happening since April of 2022 for LIDDA’s.
- FYI-HHSC sent out a letter to LiDDAS, that they should not hold up on transfers if the location code is not correct. They can then contact HHSC about correcting the location code after the fact.
-In some situations, if the LIDDA itself is not changing during the transfer (transfer from one provider to another, but LIDDA the same), then the provider needs to make the changes on the IMT form before the -LIDDA can submit. They have to complete the process in that order before the transfer can be submitted. Meaning the previous form must be done before the new form should be completed.
-One of the HCS providers shared the following information: Somewhat related to location codes. She was closing a couple of location codes after the home was no longer open. Noticing that the drop-down list is out of sync. She would put in the address of the new location and go to close the old location code and the drop-down link showed a different address for the location being closed out than it should. It is like it is out of sync. This fix happening this Friday should also fix that for the provider. Basically using right code but the wrong address is showing up in the dropdown menu’s. Referring to PLU system.
-If providers are experiencing any delays with LIDDA not submitting any forms they are required to submitted. Please try to resolve that by escalating that to LIDDA director, so HHSC says they want you to then send an email to interestlistpreenroll_liddahelp@hhs.texas.gov. then they can reach out to them directly.
–To escalate tickets: Email. LTCOPS-Escalations@TMHP.com to escalate tickets
-Another provider noted the following issue: When they migrated to TMHP, somehow their contract address was now incorrect. The provider’s company name was no longer associated with the right contract #. It is not something the provider did on their side. So far, they have had no luck in changing that address to the correct address for their contract #. Provider information update. They will need to check it on the provider system data to find out. Contract and Administration and Monitoring will have to help with the correction of the error. This is also the case if providers have questions about a contract’s begin and end date, or when it expires, etc.. Go to the contract manager. HHSC acknowledges that there has been alot of turnover in this department. (Don’t I know it, lol.) Information provided by Kaliope Schmidt was to do the following: Go to iddwaivercontractenrollment@hhsc.state.tx.us and cc Kaliopi.schmidt@hhs.texas.gov
–One Provider had a Transfer since May of 2022 that hasn’t gone through because the old provider’s address is showing on the location since transferring, so it does not match the contract of the new provider. Hopefully, the fix will come from the Friday the 13th, 2023 enhancement.
–Client assignment question: In the CARE system, this was done differently than in THMP so has caused a domino effect. i.e. Individual on temp discharge, would be re-assign to a different temp discharge location code. The local authority wanted her back into rotation. ……. We can’t view who is assigned to what location on what date, so couldn’t figure out how to move people sometimes. People at the help desk don’t even know how to look up people’s locations and assignments. What can we do?
To do that in the portal for now until June 2023, when they will have an enhancement out to correct this issue, providers must use the form status inquiry page (FSI) you can search for the consumer’s forms by imputing their Identifier (Medicaid or CARE #) and put in with search criteria. Leave the form blank but put in the date range or a little bit longer time if needed and search that. In the list should receive list of forms for the consumer for your organization. The effective date on the forms, if you click it, the system will show the list by effective date and which code has the latest effective date, and then that form as the latest location code. But won’t help unless the form is completed already. Location availability information is limited. The provider has to keep trying to look up everything in a fashion that seems long and very backward. It is the opposite of what the provider needs. It ends up being the longest way to look if up. The provider asked if they would create something in their June enhancement, that shows the moves of a person, hoping to build the function to search the function by location, what client is with them.
-If on temp discharge is the individual still assigned a code from the facility or a new code form (IMT suspension purpose code form)? Because the provider currently has to wait for the suspension form to finish the process so it is considered complete before they can do anything. How long does that usually take? Ask CARE people to get back to you.
-Another provider said they can’t do IMF form til the Residential component is changed but can’t change the residential component until IMF changed. Moving from 1 location to the other inside the same agency. Moving from HH/CC to RSS. So, when they try to change the residential type, it won’t let her progress from there in TMHP. Provider needs to submit IPC revision to change residential type. Then at the same time on that revision form, then the location code is updated for you to update IMF automatically. Don’t need to do the IMT, just the IPC revision form to change the residential type and location code. That changes the residential component type, submit IPC revision or transfer if that is the case.
-How do you know what claims to pay when you get your overpayment letter? To request a list, please contact the THMP-LTC Help desk at 1-800-626-4177 or 1-800-626-5436 (Option #1 then Option #7). The provider will need to provide a secure email for them to send the list. Should get within 24 hrs. Can also go to your Tex Med connect and remittance status screens.
HHSC asked providers to limit ISS questions at this time, but here is one that came up during the session:
-In-Home ISS come March 1st, 2023-does the provider need to submit documentation like BCBA documentation or medical/physician’s order of need, before it is entered into TMHP billing? Anything the provider needs to be prepared for? They have to go back and find out about it. Don’t know now.
Other Important Contacts:
Issues that go to UR (Utilization Review): • 8578 ID/RC form with purpose code 3 or 4 on the LTC Online Portal • Renewal or revision IPCs
Utilization Review (UR)
512-438-5055 email: deskURLONIPC@hhs.texas.gov
Issues that go to PES (Program Enrollment Services) • 8578 ID/RC with a purpose code 2 forms * initial or transfer IPCs forms • Suspensions • 3615 Continuation of Suspension forms • 3616 Request for Termination forms • Individual Movement (IMT) forms for LA Reassignments
Program Eligibility and Support (PES)
512-438-2484
enrollmenttransferdischargeinfo@hhs.texas.gov
From Our Friends at IntellectAbility: Health Risk Mitigation Tools &Training
November 10th, 2023
From our friends at IntellectAbility. Apologies, just wanted to remind you all of this wonderful tool they created, that many providers asked me about in the past (Mostly nurses, lol). Previously this tool was under a different company name. There was a change sometime back in the name of the company.
For those of you who want to learn more about IntellectAbility’s health risk mitigation tools and training by visiting ReplacingRisk.com.
Feel free to call us at 727-437-3201 or email us at Inquiries@ReplacingRisk.com.
They can provide a demo to help you detect health risks in at-risk populations and check out their helpful video about the screening tool by clicking on link below
Joint Training From HHSC For Providers
Joint Training Page Available for HCS/TxHmL/ICF/ISS Providers
The HCS and TxHmL programs now have a Joint Training Opportunities page where providers can register for upcoming classes. Class size will be limited to maximize participation, but classes will be offered regularly. Providers should check the page often for updates. There will be recordings of special presentations available for viewing on-demand later.
November 10th, 2023
November 2023 HCS/TxHmL Provider Training Opportunities
Death Notifications for HCS/TxHmL Providers
Monday, Nov. 20
4–5 p.m.
Register here for webinar.
Writing Acceptable Plans of Correction for HCS and TxHmL Providers
Wednesday, November 15, 2023
9:30 AM – 4:00 PM
Texas Health and Human Services Commission
535 S. Loop 288, Suite 2001
Room: Conference Room 2134
Denton, TX 76205
(19 MAX) Register For Live Training here
Writing Plans of Correction for Individualized Skills and Socialization Providers
2:30 p.m.–4:30 p.m.
Tuesday, November 28, 2023
October 15th, 2023
October 2023 HCS/TxHmL Provider Training Opportunities
Writing Plans of Correction for Individualized Skills and Socialization Providers
Monday, Oct. 30
2–4 p.m.
Register here for webinar.
What Surveyors Look for in Intermediate Care Facilities – ICF
Tuesday, Oct. 31
10–11 a.m.
Register here for webinar.
Understanding the Survey Process
Tuesday, Oct. 31
1–2:30 p.m.
Register here for webinar.
August 24th, 2023
September 2023 HCS/TxHmL Provider Training Opportunities
Individualized Skills and Socialization Survey Process and ANE Overview
Friday, Sept. 1
9–10:30 a.m.
Register here for webinar.
Top 10 Citations for HCS and TxHmL Providers for FY 2022
Tuesday, Sep. 5
3:30–4:30 p.m.
Register here for webinar.
Writing Plans of Correction for Individualized Skills and Socialization Providers
Tuesday, Sept. 19
1:30–3:30 p.m.
Register here for webinar.
Administrative Penalties for HCS and TxHmL Providers
Thursday, Sept. 21
11:30 a.m.–12:30 p.m.
Register here for webinar.
HCS Certification Standards: An Overview of Changes
Thursday, Sept. 28
3–4:30 p.m.
Register here for webinar.
Coming in July 2023!
HCS Certification Standards: An Overview of Changes (course description)
Wednesday, July 5, 2023
11:30 AM – 1:30 PM
Regulatory Services Incident Reporting for Individualized Skills and Socialization Providers (.5 hours) (course description)
Thursday, July 6, 2023
3:30 PM – 4:00 PM
Infection Control Basics for HCS and TxHmL Program Providers (course description
Wednesday, July 12
9:30 AM – 10:30 AM
Hurricane and Flooding Readiness for Home and Community Based Services and Texas Home Living and Individualized Skills and Socialization (course description)
Wednesday, July 19, 2023
3:00 PM – 4:00 PM
and more coming
June 13th, 2023
June 2023 HCS/TxHmL Provider Training Opportunities
Hurricane and Flooding Readiness for HCS and TxHmL Providers and Individualized Skills and Socialization Providers
Tuesday, June 13
4:30 p.m.–5:30 p.m.
Register here for webinar.
Individualized Skills and Socialization Basic Program Overview
Tuesday, June 20
1–2 p.m.
Register here for webinar.
Individualized Skills and Socialization Basic Program Overview
Thursday, June 22
10–11 a.m.
Register here for webinar.
Understanding the Health Maintenance Activity (HMA) Rules ALF
Thursday, June 22
2–3 p.m.
Register here for webinar.
Individualized Skills and Socialization Basic Program Overview
Thursday, June 22
10–11 a.m.
Register here for webinar.
Regulatory Services Incident Reporting for Individualized Skills and Socialization Providers (.5 hours) (course description)
Monday, June 26, 20232:30 PM – 3:00 PM
Hurricane and Flooding Readiness for ICFs
Tuesday, June 27
1–3 p.m.
Register here for webinar.
Regulatory Services Incident Reporting for Individualized Skills and Socialization Providers (.5 hours) (course description)
Monday, June 26, 2023
2:30 PM – 3:00 PM
Writing Acceptable Plans of Correction of HCS and TxHML (course description)
Wednesday, June 28, 2023
9:00 AM – 4:00 PM (Live Session in Conroe)
April 2023 HCS/TxHmL Provider Training Opportunities
Most Cited Deficiencies for HCS & TxHmL Providers
Wednesday, April 12
11:30 a.m.–12:30 p.m.
Register here for webinar
Individualized Skills and Socialization Basic Program Overview
Wednesday, April 12
4–5 p.m.
Register here for webinar
Writing Acceptable Plans of Correction of HCS and TxHmL
Thursday, April 20
9 a.m.–4 p.m.
Marshall, TX
Register here for in-person class
Individualized Skills and Socialization Program Basic Overview (1 hour) (course description)
Friday, April 28, 20233:00 PM – 4:00 PM
February 2023 HCS/TxHmL Provider Training Opportunities
Infection Control Basics for HCS and TxHmL Program Providers (course description)
Wednesday, February 8, 2023 11:30 AM – 12:30 PM
Administrative Penalties and Related Processes in HCS & TxHmL Settings (course description)
Tuesday, February 28, 20231:30 PM – 2:30 PM
Dec. 2022 HCS/TxHmL Provider Training Opportunities
Emergency Preparedness 101 for HCS and TxHmL Providers
Tuesday, Dec. 1311:30 a.m.–12:30 p.m.
HCS/TxHmL Program Provider Responsibilities in Death Reviews and Provider Investigating Reports
Wednesday, Dec. 211–2 p.m.
Writing Acceptable Plans of Correction for HCS and TxHmLThursday, Dec. 29
9 a.m.–4 p.m.Nacogdoches, Texas
Register here for in-person class
Oct./Nov. 2022 HCS/TxHmL Provider Training Opportunities
Top 10 Most Cited Deficiencies for HCS and TxHmL Providers (course description)
Wednesday, October 5, 20221:30 PM – 2:30 PM
Hurricane and Flooding Readiness for HCS/TxHmL (course description)
Wednesday, October 12, 20221:30 PM – 2:30 PM
Infection Control Basics for HCS and TxHmL Program Providers (course description)
Wednesday, October 19, 20222:00 PM – 3:00 PM
Emergency Preparedness 101 for HCS Program Providers (course description)
Tuesday, November 1, 20221:00 PM – 2:00 PM
July 2022 HCS/TxHmL Provider Training Opportunities
Long-term Care Regulation staff and program providers are invited to attend the following trainings hosted in July:
Writing Acceptable Plans of Correction for HCS and TxHmL
Wednesday, July 6
10:30 a.m.–12:30 p.m.
Register for the webinar.
Writing Acceptable Plans of Correction for HCS and TxHmL
Wednesday, July 6
10:30 a.m.–12:30 p.m.
Register for the webinar.
Hurricane and Flooding Readiness for HCS and TxHmL
Tuesday, July 12
1–2:45 p.m.
Register for the webinar.
Hurricane and Flooding Readiness for HCS and TxHmL
Tuesday, July 12
1:30–2:45 p.m.
Register for the webinar.
Administrative Penalties and Related Processes for HCS and TxHmL
Wednesday, July 20
1:30–2:45 p.m.
Register for the webinar.
Administrative Penalties and Related Processes for HCS and TxHmL
Wednesday, July 20
1:30–2:45 p.m.
Register for the webinar.
Infection Control Basics for HCS and TxHmL
Thursday, July 28
1:30–3 p.m.
Register for the webinar.
Additional classes may be added, and all available training opportunities can be found on the following websites:
July 5th, 2022
Nursing in HCS and TxHmL Settings -Recorded Session: April 5th, 2022
This three-hour webinar covers requirements for the provision and delegation of nursing care in HCS and TxHmL settings. A Texas Board of Nursing representative will be a guest presenter. The most frequently cited deficiencies related to these requirements will be noted during the training. No CEs are offered for this webinar. However, a certificate of attendance will be provided.
**You can still watch the recording from this session, click on the registration link below.
From April 5, 2022
11 a.m. – 2 p.m.
Register here for the webinar.
Registration is limited. A recording will be available after the presentation for those unable to attend. Contact LTCR Policy with questions.
Missed a COVID-19 training? Many COVID-19 presentations for long-term care providers are recorded and are available 24/7. Please be sure to select the most appropriate recording for your program. Note that recordings are accurate as of the date of presentation and that updated guidance may be available.
Visit the recording library at https://www.gotostage.com/channel/covid-19webinarsforltc.
Using Submit Form and Use as Template Options on IPC Renewals
November 8th, 2023
Just A Reminder (As of 10/11/23) Concerning IPC Renewals
Due to the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) rate changes effective September 1, 2023, providers and local intellectual and developmental disability authorities (LIDDAs) are advised to use the Submit Form option on Individual Plan of Care (IPC) renewals.
When to Use Submit Form Instead of Use as Template
Use Submit Form instead of Use as Template under these conditions:
- There have been rate changes or enhancements.
- A provider or financial management services agency (FMSA) has been removed, added, or changed.
- The form is not autofilling with the most current information, and all other forms (e.g., transfers or individual updates) are correctly processed and in Processed/Complete status.
Complete Related Forms Prior to Selecting Use as Template
Before using the Use as Template option, ensure that all related forms are correctly processed and marked as Processed/Complete. For more information, contact the LTC Help Desk at 800-626-4117 (select option 1).
EVV Known Issues & Resolutions
November 2nd, 2023
HHSC Now Posting EVV Known Issues and Resolutions
Vol. 1 (Last updated on 10/18/2023)
The Texas Medicaid & Healthcare Partnership (TMHP) has recently received feedback from Electronic Visit Verification (EVV) program providers and financial management services agencies (FMSAs) about ways to enhance their user experience of the HHAeXchange system. The topics listed in this article highlight the most frequently occurring issues that EVV users have identified as areas in which they require additional support.
Topics:
Service providers must download the newest version (currently v23.10.03) of the HHAeXchange+ mobile app and check regularly for updates. The forced update function has been enabled so that future updates will be pushed directly to the user. Older versions of the app will no longer be supported after October 11, 2023.
Refer to the HHAeXchange update page for more information.
HHAeXchange will provide training to service providers on how to resolve automatic verification issues through Lunch and Learn sessions and a job aid. Refer to the training page on the HHAeXchange Texas Info Hub for upcoming Lunch and Learn training opportunities and to review the Call Dashboard recorded training.
Providers can email HHAeXchange at TXsupport@hhaexchange.com to have their credentials resent or for guidance on accessing the LMS test. Include the Agency name and NPI when submitting a request.
For questions or more information about HHAeXchange, email TXsupport@hhaexchange.com.
For general questions about EVV, email TMHP at EVV@tmhp.com.
Letter To Providers From Twogether Consulting-Oct. 31st, 2023
October 30th, 2023
Update From Twogether Consulting!
On-Site Residential Inspection Form To Address New HCS Rules: Now Available For Purchase
On-Site Residential Inspection Form
TULIP Credentialing Transition Grace Period Extended
October 15th, 2023
Nurse Aides (NAs), Medication Aides (MAs), Nursing Facility Administrators (NFAs), and Nurse Aide Training Competency Evaluation Programs (NATCEPs) are now required to use the new credentialing system in the Texas Unified Licensure Information Portal (TULIP) for licensing certification or permitting activities.
Note: HHSC is extending a grace period for all NAs, MAs, NFAs and NATCEPs to allow users time to learn and understand the new credentialing system. All NAs certifications, MA permits, NFA licenses and NATCEP approvals active on June 16, 2023, will be considered active until April 30, 2024.
For registration issues in TULIP, email TULIP_Support@hhsc.state.tx.us.
For NA questions, email NurseAideRegistry@hhs.texas.gov.
For MA questions, email Medication_Aide_Program@hhs.texas.gov.
For NFA questions, email nfa_licensing_program@hhs.texas.gov.
For NATCEP questions, email Regulatory_NATCEP@hhs.texas.gov.
COVID-19 Resources
October 17th, 2023
COVID-19 Resources
COVID-19 Quick Reference (New Guidance)
From our friends at PharMerica, please go to the following link to get your free and current quick reference guide for Covid-19
July 11th, 2022
July 7, 2022 MCS COVID-19 Stakeholder Information Session
Thank you for your interest in listening to the July 7 Texas Medicaid CHIP COVID-19 Information Session.
The audio from this session can be found here.
The presentation can be found here.
Future meeting notices and information will continue to be shared on these sites, so please check back regularly.
For additional questions, please write to Medicaid_COVID_Questions@hhsc.state.tx.us.
May 8th, 2022
May 5, 2022 MCS COVID-19 Stakeholder Information Session
Thank you for your interest in listening to the May 5 Texas Medicaid CHIP COVID-19 Information Session.
The audio from this session can be found here.
The presentation can be found here.
Future meeting notices and information will continue to be shared on these sites, so please check back regularly.
For additional questions, please write to Medicaid_COVID_Questions@hhsc.state.tx.us.
April 10th, 2022
April 7, 2022 MCS COVID-19 Stakeholder Information Session
Thank you for your interest in listening to the April 7 Texas Medicaid CHIP COVID-19 Information Session.
The audio from this session can be found here.
The presentation can be found here.
Future meeting notices and information will continue to be shared on these sites, so please check back regularly.
For additional questions, please write to Medicaid_COVID_Questions@hhsc.state.tx.us.
January 9th, 2022
January 6, 2022 MCS COVID-19 Stakeholder Information Session
The audio from this session can be found here.
The presentation can be found here.
Future meeting notices and information will continue to be shared on these sites, so please check back regularly.
For additional questions, please write to Medicaid_COVID_Questions@hhsc.state.tx.us.
December 30, 2021
COVID-19 Cases Rise – Guidance for LTC Providers
COVID-19 cases are increasing across Texas. HHSC reminds providers to follow the guidelines listed below and ensure their emergency plan is up-to-date. Staff must be aware of what to do in the event of any sort of emergency, including an outbreak of flu or COVID-19.
Please review the following guidelines and rules:
- COVID-19 mitigation and visitation rules
- Any applicable COVID-19 response plans for your provider type
- Your provider’s own infection prevention and control policies
Find COVID-19 resources on:
- Your provider portal under the COVID-19 Resources section
- The HHSC COVID-19 Provider Information page
Your vigilance following infection control requirements can make a difference in protecting vulnerable Texans.
LTC providers are always required to provide services to residents or clients before, during and after an emergency. The emergency plan or policy must include:
- Planning for staff shortages.
- A backup plan to ensure operations and care of residents or clients continue.
Read program-specific rules related to staffing, emergency preparedness, and infection control.
A checklist (PDF) is available to assist you with creating a plan for dealing with an outbreak of flu or COVID-19.
If you need help with updating your COVID Mitigation Plans within Infection Control Policies or Emergency Evacuation Plans with these new updates to Mitigation of COVID-19, please contact us. We may be able to help you. Contact us at: info@twogetherconsulting.com
December 30th, 2021
Dec. 13 ICF COVID-19 Webinar Recording Available
A recording of the Dec. 13, 2021, ICF/IID COVID-19 Q&A with HHSC LTC Regulation and DSHS is available for those who could not attend.
Listen to the webinar recording here.
Email LTCR Policy for the transcript.
December 29th, 2021
Home and Community-based Services (HCS) and Texas Home Living (TxHmL)
- HCS Visitation Comparison Table (PDF)
- HCS COVID-19 Expanded Visitation Rules (PDF)
- TxHmL COVID-19 Updated Emergency Rules (PDF)
- COVID-19 Response for Home and Community-based Services Residential Providers (PDF)
- Updated COVID-19 FAQs for HCS and TxHmL Providers (PDF)
Additional Guidance and Resources
- Guidance for LTC Facilities Experiencing Staffing Shortages Due to COVID-19 (PDF)
- National Healthcare Safety Network Long Term Care Facility COVID-19 Module Enrollment (PDF)
- Long-term Care COVID-19 Vaccination Options (PDF)
- Attestation for Free COVID-19 Testing Kits for ALF, HCSSA, ICF/IID and NF Providers (PDF)
- Questions and Answers from Long-term Care Facebook Live Discussions Hosted by Sen. Zaffirini (PDF)
- Expanded Visitation in Texas Long-term Care Facilities (PDF)
- HHSC Reminds Long-term Care Providers to Check for Updated COVID-19 Guidance (PDF)
- COVID-19 Vaccination-Pharmacy Partnership for Long-Term Care (PDF)
- COVID-19: Questions and Answers Regarding Facemasks and Respirators (PDF)
Shelter-in-Place and Stay-at-Home Orders for HHSC Providers, Vendors and Contractors
HHSC Provider, Vendor and Provider Contractor Guidance for Shelter-in-Place and Stay-at-Home Orders
All mission-essential workers for HHSC, providers, vendors and contractors whose work cannot be performed through teleworking must continue to report to their work or duty stations, including in areas where local government authorities have issued shelter-in-place or stay-at-home orders. It is critical that workers for HHSC providers, vendors and contractors continue to provide the life-sustaining and lifesaving care and benefits our clients need. It is equally critical that HHSC providers, vendors and contractors provide their workers with a safe and healthy environment in which to work. To protect those workers reporting to HHSC offices and facilities, the agency is requiring additional efforts to sanitize workspaces, implement CDC social distancing measures, and limit face-to-face interaction with clients and patients as much as possible through temporary measures, such as waiving certain interview processes and prohibiting visitors to HHSC-operated and licensed facilities.
For more specific guidance, please contact the particular HHSC program or department your services involve.
Resources
- Strategies to Mitigate Healthcare Personnel Staffing Shortages
- Infection Control Basics: Personal Protective Equipment Webinar
- Provider and Information Letters
- Proper N95 Respirator Use for Respiratory Protection Preparedness
- Helping Residents with Dementia Prevent the Spread of COVID-19 in LTC Communities (PDF)
- Helping Individuals with Intellectual Disabilities and Related Conditions Prevent the Spread of COVID-19 (PDF)
November 5th, 2021
Beginning May 6, 2021, HHSC has been posting pre-recorded sessions monthly. These sessions will continue to share information with stakeholders about the implementation of various Medicaid/CHIP flexibilities in response to the COVID-19 pandemic. HHSC may return to weekly sessions as needed if there are changes to the public health emergency.
Please click on the link below to hear recorded session from NOV 4 Texas Medicaid CHIP COVID-19 Information Session Webinar
The audio from this session can be found here.
If you need a copy of the transcript or want to download a handout of the presentation, click links below:
The presentation can be found here.
Future meeting notices and information will continue to be shared on these sites, so please check back regularly.
For additional questions, please write to Medicaid_COVID_Questions@hhsc.state.tx.us.
September 15th, 2021
Oct. 4 ICF COVID-19 Webinar with HHSC LTCR
Long-term Care Regulation and the Department of State Health Services provide the latest information on the COVID-19 pandemic and take live questions from participants in this ICF provider webinar. Provider attendance is critical to staying current with COVID-19 requirements and guidance. ICF/IID providers are strongly encouraged to attend this and all COVID-19 webinars with LTCR and DSHS.
Those using Internet Explorer may have difficulties registering for the webinar. Please try another browser such as Google Chrome or Microsoft Edge.
October 4, 2021
11 a.m. – noon
Register for the COVID-19 Webinar.
September 15th, 2021
Sept. 13 ICF COVID-19 Webinar Recording Available
A recording of September 13, 2021, ICF/IID COVID-19 Q&A with HHSC LTC Regulation and DSHS is available for those who could not attend.
Listen to the webinar recording here(link is external).
August 30th, 2021
LTC Providers May Request COVID-19 Emergency Support
For Emergency Staffing Support:
The Office of the Governor directed DSHS to use staffing agencies to provide medical personnel from out-of-state to Texas health care facilities to assist in COVID-19 operations.
This support will be available to residential long-term care providers.
-Providers must demonstrate that they have exhausted all other options.
-Also that they have urgent need for assistance before requesting emergency staffing support.
The State is asking that jurisdictions and health care entities be judicious with requests for staffing, as the State will not be able to address all staffing needs, especially as the need for emergency staffing ramps up across the state.
LTC providers are always required to provide services to residents or clients before, during and after an emergency.
The emergency plan must include:
- Planning for staff shortages
- A back-up plan to ensure operations and care of residents continues
For COVID-19 Vaccination, Testing Kits, PPE, Disinfection, and HAI/EPI Support:
Long-term care providers can request:
- COVID-19 mobile vaccine clinics for residents and staff
- BinaxNow testing kits. Read PL 2020-49 for details.
- PPE (providers should exhaust all other options before request)
- Facility cleaning and disinfection
- Healthcare-associated infection and epidemiological support
To Request Support:
To initiate a request for COVID-19 support described above, contact the HHSC LTCR Regional Director in the region where the facility is located.
HHSC LTCR staff are responsible for initiating a State of Texas Assistance Request on behalf of the long-term care provider.
HHSC LTCR staff may request supporting documentation to verify need.
August 15th, 2021
LTC Provider COVID-19 Resource Contacts Have Changed
Federal COVID-19 Local Fiscal Recovery Funds are being distributed to cities and counties throughout Texas. HHSC urges long-term care providers in need of COVID-19 resources to use the following resources:
- Contact your city, county or regional advisory council to find out if resources or funds will be available for health care staffing support, testing services, resident or site assessment, and disinfecting services as these resources are no longer available through HHSC.
- For mobile COVID-19 vaccination needs, call 888-90-TEXAS to ask for a Mobile Vaccination Team to come out to your facility.
- Contact DSHS:
- Reach out to the HHSC Long-Term Care Regulation Regional Director in your region to ask for:
- BinaxNow testing kits. Review PL 2020-49 (PDF) for details.
- Health care-associated infection and epidemiological support.
- COVID-19 vaccine. Providers should go through all other options before this one.
LTC providers can now order COVID-19 therapeutics directly.
July 18th, 2021
August 2 ICF COVID-19 Webinar with HHSC LTCR
Long-term Care Regulation and the Department of State Health Services provide the latest information on the COVID-19 pandemic and take live questions from participants in this ICF provider webinar. Provider attendance is critical to staying current with COVID-19 requirements and guidance. ICF/IID providers are strongly encouraged to attend this and all COVID-19 webinars with LTCR and DSHS.
Those using Internet Explorer may have difficulties registering for the webinar. Please try another browser such as Google Chrome or Microsoft Edge.
ICF Provider Webinar
August 2, 2021
11 a.m. – 12 p.m.
Register for the COVID-19 Webinar.
July 16th, 2021
July 6 ICF COVID-19 Webinar Recording Available
A recording of the June 14, 2021, ICF/IID COVID-19 Q&A with HHSC LTC Regulation and DSHS is available for those who could not attend.
Listen to the webinar recording here(link is external).
May 2021
Building COVID-19 Vaccine Confidence Webinar
- Watch the recording and download the slide deck (PDF) from the presentation.
- Download the supplemental handout (PDF) for information and outreach materials you can use to educate your community about the COVID-19 vaccine.
- Download the Vaccinate with Confidence fact sheet (PDF) to learn about CDC tools and technical assistance available to state and territorial health departments to increase COVID-19 vaccine confidence and uptake.
May 12th, 2021
Quality In LTC Conference Online
Due to the COVID-19 pandemic, Health and Human Services made the decision to move forward with an online Quality in Long-Term Care conference. The conference presentations are available on the HHS Learning Portal, and can be accessed through August 2021. To obtain a certificate of completion, participants must view the selected presentation(s), and complete the associated learning quizzes and course evaluations. The certificate, noting any continuing education hours awarded, can be downloaded from the HHS Learning Portal.
Questions can be emailed to QMP@hhs.texas.gov
From HHSC May Newsletter
COVID-19 updated resources, see link below:
May 6th, 2021
APR 29 MCS COVID-19 Stakeholder Update
The audio from this session can be found here.
The presentation can be found here.
Future meeting notices and information will continue to be shared on these sites, so please check back regularly.
April 17th, 2021
March 18, 2021 MCS COVID-19 Stakeholder Information Session
Thank you for your interest in listening to the March 18 Texas Medicaid CHIP COVID-19 Information Session.
The audio from this session can be found here.
The presentation can be found here.
Future meeting notices and information will continue to be shared on these sites, so please check back regularly.
For additional questions, please write to Medicaid_COVID_Questions@hhsc.state.tx.us.
April 17th, 2021
Reminder: Providers Can Request Free COVID-19 Testing Kits
ALF, HCS, HCSSA, ICF/IID and NF providers in counties where the COVID-19 positivity rate is more than 10 percent can request free COVID-19 testing kits.
The test kits are only to test essential caregivers or HCSSA staff going into an NF or ALF who have direct contact with people receiving hospice services. Providers can request the free BinaxNOW point-of-care antigen COVID-19 test kits by filling out the attestation form (PDF). The attestation form includes instructions for requesting the free COVID-19 testing kits for each eligible provider type.
March 28th, 2021
Free BinaxNOW COVID-19 POC Tests Available for LTC Providers
HHSC, along with the Texas Department of Emergency Management, is expanding the criteria for requesting free BinaxNOW COVID-19 point of care test kits to all the following.
- Nursing facilities
- Assisted living facilities
- Intermediate care facilities for individuals with intellectual disability or related conditions
- Home and community-based services providers
- Home and community support services agencies
Use these free BinaxNOW COVID-19 POC test kits to test anyone including residents, staff and visitors.
Providers must attest to adhere to certain training and reporting requirements and have one of the following.
- Current Clinical Laboratory Improvement Amendment Certificate of Waiver
- Current CLIA laboratory certificate
Providers must complete and submit an attestation form for free BinaxNOW point-of-care antigen COVID-19 test kits (PDF) to request free BinaxNOW COVID-19 point of care test kits. See revised PL 2020-49 (PDF) for more information. Tests are available while supplies last.
March 22 ICF COVID-19 Webinar with HHSC LTCR
Long-term Care Regulation and the Department of State Health Services provide the latest information on the COVID-19 pandemic and take live questions from participants in this ICF provider webinar. Provider attendance is critical to staying current with COVID-19 requirements and guidance. ICF/IID providers are strongly encouraged to attend this and all bi-weekly COVID-19 webinars with LTCR and DSHS.
Those using Internet Explorer may have difficulties registering for the webinar. Please try another browser such as Google Chrome or Microsoft Edge.
ICF Provider Webinar
March 22, 2021
11 a.m. – 12:30 p.m.
Register for the COVID-19 Webinar.
Helpful Vaccination Information
Moderna EUA Storage and Handling Instructions (PDF) includes the following:
- Moderna EUA Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers)
- Moderna EUA Fact Sheet for Recipients and Caregivers
v-safe After Vaccination Health Checker Instructions (PDF)
Moderna EUA “What to Expect” Card for Healthcare Professionals (PDF)
Moderna EUA “What to Expect” Card for Vaccine Recipients (PDF)
CDC’s Moderna Clinical website is live: Moderna COVID-19 Vaccine Information. This website includes the following documents:
- Storage and Handling Summary
- BUD Guidance and Labels
- Storage and Handling Labels
- Vaccine Expiration Date Tracking Tool
- Freezer Storage Loggers (F) and (C)
- Prep and Administration Summary
- Standing Orders Template
CDC Coronavirus Disease 2019 (COVID-19)
Resources For Posters For The Facility For Staff & Individuals
AADMD Webinar Series to Return in January 2021
Catch up on the webinars you may have missed.
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
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.
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
Letter From Twogether Consulting To Providers-Sept 29th, 2023 Update
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TMHP: HCS and TxHmL Waiver Programs: Trending Issue Support
September 29th, 2023
HCS and TxHmL Waiver Programs: Trending Issue Support, Volumes 21-24
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 20
Since May 2, 2022, Home and Community-based Services and Texas Home Living program providers, local intellectual and developmental disability authorities, and financial management services agencies, billing on behalf of Consumer-Directed Services, have been submitting claims and forms to the Texas Medicaid & Healthcare Partnership (TMHP).
DH & ISS Billing
On March 1, 2023, day habilitation was replaced with individualized skills and socialization (ISS). To bill for day habilitation prior to March 1 and ISS after March 1, refer to the following unit information and prorating instructions.
Units:
· Day habilitation is a daily unit with a maximum of 260
· ISS is an hourly unit with a maximum of 1560
· 260 daily units of day habilitation equal 1560 hourly units of ISS
· The 1560 ISS unit maximum covers the extra day for leap year
Prorating instructions:
1. Determine how many days were used for day habilitation. (Example: 55 days used)
2. Subtract the number of days used for day habilitation from 260 (or the number of days requested) to determine the remaining days. (Example: 260 – 55 days used = 205 remaining days)
3. Multiply the remaining days by 6 (derived from dividing 1560 by 260) to determine how many hours remain to bill as ISS. (Example: 205 remaining days * 6 = 1230 ISS hours)
Other areas discussed were:
Dental Claims Units: Providers must bill dental claims with the dollar amount as the units.
Example: If the billed amount is $100, enter “100” as the number of units.
If previous claims were paid incorrectly because the dollar amounts were not billed as units, providers can rebill correctly by performing adjustments on the paid claims. Refer to the “Adjustments” section of the Long-Term Care (LTC) User Guide for TexMedConnect for assistance.
Submitting Transfer Forms: To avoid delays when submitting forms after transfers, the receiving providers should obtain confirmation that a transfer Individual Plan of Care (IPC) form is in Processed/Complete status before proceeding to the subsequent form
TMHP has received feedback from providers indicating additional support is needed. Resolutions regarding the most frequently reported issues may be found by reading the full alert.
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 19
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 18
January 28th, 2023
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 17
Trending Support Issues, Vol. 17: Access to PDF R&S and 835 Electronic R&S Reports, R&S Report Information and Videos
Click on link below for full report
https://www.tmhp.com/news/2023-01-27-hcs-and-txhml-waiver-programs-trending-issue-support-volume-17
Highlights from Vol. 17
Providers are encouraged to use both the PDF version and the American National Standards Institute (ANSI) 835 electronic version of their Remittance and Status (R&S) Reports.
Providers can view and save the PDF version of their R&S Reports through TexMedConnect. The PDF files are available for 90 days following the publication date of the R&S Reports.
To access their ANSI 835 electronic R&S Reports, providers must submit an Electronic Data Interchange (EDI) Agreement and set up ANSI 835 access. In addition, providers must use an approved third-party billing software vendor from the following list. Providers can retrieve their ANSI 835 electronic R&S Reports dating back to when their submitter number was linked to their contract number.
Providers should refer to the 835 Long Term Care Companion Guide for more information about the 835 Electronic R&S Reports.
In addition:
Providers can refer to the Remittance and Status (R&S) Reports for LTC Providers Quick Reference Guide (QRG) for more information.
Additionally, a three-part educational video series is available on TMHP’s HCS and TxHmL YouTube playlist and discusses the following topics:
- General R&S Report information and instructions for account administrators on how to set permissions for users to access R&S Reports (Part 1).
- How to read and understand the first section of the R&S Report: Non-Pending Claims (Part 2).
- How to read and understand the second, third, and fourth sections of the R&S Report: Pending Claims, Financial Summary, and EOB Codes and Descriptions (Part 3).
Approved 3rd party biller list
Don’t forget our friends at Millin Billing are on this list. Contact us at info@twogetherconsulting.com for assistance with getting a demo and discount on your rate.
January 15th, 2023
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 16
Trending Support Issues, Vol. 16: IPC Use as a Template button and Location Code Field on Individual Movement and IPC forms
https://www.tmhp.com/news/2023-01-13-hcs-and-txhml-waiver-programs-trending-issue-support-volume-16
**When creating IPC renewals, the Use as Template button can now be used to populate form data from the original form into the new form. This is incredibly helpful to providers now and less time-consuming.
*Another major issue that slowed down transfers I believe with LIDDA’s and also caused glitches for providers, in terms of wrong locations noted in the dropdown menu and then not being able to revise those location errors was also addressed. See “fix” below:
Effective January 13, 2023, a text box will replace the location code drop-down box on the following IMT and IPC form fields:
· IPC transfers (3608/8582) field 39a: Receiving Program Provider Location Code
· IMTs field 18: Location Code
· IMT Individual Update fields 122: Current Location Code and 123: New Individual Location Code
· IMT LA Reassignment field 111: New Location Code
The manually entered text will be validated upon submission to ensure that the submitted location code is valid for the provider. This enhancement will improve the overall system performance related to the location code fields.
The following item-by-item (IBI) guides have been updated to reflect enhancements:
For further information, contact the TMHP LTC Help Desk at 800-626-4117. Select option 1 and then option 7.
January 12th, 2023
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 15
- Trending Support Issues, Vol 15: If you missed it, know that it includes information about determining your ARPA payments: https://www.tmhp.com/news/2022-12-30-hcs-and-txhml-waiver-programs-trending-issue-support-volume-15
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 14
Trending Support Issues, Vol 14: PEMS Revalidation and Enhancements to updating effective date of some forms : https://www.tmhp.com/news/2022-12-30-hcs-and-txhml-waiver-programs-trending-issue-support-volume-14
December 16th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 13
Since May 2, Home and Community-based Services and Texas Home Living program providers, local intellectual and developmental disability authorities, and financial management services agencies billing on behalf of Consumer-Directed services have been submitting claims and forms to the Texas Medicaid and Healthcare Partnership (TMHP).
TMHP has received feedback from providers and LIDDAs indicating additional support is needed. Resolutions regarding the most frequently reported issues may be found by reading the full alert.
November 20th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 12
Since May 2, Home and Community-based Services and Texas Home Living program providers, local intellectual and developmental disability authorities, and financial management services agencies, billing on behalf of Consumer-Directed Services, have been submitting claims and forms to the Texas Medicaid and Healthcare Partnership (TMHP).
TMHP has received feedback from providers indicating additional support is needed. Resolutions regarding the most frequently reported issues may be found by reading the full alert.
HCS and TxHmL Waiver Programs: Migration Trending Issue Support, Volume 11
The following is a list of common form submission statuses with descriptions and actions needed:
- Pending DADS Review
- Description: The form is pending Texas Health and Human Services Commission (HHSC) long-term care (LTC) staff review.
- Action:
- Forms 8578, 3608, and 8582: For Change LON on Existing Assessment, renewals and revisions, the submitter may need to submit a review packet to the HHSC Utilization Review (UR) department. For questions and to provide supplemental documentation, submitters can contact the HHSC UR department at 512-438-5055 or email deskURLONIPC@hhs.texas.gov.
- 8578, 3608, 8582, and 3615 Forms: For questions and to provide supplemental documentation about enrollments, transfers, or continuation of suspensions, LIDDAs can contact HHSC Program Eligibility and Support (PES) at 512-438-2484.
- 3616 Termination Forms: For questions and to provide supplemental documentation, providers and LIDDAs can contact HHSC Program Eligibility and Support (PES) at 512-438-2484.
- Suspensions Pending….. read more
October 17th, 2022
HCS and TxHmL Waiver Programs: Migration Trending Issue Support, Volume 10
October 7th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 9
Since May 2, Home and Community-based Services and Texas Home Living program providers, local intellectual and developmental disability authorities, and financial management services agencies, billing on behalf of Consumer-Directed Services, have been submitting claims and forms to the Texas Medicaid and Healthcare Partnership.
TMHP has received feedback from providers indicating additional support is needed. Resolutions regarding the most frequently reported issues may be found by reading the full alert
-Preventing claim denials for invalid date spans
Claims billed with date spans may deny with one of the following explanations of benefits (EOBs):
F0126: Claim line items cannot span current fiscal years.
The new state fiscal year (SFY) runs from September 1, 2022, through August 31, 2023. Claims will be denied with EOB F0126 if they are submitted with line item dates of service (DOS) spanning the previous SFY ending August 31, 2022, and the current SFY. Providers and LIDDAs submitting claims with DOS spanning the previous and current SFYs should submit separate claims for each SFY.
F0326: Incorrect number of days billed for this service.
Services that only allow billing for individual DOS may be denied with EOB F0326 if they are billed with date spans. These services should be billed as separate line items for each service date.
-Claims adjustments reminder
Claims that have processed successfully can be adjusted. For instructions on how to adjust claims, refer to the “Adjustment” section of the LTC User Guide for TexMedConnect.
Providers can also adjust a previously adjusted claim in TexMedConnect. For instructions, refer to HCS and TxHmL Waiver Programs: How to Adjust a Previously Adjusted Claim
September 11th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 8
-Termination Forms Submitted by LIDDAs
For clients who have CDS services only, termination forms are submitted by LIDDAs. After form submission, LIDDAs need to contact HHSC Program & Eligibility Support (PES) to acknowledge and review the forms. LIDDAs can contact HHCS PES by calling 512-438-2484, faxing 512-438-4249, or emailing enrollmenttransferdischargeinfo@hhs.texas.gov.
Read more on the following items:
–Long-Term Care Online Portal Sessions Must Be Restarted Daily
–Using the “Resubmit to SAS” Button
Access to Electronic R&S and PDF R&S Reports
August 31st, 2022
Migration Trending Issue Support Vol 7:
August 16th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support Volume 6
–Individual’s residential address in Individual Search
–“Pending LA Review” status and action needed
–Using the correct IMT Form to update the service coordinator (SC)
–HCS and TxHmL call queue
For info on these trending issues see the following link:
https://www.tmhp.com/news/2022-08-16-hcs-and-txhml-waiver-programs-trending-issue-support-volume-6
August 13th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support Volume 5
Since May 2, 2022, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers, local intellectual and developmental disability authorities (LIDDAs), and financial management services agencies (FMSAs) that bill on behalf of consumer-directed services (CDS) have been submitting claims and forms to Texas Medicaid & Healthcare Partnership (TMHP). TMHP has received feedback from providers indicating that additional support is required.
Here are the latest resolutions to trending issues below:
HCS and TxHmL Call Queue
Status: When contacting TMHP, providers need to select option 1 then option 7 to enter the HCS and TxHmL Waiver Programs queue. The full number is 800-626-4117, Option 1, then Option 7.
Location Code Issue
Resolution: LIDDAs submitting Individual Plan of Care (IPC) transfers for clients were receiving incorrect location codes. This issue has been resolved. Providers that received an incorrect location code need to resubmit the IPC transfer.
See previous Volumes and info below:
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 4
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 3
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 2
HCS and TxHmL Waiver Programs: Trending Issue Support
Important Claims Submission Information for HCS and TxHmL Programs
LTC Online Portal Dashboard Accessibility Issue Resolved
IPC Forms 3608 and 8582 Issue Resolved
HCS and TxHmL FAQ Updates Available May 9, 2022, and May 23, 2022
Individual Plan of Care (IPC) Training Materials for HCS and TxHmL Waiver Programs
Now Available: HCS and TxHmL Programs Forms and Claims Submissions to TMHP
EVV Updates for the HCS and TxHmL Transition to TMHP for Claims Submission
June 1st, 2002
Resolutions to the most frequently reported issues may be found at the following link for TMHP issues concerning entering IPC’s, dual entry into CARE, submitting claims, and more: “Trending Issue Support” Table
In addition, please see helpful links below including recent HCS/TxHmL FAQ’s in May of 2022.
View previous postings:
- Important Claims Submission Information for HCS and TxHmL Programs
- LTC Online Portal Dashboard Accessibility Issue Resolved
- IPC Forms 3608 and 8582 Issue Resolved
- HCS and TxHmL FAQ Updates Available May 9, 2022, and May 23, 2022
- Individual Plan of Care (IPC) Training Materials for HCS and TxHmL Waiver Programs
- Now Available: HCS and TxHmL Programs Forms and Claims Submissions to TMHP
- EVV Updates for the HCS and TxHmL Transition to TMHP for Claims Submission
Employment First Assessment Tool: Meaningful Skills Development and Employment Services for ISS
September 28th, 2023
TMHP Claims Vendor Contract Change Coming December 2024
September 28th, 2023
Beginning December 2024 a third TMHP contract for Claims Processing and Adjudication and Financial Services (Claims) with Conduent State Healthcare, LLC(Conduent) will be implemented.
- The TMHP Claims vendor will perform fee-for-service claim processing and fiscal agent responsibilities such as claim payment and recovery of overpayments.
TMHP claims processing will continue as-is until the new TMHP Claims contract is fully implemented in December 2024.
Remember, if you haven’t already, please sign up for GovDelivery to receive email updates and check tmhp.com regularly, and be on the lookout for HHSC providing more info about the transition prior to Dec. 2024..
HCS Provider Letters, Contacts and Resources
September 13th, 2023
Home and Community-based Services (HCS)
Provider Letters/Provider Communications!!!
Click here for news, information letters (ILs) & provider letters (PLs).
Receive Emails from HHS Every Sunday
The Texas Health and Human Services Commission contracts with a company called Granicus to provide email updates, called GovDelivery. In accordance with your contract, and contracting rules at 40 Texas Administrative Code §49.302(g), you must subscribe to receive HHSC email updates, using this GovDelivery signup, and select Information Letters, Provider Alerts and the contract program type(s).
When you sign up for email updates, you are giving your information to both HHSC and to Granicus. When HHSC has your information, it is subject to the HHSC privacy policy. When Granicus has your information, it is subject to the Granicus GovDelivery privacy policy.
Contact Program Staff
- Provider/policy information: hcs@hhsc.state.tx.us / hcspolicy@hhsc.state.tx.us
- Contracting information: 512-438-3234 / IDDWaiverContractEnrollment@hhsc.state.tx.us
- Eligibility information: Your local authority
- Regional nurses: Community Services regional contacts for your region
Resources
COVID FAQ’s & Guidance
- Updated COVID-19 FAQs for HCS and TxHmL Providers (PDF) – revised July 22, 2022
- COVID-19 Response for HCS Residential Providers (PDF) – revised June 24, 2022
Infection Control & Vaccine Resources
- Infection Prevention and Control Measures for Common Infections in LTC Facilities (PDF)
- Infection Control Basics & PPE Training for Essential Caregivers (PDF)
- Helping Individuals with Intellectual Disabilities and Related Conditions Prevent the Spread of COVID-19 (PDF)
- Long-term Care COVID-19 Vaccination Options (PDF)
HB 3720
State Rules (Title 40 Subchapter D replace with Title 26 part I Ch 263 & 565)
- Texas Administrative Code, Title 26, Part 1, Chapter 263: Home and Community-based Services (HCS) Program and Community First Choice (CFC)
- Texas Administrative Code, Title 26, Part 1, Chapter 565: Home and Community-Based Services (HCS) Program and Community First Choice (CFC)
- Texas Administrative Code, Title 40, Part I, Chapter 41: Consumer Directed Services
- Texas Administrative Code, Title 40, Part 1, Chapter 49: Contracting for Community Services
Surveyor Review Tools and Forms
- ISS Attestation and Provider Compliance Form (PDF)
- Form 1573, Residential Review Evidence of Correction for Results Less Than 90%
- Form 3609, Waiver Survey and Certification Residential Checklist
- Form 5611, Waiver Survey and Certification — HCS Personnel Checklist
- Form 5607, Waiver Survey and Certification DFPS Checklist
- Form 5610, Fire Drills
- Form 8576, Individual Profile Information
- Form 8608, Sample Appeal Letter
Additional Resources
- Provider and LIDDA CARE Report Crosswalk (PDF)
- Provider and LIDDA CARE Screen Crosswalk (PDF)
- Comprehensive Nursing Assessment FAQ (PDF)
- HCS and TxHmL Transformation Webinar (PDF)
- Interpretive Guidance Booklet (PDF)
- HCS & TxHmL Certification Principles Webinar Series: Participant Q&A (PDF)
- Regulation of Individual Skills and Socialization webinar (PDF)
- Regulation of Individual Skills and Socialization webinar Recording
VERY IMPORTANT: Provider Enrollment Revalidation Requirements
September 4th, 2023
VERY IMPORTANT: Provider Enrollment Revalidation Requirements
Provider Enrollment Revalidation Requirements https://www.tmhp.com/news/2023-09-01-reminder-provider-enrollment-revalidation-requirements
Providers must complete their revalidation enrollment before the end of their enrollment period. Providers can revalidate their enrollment in the Provider Enrollment and Management System (PEMS) up to 120 calendar days before their current revalidation due date.
Providers who do not complete the revalidation process by their deadline will be disenrolled from all Texas state healthcare programs, and claims and prior authorization requests will be denied.
Providers may find more information and begin their revalidations in PEMS through the tmhp.com website at tmhp.com/topics/provider-enrollment/how-apply-enrollment under “Determine Your Application Type.”
For more information, call the TMHP Contact Center at 800-925-9126.
Provider Requirements
Revalidating providers may need to provide fingerprints, submit additional documentation, or complete other screening requirements.
Providers may view and confirm their revalidation date and enrollment information in PEMS. To reduce application time, we encourage providers to have the following information available:
- First and last name
- Organization name
- Social Security number
- Date of birth
- Employer’s Tax Identification Number and legal name
- Licenses or certifications, if applicable
- Identification for the provider and any person who meets the definition of owner, creditor, principal, subcontractor, or managing employee
- Documentation related to disclosures, if needed
- Additional documentation required for program participation
Providers revalidating an existing enrollment should continue to submit claims to meet their timely filing requirements.
Certain revalidating providers must pay an application fee. Please see: State of Texas Provider Types Required to Pay an Application Fee to determine which type of providers must pay the provider enrollment application fee and for additional information, please look at the Texas Medicaid Provider Procedures Manual, Vol. 1, Provider Enrollment and Responsibilities
New Phone System-TMHP (HCS/TxHmL)
September 5th, 2023
As of Sept. 5th, TMHP had implemented improvements to the phone system, including the Automated Inquiry System (AIS).
Here are some of the improvements:
A. Some of the menu options and messages have changed.
B.TMHP is adding direct transfers where applicable.
The new system has the ability to recognize menu options through touch-tone keypad selection or speech recognition to engage callers. For more information call the TMHP help desk at 800-626-4117
LONG Term Care 800-626-4117
Option 1 LTC Customer Service
Option 2 LTC Nurse
Option 3 EDI
Option 4 EVV
Option 5 Fair Hearing (Providers only)
Option 6 Third Party Liability (TPL) , Other Insurance (OI) , Update to MESAV
Customer Service Line: Option 1 (Sub-Options below)
Sub-Option 1 HCS/TxHmL Forms and Claims Inquiries
Sub-Option 2 MN
Sub-Option 3 Claims
Sub-Option 4 All Other Forms
Sub-Option 5 All Other Inquiries
PPAT Fall Conference For September 6th-8th, 2023-Update
August 31st, 2023
26th ANNUAL PPAT CONFERENCE
Doubletree Hotel Austin
6505 IH-35 North, Austin, TX 78752
*Twogether Consulting will have an exhibitor booth at this event. Please come by and meet us and our friends from ADP Payroll & HR Services
Join PPAT for Their Annual PPAT Conference, September 6-8, 2023!
Though not inclusive, below are a few conference sessions topics:
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Wednesday, September 6, 2023 (Subject To Change) |
CONFERENCE AT A GLANCE |
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1:15-2:30 |
Welcome & Keynote: (Phoenix North) TBD |
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2:30-3:00 |
Refreshment Break with Exhibitors: Cookie, Cupcake & Dessert Bar with Exhibitors (Phoenix Central) |
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3:00-4:45 |
Opening Session: (Phoenix North) TBD |
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4:45-6:45 |
Reception & Silent Auction Opening: Hors D’oeuvres & Cash Bar (Phoenix Central) |
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Thursday, September 7, 2023 |
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7:00-6:00 |
Exhibit Hall Open (Phoenix Central) |
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7:00-8:00 |
Breakfast Buffet with Exhibitors: (Phoenix Central) |
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Phoenix North |
Austin |
Robertson |
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8:10-9:10 |
Guardianship Program, Rose Cohen, Attorney at Law, Law Office of Mark Cohen and Rose Cohen, Bernadette Richardson, VP of Operations, Kenmar Residential Services, Inc. |
Overview of the Olmstead Decision |
Emergency Telemedicine for Persons with IDD, Kaylee Graham, R.N., StationMD |
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9:15-10:15 |
SB 944 (Kolkhorst): Panel discussion of what it requires and its impact on IDD services |
TMHP Issues |
How to Be An Effective Advocate |
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10:15-10:45 |
Refreshment Break with Exhibitors (Phoenix Central) |
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10:45-Noon |
Coffee with Clair, Clair Benitez, HHSC |
Individualized Skills and Socialization (policy and enforcement) |
Topic TBD, Jerri Ward, Attorney at Law, Garlo Ward, P.C. |
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1:15-2:45 |
EVV, Tricia Barrett, HHSC |
Another Year in Review. Joanalys Smith, Attorney at Law, Smith & Associates |
Topic TBD, Jerri Ward, Attorney at Law, Garlo Ward, P.C. |
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2:45-3:15 |
Refreshment Break: Cookie, Cupcake & Dessert Bar with Exhibitors (Phoenix Central) |
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3:15-4:45 |
Overview and Discussion of Newly Adopted HCS Standards |
Poems, Prayers & Penalties, Joanalys Smith, Attorney at Law, Smith & Associates |
Collaboration with LIDDAs |
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4:45-6:30 |
Happy Hour & Silent Auction Closing: Appetizers & Cash Bar (Phoenix Central) |
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Friday, September 8, 2023 |
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Phoenix North |
Austin |
Robertson |
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8:30-10:00 |
End of Continuous Medicaid Coverage & related Medicaid Eligibility Issues |
HCBS Settings Rules & Statewide Transition Plan |
Closed |
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10:00-10:15 |
Refreshment Break: Continental Breakfast (Phoenix North) |
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10:15-Noon |
Closing Session: (Phoenix North): TBD |
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Hotel Reservation Link – 2023PPATConfHotelReservations
Registration is Closed!
(Exhibitor schedule below. Subject to change.)
Wednesday, September 6th
Exhibitor Hall Open: 1:30 p.m. to 7:00 p.m.
Exhibitor Set-up: 8:00 a.m. to 1:00 p.m.
Location: Phoenix North Ballroom – Exhibitor’s Hall
Break Service with Exhibitors: 2:30 p.m. to 3:00 p.m.
Reception, Hors D’oeuvres, Cash Bar & Silent Auction Opening: 4:45 p.m. to 7:00 p.m.
The silent auction will remain open until the end of the night. It will re-open at the Thursday Breakfast Buffet with Exhibitors.
Thursday, September 7th
Exhibitor Hall Open: 7:00 a.m. to 6:00 p.m.
Exhibitor Set-up: 6:00 a.m. to 7:00 a.m.
Breakfast with Exhibitors: 7:00 a.m. to 8:00 a.m.
Break Service: 10:15 a.m. to 10:45 a.m.
Cookie, Cupcake & Dessert Bar with Exhibitors: 2:45 p.m. to 3:15 p.m.
Appetizers, Happy Hour, Cash Bar & Silent Auction Closing: 4:45 p.m. to 6:30 p.m.
BREAKDOWN Exhibitor Booths: 6:30 p.m.
Friday, September 9th
Although booths are closed on Friday, Exhibitors are encouraged to stay and attend the last day of the conference.
All break services and the Silent Auction will be held in the Exhibit Hall throughout the entire day on Wednesday and Thursday. Winners for the Silent Auction will be announced at the end of the Thursday night Happy Hour. At that time, Exhibitors will need to break down their booths.
Rates For HCS, TxHmL, ICF & DBMB Effective Sept. 1, 2023
August 24th, 2023
HCS Survey Process Changes
August 24th, 2023
Registration is available at:
https://apps.hhs.texas.gov/providers/training/HCS-TxHmL-Training.cfm
HHSC New HCS Provider Letter 2023-09 HCS Survey Process and Expectations
HHSC published Home and Community-Based Services (HCS) provider letter (PL) 2023-09 HCS Survey Process and Expectations on August 23. This letter provides guidance for HCS program providers on the revised HCS survey process that begins on September 1, 2023.
August 16th, 2023
HHSC is preparing a provider letter for distribution to stakeholders to explain the revised survey process (i.e., the unannounced surveys – no more advance notice.
- In addition, it will discuss the new health and safety checks that will be conducted.
- The letter should be issued before September 1, 2023.
- The letter will explain the changes and what providers should expect.
- We do realize there has been some confusion in what has been relayed previously at different times and the 3 IDD Provider Associates have requested a meeting to discuss these issues, which will take place on August 21st, 2023.
Person Centered Planning/ Practices Training Opportunities
August 23rd, 2023
Person-Centered Training Opportunities
Our good friend at IntellectAbility, Patrick Lane has provided a link where providers or anyone else interested can register for online Person-Centered Thinking training. FYI-this is a requirement in the HCS/TxHmLTAC rules for all persons who are a part of the development of the Implementation Plan (IP), to have this training within the first 2 year of hire.
Staff Member and Service Provider Requirements
The session is a $275 per person.
This is a 3-day series of zoom sessions, each 6 hrs long.
There are multiple live Zoom training dates listed, so take your pick.
https://replacingrisk.com/virtual-person-centered-thinking-training/
To learn more about IntelectAbility, here is their main website page https://replacingrisk.com/
HHSC Person-Centered Planning/Practice Training Information
What Training Is Required?
Online Introductory Course
The Texas Health and Human Services Online Introductory Course is appropriate for any member of the planning team, including:
- Legally authorized representatives
- Family members
- Friends
- Nurses (required in some instances)
- Behavior specialists (required in some instances)
- Employment specialists (required in some instances)
- Attendants (required in some instances)
- Direct support professionals (required in some instances)
- Anyone asked to be a member of the planning team
Note: To access and complete this free online training, please go to the HHS Learning Portal, create a user login, and follow instructions to complete the training.
Person-Centered Thinking Classroom Course
To register for the Person-Centered Thinking 2-day classroom course, please go to the HHS Learning Portal, create a user login, and follow instructions to register for a class that is most convenient to your location. Begin Training An introductory course also is offered by DirectCourseOnline. The online offering includes courses in Person-Centered Counseling (PCC) and Person-Centered Thinking and Practice. There are 12 lessons in all.
2-Day Online Training for Person-Centered Training (with virtual classroom). Be sure to sign up for the e-learning portal from HHSC, if you have not done so already, before taking the course.
HHS Approved Full Training
The following training is approved by Texas Health and Human Services for people required to take the full training, specifically case managers, service managers and service coordinators. If you would like to submit a training course to HHS for approval, email: Medicaid_HCBS_Rule@hhsc.state.tx.us. Remember to keep your training certificate.
- Delmarva Foundation’s Person-Centered Thinking Training or call 1-866-755-3506
- DirectCourseOnline
- Person-Centered Counseling (PCC), Person-Centered Thinking and Practice (online) and Person-Centered Thinking and Practice In-Person Course (one-day facilitated training)
- eCourse Catalog Person-Centered Counseling: Person-Centered Thinking and Practices [12 lessons; 8.5 contact hours]
- Lara Consulting Services
- Institute for Person-Centered Planning Person Centered Thinking
- Learning Community for Person Centered Practices’ Person Centered Thinking Training, which can be provided by any Learning Community-certified trainer
- United Health Care Person-Centered Transitions to Community Living providerservicestx@uhc.com or uhc_cp_prov_relations@uhc.com Provider call center: 888-887-9003, 877-842-3210 or 800-905-8671
Provider Resource: ADP Payroll & HR Services
Get Your Promotions for Becoming A New ADP Client:
– 1st 3 months free
– Other Discounts Available!
*Please Let ADP know how you found out about their services to get your 1st 3 months free!
August 21st, 2023
Twogether Consulting strives to find a variety of good resources for our IDD providers and hope that ADP may be able to help some of you out there with Payroll and HR needs.
Our newest contact from ADP is, Sophia Luna. She is the Small Business Consultant For Central Texas. She is located in the Austin Area, but can help you with your business needs anywhere in Texas She can assist our HCS/TxHmL/ICF & ISS providers that have 50 or fewer employees, although she is able to refer those with more than 50 employees to an appropriate consultant from ADP. ADP works with many partners that may be able to help with ADP packages and partners to work with you on your HR concerns such as employee onboarding/new hire process and keeping track of background checks (including monthly OIG/LEIE checks) and tracking employee training-initial and renewal, EVV (Electronic Visit Verification), and assistance with your 1099 contractors. In addition, some of the other needs we see from our providers are help with finding insurance (they have great insurance brokerage partners) as well as general policies and procedures that ADP can assist with or provide some resources.
Sophia is our main provider liaison with ADP and she also works with other health related programs such as home health agencies, hospice ahd behavioral health programs. Some of you may also be providers of these services as well, so please don’t hesitate to reach out to her..
Sophia’s contact info: 956-648-1265 and his email is, Sophia.Luna@ADP.com
Tanner Harmon is our ADP contact for programs with 50 + employees. You can contact Tanner at 214-802-6966 or his email is Tanner.Harmon@ADP.com
November 15th, 2021
From Stevie Laas at WorldMarket (ADP Company/Partner):
WorldMarket Platform Overview-Youtube video
1099 Solutions
“When I think of clients in the healthcare industry, we know they are facing a few outside factors:
With the aging population there is a greater demand for services in nursing facilities and home health
Healthcare services companies are looking to quickly onboard and maintain talent pools of highly skilled health professionals
These organizations are facing inefficient and outdated solutions to maintain 1099s resulting in increasing administrative burden
Due to the nature of this sector, utilizing secure and reliable systems are important to stay in compliance.”
WorkMarket can help in a many ways. A few that stand out:
- Streamlined onboarding
- Automated vetting to quickly ensure all workers have up to date and accurate certifications, background checks, etc
- Streamlined payment process that allows flexibility on payments, as often as daily pay if needed
- Compliance safeguards
- Year-end 1099 administrative burden offloaded so the business can focus on generating revenue
I have included a few items that will help give you an overview of WorkMarket. Please see the 2 attachments. This video is also a quick way to highlight what we do for clients. WorkMarket Overview Keep in mind, the system is very customized so not all clients would need everything outlined in the video. We build it out to be specific to what they need!
Stevi Laas/Enterprise Sales Executive
Cell: 830 708 3384
Stevi.Laas@adp.com
September 13th, 2021
Attention:
ADP has provided Twogether Consulting and our clients with some new information that many of you may be interested in hearing about, regarding
The Summary of the Executive Order from President Biden: Vaccine Mandate and what it means to employers.
Below is the ADP link that discusses how they are helping companies track all of what they are expected to put in place, based on the new vaccine mandate
https://mediacenter.adp.com/2021-09-13-ADP-Bolsters-Return-to-Workplace-Mobile-Solution-with-COVID-19-Test-Result-Tracking
Here is the link to PDF Handout as well: ADP’s Informational Handout About the Vaccine Mandate From President Biden.
Employees Returning From COVID-19
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
Click here for ADP’s COVID-19 Resource Center
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
ISS Updates & New Rules (HCS/TxHmL)
August 18th, 2023
Transition to Individualized Skills and Socialization Survey Deadline Extended
HHSC implemented individualized skills and socialization services in the Home and Community-Based Services (HCS) and Texas Home Living (TxHmL) Medicaid 1915(c) waiver programs, effective Jan. 1, 2023.
HHSC is requesting feedback from HCS and TxHmL program providers only on the impact this change has had on individuals receiving services in the form of a short survey.
Take the survey to provide your feedback.
We thank you for your input. HHSC is extending the deadline to submit responses until Aug. 31, 2023.
All HCS and TxHmL program providers who have not submitted a response must complete the survey by this deadline. Providers who have already completed the survey do not need to submit an additional response.
July 17th, 2023
HHSC Updated the Individualized Skills and Socialization Hold Harmless Period through March 17th, 2024
On Jan. 1, 2023, HHSC implemented the DAHS Individualized Skills and Socialization program and offered an initial hold harmless period from Jan. 1, 2023, through June 30, 2023.
HHSC agreed to extend part of the hold harmless period related to the provision of off-site services.
HHSC will survey for compliance with off-site service delivery but will not move forward with enforcement action.
For all other regulatory requirements, beginning July 1, 2023, HHSC will survey for compliance and move forward with applicable enforcement actions as outlined in Title 26 Chapter 559, Subchapter H, Division 4.
The new hold harmless period related to the provision of off-site Individualized Skills and Socialization services begins July 1, 2023, and ends March 17, 2024.
March 28th, 2023
Host Home Companion Care Providers Concerning ISS & PHE Flexibilities For In-Home ISS
Clarification Concerning Information Letter No. 2023-10 (Replaces IL 2023-06) from February 2023
In-Home Individualized Skills and Socialization Information for Program Providers for COVID-19 PHE
In response to COVID-19 and to provide access to day habilitation services, the Health and Human Services Commission (HHSC) temporarily waived certain requirements in Sections 3710, 4381.3, 4381.7(6) and 4381.7(7) of the HCS Billing Requirements and the TxHmL Billing Requirements. Until the end of the COVID-19 PHE, this flexibility will continue as part of in-home individualized skills and socialization.
Effective May 12, 2023, these flexibilities will no longer be in effect:
The flexibility has allowed HCS and TxHmL program providers to provide in-home individualized skills and socialization to an individual in the individual’s residence, including those residing in their own homes or family homes, without having the required justification outlined below. Program providers and LIDDAs need to have transition plans ready for individuals who receive in-home individualized skills and socialization prior to this end date (before May 12th, 2023).
Beginning May 12th, 2023:
in order to receive in-home individualized skills and socialization, individuals must meet all requirements outlined in the HCS and TxHmL Program Rules, the HCS Billing Requirements, and the TxHmL Billing Requirements, which include:
• A physician has documented that the individual’s medical condition justifies the provision of in-home individualized skills and socialization; or
• A licensed professional or behavioral support service provider has documented that the individual’s behavioral issues justify the provision of in-home individualized skills and socialization; or
• The individual is 55 years of age or older and requests to receive in-home individualized skills and socialization.
In addition, after May 11, 2023, a service provider of host home/companion care will not be permitted to provide in-home individualized skills and socialization to the individual to whom they provide host home/companion care services.
Clarification & Answer to Question From Some of Our Readers:
This letter indicates that HHSC does not appear to prevent a host home provider from becoming an ISS provider, nor does it prevent that licensed ISS provider from providing on-site and/or off-site services to their own individuals living with them. In other words, it would appear they can be a HH/CC provider and licensed ISS provider at the same time and they can provide ISS services to their own individuals they are serving as HH/CC providers. They can not provide their own in-home ISS (anymore) as an HH/CC provider as of May 12th, 2023. The only ISS they can provide after May 11th, is if they are a licensed on-site and/or off-site provider.
March 1st, 2023
Reminder Must Be Licensed As ISS Provider To Bill As Of March 1st, 2023
For HCS/TxHmL Providers, you can’t bill for On-site &/or Off-site ISS as of today March 1st, 2023, if you send someone to an ISS location or have staff providing Off-site services (previously Community DH), if they are not listed as a licensed ISS program.
The directories may be accessed at: https://www.hhs.texas.gov/providers/long-term-care-providers/day-activity-health-services-dahs to find out if the ISS program is licensed.
**You can bill for In-Home ISS as persons providing In-Home ISS do not have to be licensed! No justification is needed for In-Home through May 11th, 2023 I believe. I believe HH/CC providers can still provide In-Home (This was part of the PHE exception prior to March 1st) up through May 11th, 2023, but I am still unclear and will inquire and update everyone when I get some kind of definitive answer.
Previous DH providers & New ISS Provider applicants: If you do not have a temporary ISS license by March 1, 2023, you may not provide or bill HCS, TxHmL, or DBMD providers for on- and off-site ISS services until the temporary license is received. HCS/TxHmL, DBMD Providers who have individuals attending an ISS program may not send persons to the program until they confirm that the operator of the program has received the license. There are no exceptions.
February 21st, 2023
More ISS Training
Very Important: Surveys of ISS Providers With Temporary Licenses
In case this information was overlooked by new ISS providers:
- Once HHSC issues a temporary license, HHSC may conduct a survey at any time.
- HHSC may conduct a survey of any licensed Individualized Skills and Socialization Providers prior to March 1, 2023.
- i.e. if HHSC issues a temporary license on Feb. 21, 2023, HHSC may conduct an initial survey on Feb. 27, 2023.
- HHSC conducts unannounced surveys of ISS Providers.
- For on-site ISS providers, the address on the license must match the address for service provision.
- ISS providers must allow HHSC surveyors access to the on-site location and off-site activity locations.
Please refer to Texas Administrative Code Title 26, Chapter 559 for more info on the LTCR survey process.
February 10th, 2023
How Do I Find A Licensed ISS Provider?
HHSC has now posted directories on the DAHS webpage to help people find a licensed ISS Provider.
The directories may be accessed at: https://www.hhs.texas.gov/providers/long-term-care-providers/day-activity-health-services-dahs
Please note the following:
- There are 2 directories: DAHS with ISS and DAHS-ISS Only.
- The DAHS with ISS Directory is intended to reflect entities licensed as just a DAHS, and entities licensed as DAHS with ISS.
- At this time, this particular directory lists all entities as just having a DAHS license. This is because the commission has yet to approve any DAHS with ISS licenses. The process for approving a DAHS with ISS application takes longer than that of a provider applying as an ISS-only entity. According to HHSC, the entity must undergo an LSC and Health survey before a license is issued to a DAHS with ISS entity. Once these have been approved, they will be listed in this directory as DAHS with ISS.
- Entities listed in the DAHS – ISS Only Directory, currently reflect a 6-month license. This is because these licenses are considered ‘temporary’ at this time. Once the health survey is conducted the entities will receive a one, two or three-year license.
February 5th, 2023
HHSC LTCR Updates the ISS FAQ’s
HHSC Long-term Care Regulation updated the Individualized Skills and Socialization frequently asked questions document on Feb. 01, 2023.
January 27th, 2023
FYI- somehow I missed this alert back in November for Licensed ISS providers. Please be sure to log in and set up your account.
PL 22-32 letter issued 11/28/22 to ISS providers that was sent out concerning Blackboard Connect Emergency System
The purpose of this letter was to inform providers of the emergency communication system called Blackboard Connect, how it will be used, and your responsibility in signing up for the system if you are an ISS provider. This system will be used to send emergency and outreach notifications through email, phone, voice and text if available.
The rules require program providers to assign a designee to enroll in and respond to requests through the system. The designee should be someone who is associated with the licensed building or someone who is responsible for communicating emergency communications. However, you may also have other designees, such as corporate headquarters staff, sign up.
Blackboard Connect sign-up process:
Go to this link and click “Sign Me Up!”
If you have any questions, please contact the Policy and Rules Section by email at LTCRPolicy@hhs.texas.gov or call (512) 438-3161.
Rember, this also applies to HCS, TxHmL and ICF providers among other services.
January 16th, 2023
- The ‘new’ IPC referenced in IL 2022-03 will most likely not be ready until March. They did not have answers as to what providers should do in the interim or even how service logs should be revised until new ones are available. (The letter does indicate that those individuals receiving DH at the time of the switch to ISS (March 1st, 2023) will initially roll over automatically to ISS ).
- After Feb. 28th this would apply to all current clients as far as IPC units are concerned. Persons who don’t have any Day Hab units/days on their plan as of Feb. 28th, 2023 and want ISS hours, will have to do a new PDP and request IPC hours. Providers will have a new IPC form, with ISS on it, before March 1st, 2023.
- To date, no provider has been issued an ISS license.
- Providers can confirm that an entity has an ISS license by checking the DAHS directory on the DAHS webpage: https://www.hhs.texas.gov/providers/long-term-care-providers/day-activity-health-services-dahs
ISS FAQs and Upcoming Webinars:
On January 26, 2023, from 9:00 to 10:30 HHSC will conduct its quarterly LTC webinar which will focus on ISS. To register for the webinar, go to: https://register.gotowebinar.com/register/5204373791714060639
January 12th, 2023
Information Letter No. 2023-03 Individualized Skills and Socialization Automatic Service Authorizations
Effective January 1, 2023, individualized skills and socialization became an available service in the HCS and TxHmL Programs. For the time period of January 1, 2023 to February 28, 2023 both day habilitation and individualized skills and socialization will be allowable program services.
Day habilitation will no longer be a Medicaid-billable service in the HCS or TxHmL Programs for dates of service beginning March 1, 2023, and ongoing.
On January 9, 2023, HHSC will automatically add units of individualized skills and socialization for all individuals with day habilitation (including individuals receiving in-home day habilitation through the COVID-19 flexibility) currently authorized on their individual plan of care (IPC). The units will be available for billing immediately for the provision of on-site, off-site, or in-home individualized skills and socialization and will be visible to program providers in the Medicaid Eligibility Service Authorization Verification (MESAV). The added units will be authorized beginning January 1, 2023 through the end of the individual’s current IPC period. For individuals with an IPC period that must be renewed between January 1, 2023 – April 30, 2023, the added units will be authorized until December 31, 2023.
These units for individualized skills and socialization will not be visible to program providers or service coordinators on the IPC in the Long-term Care Online Portal (LTCOP) on the Texas Medicaid & Healthcare Partnership (TMHP) website nor on the dashboard until a revision or renewal IPC is entered. This automatic service authorization will give service coordinators additional time to meet with the individual’s service planning team (SPT) to update the individual’s person-directed plan (PDP) and for program providers to update the individual’s implementation plan (IP) as this new service takes effect. HHSC is implementing this process to minimize disruption to an individual’s desired services.
Service Plan Revisions
At the individual’s next service planning team meeting to complete a revision or renewal IPC (whichever occurs first) for individuals receiving individualized skills and socialization, service coordinators should update the individual’s PDP to reflect the new individualized skills and socialization service. During the service planning team meeting, any new goals related to the provision of on-site and off-site individualized skills and socialization should be discussed and documented in the new action plan. Until the PDP is updated, the individual’s current day habilitation goals, frequency, and duration should be followed for the individualized skills and socialization service.
Following the update to the PDP, the IPC and IP must be updated in accordance with applicable HCS or TxHmL Program rules with the appropriate units of individualized skills and socialization. HHSC will update the IPC and IP form to add individualized skills and socialization by March 1, 2023.
All individual’s PDPs, IPCs, and IPs must be updated with the appropriate units of individualized skills and socialization in accordance with applicable HCS or TxHmL Program rules by December 31, 2023.
For new enrollees and current enrollees who are not currently receiving day habilitation, individualized skills and socialization will need to be added, once the IPC and IP form have been updated, to the individual’s service plan because units will not be auto-authorized for these individuals. Day habilitation can be added and delivered until February 28, 2023.
To read more, please click on link below, for Information Letter 2023-03 related to ISS automatic service authorizations and EVV
January 3rd, 2023
Easier Format For ISS Licensing Rules effective Jan. 1, 2023
The link below provides a format that is easier to read and understand the newly adopted licensing rules rather than those when published as adopted in the Texas Register
Effective Jan. 1, 2023, HHSC adopts new Individualized Skills and Socialization rules for providers who want to deliver individualized skills and socialization services. New rules provide guidance regarding:
- applying for an Individualized Skills and Socialization license;
- provider requirements; and
- HHSC survey and enforcement actions.
Read the new rules in Title 26 of the Texas Administrative Code, Chapter 559, Subchapter H.
HHSC also published Provider Letter 2023-01 New Regulatory Rules for Long-term Care Regulation (LTCR) Individualized Skills and Socialization Services. This PL provides guidance to Individualized Skills and Socialization providers about the new rules.
Read PL 2023-01.
December 23rd, 2022
NEW RULES FOR ISS & ISS LICENSE
HHSC Adds Individualized Skills and Socialization to Email and Text Updates
HHSC added an option to the HHSC email and text update GovDelivery system that subscribers can select to receive updates related to the Individualized Skills and Socialization services program. Users can select to receive Individualized Skills and Socialization program alerts from the “Provider Alerts” drop-down menu.
To sign up for updates, select this link Texas Health and Human Services Commission (govdelivery.com).
For questions about Individualized Skills and Socialization, please email LTCRPolicy@hhs.texas.
November 28th, 2022
Webinar for New Licensing Process Nov. 30th, 2022 Extended to 2 hrs
All providers interested in the new licensing process for the Day Activity Health Services Individualized Skills and Socialization program are invited to a 2-hour webinar on Nov. 30. Originally it was a 1 hr session but has now been extended to have enough time for questions and explanations.
HHSC Long-Term Regulation staff will discuss how to navigate TULIP, the licensing system, explain the license application process and provide an overview of the survey process. There will also be a Q&A session as time allows.
Register for the webinar: Licensing Process Webinar
November 19th, 2022
DAHS ISS Licensing Application Available!
On Dec. 1, 2022, HHSC will launch the Day Activity Health Services (DAHS) Individualized Skills and Socialization License Application in the Texas Unified Licensure Information Portal (TULIP).
Link to TULIP: https://txhhs.force.com/TULIP/s/
Email TULIP_Support@hhsc.state.tx.us with questions related to TULIP functionality or if you have issues gaining access.
Email LTC_NF_DAHS_Licensing@hhs.texas.gov with questions related to the DAHS Individualized Skills and Socialization licensing application
October 13th, 2022
Licensing Application Process For ISS:
October 2nd, 2022
Register for Individualized Skills and Socialization Provider Portal Trainings
Individualized Skills and Socialization Provider applicants are required to complete HHSC Individualized Skills and Socialization Provider Trainings. Below are two computer-based trainings, which will assist Individualized Skills and Socialization Providers with applying for a license and preparing for an inspection.
- Prelicensure Training for Individualized Skills and Socialization Providers
This training was designed for providers who wish to offer individualized skills and socialization services. Prior to surveys or inspection, an entity must submit an application for a Day Activity and Health Services license. Information about the requirements to obtain a license will be shared. Register for the training. - Preparing for an Inspection
This training was designed to assist Individualized Skills and Socialization Providers to prepare for an inspection. In this course, information about the inspection process and licensure rules will be shared. Register for the training.
September 24th, 2022
HHSC Moved The Individualized Skills and Socialization Webpage
The Individualized Skills and Socialization webpage moved from the Resources webpage to the main Long-term Care Providers webpage. This was done so its location is consistent with other Long-term Care Regulation programs and is easier to find.
Individualized Skills and Socialization can be found under the “Community-based Programs” heading.
August 23rd, 2022
No Public Hearing on ISS Licensing Rules
Comments must be submitted no later than 31 days after the date the rules were published in the Texas Register; i.e., 31 days after August 12, 2022.. Comments must be (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered before 5:00 p.m. on the last working day of the comment period; or (3) emailed before midnight on the last day of the comment period. If the last day to submit comments falls on a holiday, comments must be postmarked, shipped, or emailed before midnight on the following business day to be accepted. When emailing comments, please indicate “Comments on Proposed Rule 22R050” in the subject line.
Public Hearing on ISS Program Rules
HHSC will conduct a public hearing on the proposed HCS, TxHmL and DBMD ISS program rules on September 7, 2022 from 8:00 am. until Noon. To register for the virtual hearing, go to: https://attendee.gotowebinar.com/register/927810115195515152
For a copy of the proposed ISS license rules or go to: https://www.hhs.texas.gov/regulations/policies-rules/health-human-services-rulemaking/comment-proposed-draft-rules
August 13th, 2022
Texas HHSC has developed the Individualized Skills and Socialization Provider Portal, an online source of information for providers of individualized skills and socialization.
The Individualized Skills and Socialization Provider Portal will allow providers to:
- Complete and review trainings on the Individualized Skills and Socialization service.
- Find and review provider letters and other information and releases related to Individualized Skills Socialization.
- Link to rules and other services related to Individualized Skills and Socialization.
Provider Communications
- PL 2021-42 – This Provider Letter offers a brief introduction to the new individualized skills and socialization service and what providers can expect as HHSC implements the service.
- Individualized Skills and Socialization Services webinar – This helpful webinar provides an introduction and overview to Individualized Skills and Socialization
- Individualized Skills and Socialization FAQs – revised April 26, 2022
- July 2022 – Individualized Skills and Socialization Provider Webinar – This webinar covers the service description, ratio requirements, and licensing information based on HHSC’s draft individualized skills and socialization rules.
August 6th, 2022
See Draft/Proposed Rules for ISS in HCS and TxHmL below:
Proposed ISS Rules (Main portion of rules start on page 13-52)
- The anticipated adoption date is October, 2022 with an effective date of November 2022. These dates also apply to the proposed rules for the DBMD waiver program.
- Very few changes were made from comments HHSC received during the informal comment period earlier this year. Though we had been apprised of such before this positing, know that any comments you submitted during the informal comment period will need to be resubmitted.
- Carefully review the introduction to the HCS and TxHmL rules on pages 1 -4, including the sections on Issues and Alternatives and Stakeholder Involvement on page 3.
- Carefully review the preamble to the rules before reading the actual rules and pay attention to the sections on Impact to Small Businesses.
- The proposed HCS and TxHmL rules are included in one document. To help you navigate the document, the following is offered:
COVID-19 Update to Temporary Change in HCS and TxHmL Policy for Service Providers of DH, Respite and CFC PAS/HAB
August 19th, 2023
Exception Extended to August 31st, 2024
In March 2020, HHSC started a temporary policy change for respite and Community First Choice (CFC) Personal Assistance Services (PAS)/Habilitation (HAB) provided in the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver programs.
This change allows service providers of respite and CFC PAS/HAB to live in the same home as the person receiving these services. A person’s spouse, or parent if the person is under 18, is not allowed to be a paid service provider of these services in accordance with the HCS, TxHmL and CFC Billing Requirements.
This temporary policy change is effective March 27, 2020, through Aug. 31, 2024. HHSC will provide guidance if anything changes.
Program providers must complete the required background checks for all service providers, including respite and CFC PAS/HAB providers living in the same home as the individual receiving services. Requirements can be found in the following references:
- The Texas Administrative Code (TAC), Title 26, Part 1, Chapter 263, and Chapter 262.
- HCS and TxHmL Rules, 26 TAC §565.9(b) and §566.9(r) and (s).
- The HCS Program Billing Requirements and the TxHmL Program Billing Requirements, Section 3400 for service provider qualifications, and the CFC Billing Requirements for HCS and TxHmL Program Providers.
Exception Ending August 31st, 2023
REMINDER: COVID-19 Update to Temporary Change to HCS and TxHmL Policy for Respite, CFC PAS/HAB Service Provider
In March 2020, HHSC implemented a temporary policy change for respite and Community First Choice Personal Assistance Services/Habilitation provided in the Home and Community-based Services and Texas Home Living waiver programs. This change allows service providers of respite and CFC PAS/HAB to live in the same home as the person receiving these services.
This change has given greater access to needed services for people living in their own home or family’s home. A person’s spouse or the person’s parent, if the person is under 18, is not allowed to be a paid service provider of these services in accordance with the HCS, TxHmL and CFC Billing Requirements.
This temporary policy change is effective March 27, 2020, through Aug. 31, 2023. HHSC will provide guidance if anything changes.
Program providers must complete the required background checks for all service providers. They must follow:
- The Texas Administrative Code, Title 26, Part 1, Chapter 263 and Chapter 262.
- HCS and TxHmL Rules, Section 9.177 (n) and (o), and Section 9.579 (r) and (s).
- The HCS Program Billing Requirements and the TxHmL Program Billing Requirements Section 3400 for service provider qualifications and the CFC Billing Requirements for HCS and TxHmL Program Providers.
October 4th, 2022
COVID-19: HHSC Publishes In-Home Day Habilitation Information for Program Providers (Replaces IL 2022-48)
IL 2022-51 is posted on the HHS webpage for Home and Community-based Services, Texas Home Living, local intellectual and developmental disability authority, and financial management services agency program providers.
HHSC is temporarily waiving certain requirements in Section 3710, 4381.3, 4381.7(6) and 4381.7(7) of the HCS Billing Guidelines and TxHmL Guidelines. This is due to COVID-19 and provides access to needed day habilitation services.
HHSC has published a revision to this guidance in IL 2022-51 In-Home Day Habilitation Information for Program Providers for COVID-19 (PDF). This replaces IL 2022-48.
It extends the temporary guidance through October 31st, 2022, unless the COVID-19 public health emergency ends sooner. HHSC will provide guidance if there are any changes.
Email questions to HCS Policy.
May 30, 2022
COVID-19 Update to Temporary Change for Service Providers of Respite and CFC PAS/HAB
In March 2020, HHSC implemented a temporary policy change for respite and Community First Choice Personal Assistance Services/Habilitation. This change allows service providers of respite and CFC PAS/HAB to live in the same home as the person receiving Home and Community-based Services or Texas Home Living program services.
This change has given access to needed services for people living in their own or family’s home. A person’s spouse or a child or teenager’s parent still cannot be a paid service provider of these services due to guidelines in HCS, TxHmL and CFC handbooks located under Long-term Care Waiver Programs.
This temporary policy change is effective March 27, 2020 through October 31st, 2022, unless the COVID-19 public health emergency ends sooner. HHSC will provide guidance if anything changes. Program providers must complete the required background checks for all service providers. They must follow:
- The Texas Administrative Code, Title 40, Part 1, Subchapter D and N.
- HCS and TxHmL Rules, Section 9.177 (n) and (o), and Section 9.579 (r) and (s).
- HCS and TxHmL Billing Guidelines Section 3400 for service provider qualifications.
FYI- Don’t forget that currently (Due to COVID-19) HHSC has said if you need to add on more CFC PAS/HAB units on the IPC, you are not required to request SC to update the CFC PAS/HAB assessment. The provider needs only complete an IPC revision and IP update.
Please Fill Out The ISS Survey!
August 16th, 2023
ISS Remediation & Validation Process
August 15th, 2023
Remediation & Validation Process
New Quarterly HH/CC On-Site Visits/Reviews
August, 15th, 2023
Compliance with new rules in Ch 565 on additional oversight for HH/CC service providers & Individuals receiving services
- Concerning the now required quarterly HH/CC On-site Visits to review specific areas that providers must conduct, providers have expressed concerns about HH/CC service providers being very upset with this new change of more oversight by the provider and HHSC, and they have concerns that it will be too intrusive.
- There are also concerns that this will be an added cost to the provider to add these additional visits.. HHSC has explained that the purpose of the change was to ensure the health and safety of persons receiving HH services.
- HHSC stated they would discuss the increased cost matter, as well as the concerns about the type of documentation surveyors would expect providers to maintain as evidence that the visits were made, internally and follow up with providers.
- HHSC also stated that as the rule is new, there is no expectation (at least for now) on behalf of Regulatory that providers should have already initiated the visits!
- Surveyors will expect to see a plan of action or schedule for conducting the visits.
HELPFUL TIPS: For Individualized Skills & Socialization (ISS) Providers
July 31st, 2023
Just wanted to post some helpful tips for all of the new ISS providers out there.
#1. Be sure you date your ISS policies, and specifically for any Evacuation &/or Emergency Response Procedures When you revise them, show the revision dates on those policies. ISS Service Providers can receive a violation from the survey team for not doing so.
#2. Be sure to get with your local emergency response coordinators in your areas, to help you with developing your Evac/ER Response procedures.
#3 Be sure to utilize a Hazard Valuation Assessment Tool to evaluate the potential hazards and issues for emergencies that occur in your area (fire, flood, hurricane, tornado, earthquake, chemical spills, active shooters, etc..) and assess how you are preparing currently and again re-assess after any emergencies to see how your ISS facility did in responding to the situation and how you could improve.
#3. Be sure you review your ISS policies and procedures and discuss how you will implement those policies and/or procedures, as part of the implementation process involves training staff/employees.
For example:
- Can you show in-service/training resources or material used to teach employees about what is expected for documenting ISS services or documenting critical incidents?
- Can you show that employees are trained on how and where to report critical incidents?
- Can you show what resources you will use to train the staff about fire drills, fire evacuation, and other emergency protocols for the facility, including during off-site ISS?
- Can you show how you trained employees on the complaint process and the individuals in the program or about Abuse, Neglect and Exploitation and how to report it?
We will continue to add “TIPS” for ISS Service Providers periodically on this page!
FREE 2023 Positive Behavior Management and Support (PBMS) Zoom Workshop
July 29th, 2023
Texas HHSC is hosting a FREE 2023 Positive Behavior Management and Support (PBMS) Zoom Workshop.
HHSC will be providing Continuing Education Units (CEUs) for: Social workers, certified nurse aides, licensed nursing facility administrators, nursing facility activity directors, assisted living facility managers, day activity and health services managers, qualified developmental disabilities professionals, and qualified intellectual disabilities professionals.
See Registration Link Below:
PBMS 2023: Zoom, September 20th and 21st, 2023 (alchemer.com)
Please carefully fill out all questions asked as part of the registration form for the workshop scheduled for September 20th and September 21st, 2023.
The training can be accessed with the Zoom link below:
https://unt.zoom.us/j/85740807478
The training begins promptly at 9:00 a.m. on both days.
9:00 a.m. – 5:00 p.m. first day
9:00 a.m. – 12:30 p.m. second day
For questions, please contact LaQuette Newsome at laquette.newsome01@hhs.texas.gov
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2023
2022
April 9th, 2022
Change is inevitable, as we all know well in this line of work. Our editor for the newsletter (James) has been with us for almost 8 years now and we will miss him, but his schedule has gotten super busy and he will not have as much time available. Meghan Jones will be transitioning as the new editor. Many of you know Meghan as she is our administrative assistant and you have probably contacted her for registrations and such in the past. Due to this change as well as the upcoming Easter and Passover Holidays, we have decided to not put out a mid-month edition for April. Our next newsletter will go out on May 1st, 2022. Thank you for your patience and understanding.
2021
October 22nd, 2021 (late mid-month edition)
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:
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.
HHSC Caregiver Webinar Series Begins August 16th, 2023
July 25th, 2023
Please click on the link below to register for the Caregiver Webinar Series from HSC
Abuse, Neglect, & Exploitation Training for ISS
July 6th, 2023
If you need some help with training your On-Site and Off-Site ISS staff on Abuse, Neglect, and Exploitation, Twogether Consulting has developed a short 45 min-1hr training to address everyone from direct support staff at your ISS to your Administrator.
Included are but not limited to: definitions of Abuse (Physical, Mental, and Sexual), Neglect, Exploitation, and Mistreatment as well as signs and symptoms of each one of these. This session also discusses who to report to, CII (Critical Incident Intake), and some discussion about the 3613-A PIR (Provider Investigation Report) Form, as well as which other critical incidents need to be reported to CII.
We provide handouts, ppt with narrative and recording of the training. You will need to have your staff sign off on training inservice/signature sheet for proof of training or contact us to discuss other options
(we can set it up as a scheduled pre-recorded webinar for you and staff. Each person registered will receive a certificate at the end of watching the entire video and filling out the post-test or post-survey).
Cost: $75
You may use this general payment link to pay and notify us before doing so, so we can send you the training once payment is made. Or you may ask to make payment via Zelle or our business Venmo account.
TxHmL & CFC Certification Standards-New TAC Rules-Adopted
June 20th, 2023
-The rules describe the following certification standards
Service Delivery
Requirements related to abuse, neglect, and exploitation
Staff Member and Service Provider requirements
Quality Assurance
Prohibitions
ERS
Other Program Provider Requirements
And more
Blackboard Connect Emergency System (HCS, TxHmL, ICF, & DAHS-ISS Providers)
June 26th, 2023
FYI- Reminder, if you missed this alert back in November of 2022 for HCS, TxHmL, ICF and Licensed ISS providers as well, please be sure to log in and set up your account.
PL 22-32 letter issued 11/28/22 to ISS providers that was sent out concerning Blackboard Connect Emergency System
(This also applies to DAHS-ISS Providers)
The purpose of this letter was to inform providers of the emergency communication system called Blackboard Connect, how it will be used, and your responsibility in signing up for the system if you are an ISS provider. This system will be used to send emergency and outreach notifications through email, phone, voice and text if available.
The rules require program providers to assign a designee to enroll in and respond to requests through the system. The designee should be someone who is associated with the licensed building or someone who is responsible for communicating emergency communications. However, you may also have other designees, such as corporate headquarters staff, sign up.
Blackboard Connect sign-up process:
Go to this link and click “Sign Me Up!”
If you have any questions, please contact the Policy and Rules Section by email at LTCRPolicy@hhs.texas.gov or call (512) 438-3161.
Don’t forget, this also noted in the Rules under 565 for HCS ( §565.1 Emergency Response System) and 566 for TxHmL
Electronic Visit Verification (EVV) Policies
June 26th, 2023
EVV Policies
Policy Handbook
Policy Handbook Revision Log
Medicaid Resource: State Strategies & Programs To Support Adults with IDD & Their Caregivers
July 25th, 2023
Thought I would share this information from a recent Linkedin post I received.
“Centers for Medicare & Medicaid Services (CMS) offers this resource for state Medicaid and partner agencies seeking to address the needs of adults with intellectual and developmental disabilities (I/DD) and their aging caregivers with the aim of improving access to high-quality home and community-based services (HCBS) for people eligible for Medicaid. This resource synthesizes information on innovative state strategies and programs designed to strengthen supports for adults with I/DD and their aging caregivers.”
*Interagency Partnerships & Relationships
*Engagement and Navigation Supports
*Person- and Family-Centered Systems of Support
*Planning for the Future
*Data Resources
Click on link below:
https://lnkd.in/gVFNf6vg
HCS & CFC Certification Standards-New TAC- Adopted- Effective June 21st, 2023
June 19th, 2023
-The rules describe the following certification standards
Service Delivery
Rights of individuals
Requirements related to abuse, neglect, and exploitation
Staff Member and Service Provider requirements
Quality Assurance
-In Addition:
Requirements from The Residential Checklist
New Requirements for Emergency Preparedness, Fire Drills, and Evacuation Drills in all residential types in the HCS program.
The Rules will have increased oversight of HCS host home/companion care homes
There is a clarification of Restraint and Seclusion Requirements
Adds language for Restricting the Use of Enclosed Beds.
-In addition, there is the modification of The HHSC surveyor requirements that will allow for survey flexibility as the HCS waiver program evolves.
Recent Legislative Bills Passed during 88th Legislature
ICF/IID Updates
June 15th, 2023
Personal Needs Allowance Increase Bill passed during 88th legislature session
December 15th, 2022
ICF Resources
These resources can also be found on the ICF Provider Portal page.
September 25th, 2022
HHSC Publishes Updated Guidance on the Amelioration of Administrative Penalties for ALF, ICF/IID, and NF Providers
HHSC Long-term Care Regulation has published Provider Letter 2022-24 – Amelioration of Administrative Penalties (replaces PL 2013-18).
The letter provides guidelines to assisted living facilities,
intermediate care facilities for individuals with an intellectual
disability or related conditions, and nursing facilities about
the amelioration of administrative penalties assessed for state licensure
violations.
Read the provider letter details.
June 12th, 2022
ICF COVID-19 Vaccination Reporting Emergency Rules Expired June 6!!
Emergency rules for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions that require COVID-19 vaccination reporting expired June 6.
This means that effective June 7, ICFs no longer have to report COVID-19 vaccination data for staff and individuals to HHSC.
The following rules expired June 6:
- 26 TAC §551.48 – ICF/IID Provider COVID-19 Vaccination Data Reporting Requirement.
Here is a copy of the previous rule that expired:
551.48.ICF/IID Provider COVID-19 Vaccination Data Reporting Requirement.
(a) An intermediate care facility administrator and one additional designee must enroll in an emergency communication system in accordance with instructions from Texas Health and Human Services Commission (HHSC).
(b) An intermediate care facility must respond to requests for information received through the emergency communication system in the format established by HHSC.
(c) Within 24 hours of becoming aware of a staff or resident’s COVID-19 vaccination, an intermediate care facility must accurately report COVID-19 vaccination data for staff and individuals in the format established by HHSC.
(d) Subsection (c) of this section does not apply to state supported living centers.
The agency certifies that legal counsel has reviewed the emergency adoption and found it to be within the state agency’s legal authority to adopt.
Filed with the Office of the Secretary of State on August 10, 2021.
Email questions to LTCR Policy.
April 29th, 2022
ICF Visitation Rules Update
An alert went out to remind providers that all visitation must be allowed. Essential caregiver and end-of-life visits must be allowed for all individuals with any COVID-19 status. A facility may be cited if visitation is not allowed.
Review ICF/IID visitation rules from April 4th, 2022, for additional information.
April 10th, 2022
COVID-19 ICF Mitigation, Response Rule Revised Effective April 6
HHSC Long-term Care Regulation has published a revised Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions COVID-19 Mitigation and Response Emergency Rule. It is effective April 6, 2022.
The revised rule:
- Removes the requirements to have plans for obtaining and maintaining a two-week supply of full PPE.
- Clarifies that a facility does not have to provide the name of the person who tested positive for COVID-19 when reporting to CII.
April 10th, 2022
HHSC Publishes Description of Key Changes to 26 TAC 551, ICF/IID (PL 2022-07)
HHSC has published Provider Letter 2022-07, Description of Key Changes to 26 TAC 551, Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions, for ICF/IID providers. This letter describes the key changes to Title 26 of the Texas Administrative Code, Chapter 551, that were effective on Feb. 24.
Throughout the rule, HHSC updated citations, agency names, and terminology; corrected minor grammatical and punctuation errors; and revised sentence structures to make the chapter easier to read. In addition, the following items are addressed in this letter:
– New Requirements for Infection Prevention and Control Policies and Procedures
-HHSC included a state rule that refers to each Centers for Medicare & Medicaid Services (CMS) Condition of Participation (CoP). Additions to 26 TAC 551 include • Governing Body • Client Protections • Facility Staffing • Active Treatment • Client Behavior and Facility Practices • Health Care Services • Physical Environment • Emergency Preparedness • Dietetic Services.
– transition from paper applications to the use of the online licensure portal, called the Texas Unified Licensure Information Portal (TULIP) (Disclose information when applying for “relocation” and application information must be submitted through portal in “TULIP” system)
-Now require evaluation of the emergency preparedness and response plan at least every two years, instead of annually.
-ANE & Incident definitions
-Administrative penalties for each visit are limited to the cap amount, regardless of the number or duration of violations as of Sept. 1st, 2021
****If you have any questions about this letter, please contact the Policy and Rules Section by email at LTCRPolicy@hhs.texas.gov or call (512) 438-3161
April 6th, 2022
COVID Screening in ICF’s
ICF COVID-19 Mitigation and Provider Response emergency rules require an intermediate care facility must screen individuals according to HHSC guidance
.ICFs must screen individuals:
•upon admission or readmission to the facility; and
•at least once a day.
ICFs must screen each employee or contractor for the following criteria (listed below) before entering the facility at the start of their shift.
•Staff screenings must be documented in a log kept at the facility entrance and must include the name of each person screened, the date and time of the evaluation, and the results of the evaluation.
**Staff who meet any of the criteria must not be permitted to enter the facility.
As per ICF/IID Expansion of Reopening Visitation Emergency rules, ICFs are required to screen all visitors for signs or symptoms of COVID-19.
*Visitor screenings must be documented in a log kept at the entrance to the facility, which must include the name of each person screened, the date and time of the screening, and the results of the screening. The visitor screening log may contain protected health information and must be protected in accordance with applicable state and federal law .
*A visitor may not participate in a visit if the visitor has signs and symptoms of COVID-19 or active COVID-19 infection.
Screening Criteria:
•fever, defined as a temperature of 100.4 Fahrenheit and above, or
signs or symptoms of a respiratory infection, such as cough, shortness of breath, or sore throat;
•other signs or symptoms of COVID-19, including
-chills,
-new or worsening cough,
-shortness of breath or difficulty breathing,
-fatigue,
-muscle or body aches,
-headache,
-new loss of taste or smell,
-sore throat,
-congestion or runny nose,
-nausea or vomiting,
-or diarrhea;
•any other signs and symptoms as outlined by the CDC in Symptoms or Coronavirus at cdc.gov;
•contact in the last 14 days with someone who has a confirmed diagnosis of COVID-19, is under investigation for COVID-19, or is ill with a respiratory illness, regardless of whether the person is fully vaccinated, unless the person is entering the facility to provide critical assistance; or
•testing positive for COVID-19 in the last 10 days.
April 6th, 2022
Reporting Confirmed Case of COVID-19 in ICF/IID
A facility must notify the Texas Health and Human Services Commission (HHSC) Complaint and Incident Intake of COVID-19 activity as described below.
(1) A facility must notify HHSC of the first confirmed case of COVID-19 in staff or individuals, and the first confirmed case of COVID-19 after a facility has been without cases for 14 days or more, at HHSC Complaint and Incident Intake (CII) through TULIP, or by calling 1-800-458-9858, within 24 hours of the positive confirmation.
(2) A facility must submit a Form 3613-A Provider Investigation Report, minus the name of the person who tested positive for COVID-19, to HHSC Complaint and Incident Intake, through TULIP, by email at ciiprovider@hhs.texas.gov, or by fax at 877-438-5827, within five working days from the day a confirmed case is reported to CII.
April 6th, 2022
COVID-19 Mitigation and Response Emergency Rule Updated
HHSC Long-term Care Regulation has published a revised Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions COVID-19 Mitigation and Response Emergency Rule.
It became effective April 6, 2022.
The revised rule:
•Points to guidance from the Texas Department of State Health Services and HHSC rather than the CDC.
•Removes the requirements to have plans for obtaining and maintaining a two-week supply of full PPE.
•Removes the requirement to have spaces to don and doff PPE
•Clarifies that a facility does not have to provide the name of the person who tested positive for COVID-19 when reporting to CII.
February 27th, 2022
HHSC Adopts Revised ICF/IID Rules – Effective Feb. 24th, 2022
HHSC Long-term Care Regulation has adopted updates to the Intermediate Care Facilities for Individuals with an Intellectual Disability (ICF/IID) or Related Conditions program rules. The revised rules are in the Texas Administrative Code Title 26, Chapter 551. They are effective Feb. 24, 2022.
Key changes to the rule are to:
- Implement House Bill 1848 from the 86th Legislature, Regular Session, 2019 which requires new infection control policies and procedures in long-term living facilities.
- Implement House Bill 3720 from the 87th Legislature, Regular Session, 2021 which limits the total amount of an administrative penalty assessed against an ICF/IID.
- Reintegrate the conditions of participation from the Code of Federal Regulations.
- Corrects legacy agency terms, update rule citations, and edit for clarity and consistency.
COVID-19 ICF/IID Webinar Recording from Feb. 14 Available
A recording of the Feb. 14 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions COVID-19 Q&A with HHSC Long-term Care Regulation and DSHS is available for those who could not attend.
There have been changes made to the PowerPoint based on the information provided by DSHS during the webinar.
Listen to the webinar recording.
Email LTCR Policy for the transcript.
February. 20th, 2022
Mar. 07 ICF COVID-19 Webinar with HHSC LTCR
Long-term Care Regulation and the Department of State Health Services will provide the latest information on the COVID-19 pandemic and take live questions from participants in this intermediate care facilities provider webinar.
Provider attendance is critical to staying current with COVID-19 requirements and guidance. ICF/IID providers are strongly encouraged to attend all COVID-19 webinars with LTCR and DSHS.
Those using Internet Explorer may have difficulties registering for the webinar. If so, try using another browser, such as Google Chrome or Microsoft Edge.
March 7, 2022
11 a.m.–12 p.m.
Register for the COVID-19 Webinar.
February 13th, 2022
HHSC is not currently assessing compliance with CMS’s Omnibus COVID-19 Health Care Staff Vaccination rules, published in the Federal Register on November 5, 2021.
ICF COVID-19 Vaccination Data Reporting and Emergency Communication System – Feb 7
HHSC Long-term Care Regulation has published a revised ICF/IID Provider COVID-19 Vaccination Data Reporting Rule (PDF). It became effective February 7, 2022 and includes Emergency Communication System Enrollment for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions providers.
The rule requires ICF/IIDs to:
- Report COVID-19 vaccine data within 24 hours
- Enroll in an emergency communication system
January 7th, 2022
ICF COVID-19 Response Plan and FAQ Updated – Jan. 7
Document Version Date Change Comments
Version 3.5 1/5/2022 Changes to pages 6, 31, 38, 39, 40, 51, 72 71, and Changes made to reflect the most updated CDC guidance.
Version 3.4 12/07/2021 Changes to pages 15, 16, 25, 26, 31, 35 Edited to include revised ICF COVID-19 Provider Response Mitigation Rules for ICFs/IID
For changes made previous to 12/07/2021, please read the Table of Changes starting with page 7 of 19 of the Response Plan.
Update your Infection Control Policies and other related policies accordingly.
HHSC has revised the ICF COVID-19 Response Plan and Frequently Asked Questions document in response to the most recent CDC guidance.
November 21st, 2021
HHSC Publishes PL 2021-38 Medicaid Bed Reallocation
HHSC published Provider Letter 2021-38 Medicaid Bed Reallocation which explains the process to request reallocated ICF/IID Medicaid beds from HHSC. This letter replaces Provider Letter 2019-21.
November 4th, 2021
Updated ICF/IID COVID-19 FAQ and COVID-19 Response Plan Revised
HHSC has revised the Frequently Asked Questions for ICF/IIDs about COVID-19 (PDF) and the ICF/IID COVID-19 Response Plan (PDF) in response to the revised COVID-19 Expansion of Reopening Visitation for ICF Providers rules.
October 24th, 2021
New PL 2021-21 COVID-19 – Expansion of Reopening Visitation for ICF Providers
Super important!!!!
HHSC has published Provider Letter 2021-21, COVID-19 Response – Expansion of Reopening Visitation (PDF) for ICF/IID providers. This letter replaces Provider Letter 2021-10. This letter describes the criteria for expanded visitation as well as address changes in response to Executive Order No. GA-38(link is external) and updated CDC guidance.
Updated COVID-19 Expansion of Reopening Visitation Emergency Rules for ICF Providers
HHSC Long-term Care Regulation has published revised COVID-19 Expansion of Reopening Visitation Emergency Rules for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID) or Related Conditions (PDF). The rules address changes in response to Executive Order No. GA-38 (PDF)(link is external) and updated CDC guidance.The rules became effective on October 20, 2021.
September 15th, 2021
HHSC Publishes Amended Statutory Cap Regarding Administrative Penalties for ICFs: (PL 21-34)
HHSC published Provider Letter 21-34 Amended Statutory Cap Regarding Administrative Penalties for Intermediate Care Facilities. PL 21-34 notifies providers of changes to how HHSC determines and imposes administrative penalties based on changes made by House Bill 3720 (87th Legislature, Regular Session, 2021).
September 5th, 2021
Guidance for Providers Regarding Entry into LTC Facilities (PL 2021-33)
HHSC Long-term Care Regulation has published Provider Letter 2021-33, Authority to Enter Long-term Care Facilities (PDF), for ALF, HCS, ICF/IID and NF providers. This letter reminds providers that they must allow persons providing critical assistance and providers of essential services to enter the facility if they pass the facility’s COVID-19 screening.
September 5th, 2021
ICF/IID Leave During COVID-19 Rule Reinstated
HHSC has published IL 2021-42 ICF/IID Services During COVID-19 (PDF), which replaces IL 2020-43.
A resident must be discharged from the Intermediate Care Facility for Individuals with an Intellectual Disability or Related Conditions, with or without a contract to hold the resident’s placement in accordance with 26 TAC Section 261.227(j), if the resident is absent from the ICF/IID for one full day or more and the absence is not during leave described in 26 TAC Section 261.226.
August 1st, 2021
HHSC Publishes Updated COVID-19 Response Plan and Frequently Asked Questions for ICF Providers
HHSC Long-term Care Regulation updated the ICF COVID-19 Response Plan and FAQ document on July 29, 2021.
Read the updated ICF COVID-19 Response Plan (PDF).
Read the updated ICF FAQs (PDF).
March 24th, 2021
HHSC Adopts New Expansion of Reopening Visitation Emergency Rules for ICF Providers!!!
HHSC has adopted new Expansion of Reopening Visitation (PDF) emergency rules that establish criteria for expanded indoor and outdoor visitation as well as essential caregiver visits. These rules are effective March 24, 2021.
HHSC Publishes COVID-19 Response – Expansion of Reopening Visitation for ICF Providers (PL 2021-10)
HHSC has published Provider Letter 2021-10, COVID-19 Response – Expansion of Reopening Visitation (PDF) for ICF/IID providers. This letter replaces Provider Letter 2020-43. This letter describes the criteria for expanded indoor and outdoor visitation as well as essential caregiver visits.
March 22nd, 2021
ICF COVID-19 March 22 Webinar Recording Available
A recording of the March 22, 2021, ICF/IID COVID-19 Q&A with HHSC LTC Regulation and DSHS is available for those who could not attend.
Listen to the COVID-19 Q&A recording.
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.
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.
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.
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)
Answer: Regulations regarding ICF/IID discharge have not been waived. A discharge, even on a temporary emergency basis, requires that key developmental, behavioral, social, health and nutritional information be shared with the accepting facility in the community or non-facility provider. CMS is aware that staffing shortages and/or client surges due to the PHE create a high demand on available staff time that makes it difficult to complete a full discharge summary for each client. Each ICF will need to evaluate what amount and detail of documentation is necessary to ensure that critical health information is shared with the accepting facility or other provider. When available and if appropriate, the Interdisciplinary Team (IDT) should maximize the use of telehealth for the completion of a client’s discharge plan during the PHE.
Answer: Yes. CMS has temporarily waived certain regulatory requirements providing flexibilities to assist RHCs and FQHCs in furnishing services during the COVID-19 PHE. This includes temporarily modifying the following:(a)50% mid-level staffing requirement for RHCs;(b)Physician supervision requirement for nurse practitioners (NPs), to the extent permitted by State law; and(c)Location requirements for existing RHCs and FQHC to allow additions of temporary service locations.Please see https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf for additional waiver information. Additional flexibilities, including guidance for RHCs and FQHCs furnishing telehealth services during the PHE, are also described in this CMS MLN Article: https://www.cms.gov/files/document/se20016.pdf
Answer: Yes. During the COVID-19 PHE, CMS is allowing currently approved RHCs/FQHCs to provide patient care services in temporary expansion sites to help address the urgent need for supplementary care. These temporary sites are not restricted to the rural/shortage area location requirements. Each location is obligated to follow RHC/FQHC regulations to the extent not waived. Therefore, the RHC/FQHC may provide services provided at a temporary location under the CMS Certification Number (CCN) for the permanent location. The RHC/FQHC is expected to be operating in a manner not inconsistent with its state’s emergency preparedness plan. Note: FQHCs must also have an updated Health Resource and Service Administration (HRSA) Notice of Award, expanding the scope of service to include the temporary location(s) to support response to the COVID-19 PHE.
My RHC participates in Medicare through one of the two CMS-approved RHC Accreditation Organizations (AOs). Do waivers of CMS regulations apply to CMS-approved accrediting programs? Do I need to notify the AO of my desire to temporarily add a service location during the COVID-19 PHE?
Answer: To assist RHCs and FQHCs in furnishing service during the COVID-19 PHE, CMS has provided additional flexibilities related to billing for services. These temporary flexibilities currently include Expansion of Virtual Communication Services for RHCs and FQHCs to include online digital evaluation and management services using patient portals, and Revision of Home Health Agency Shortage Area Requirement for Visiting Nursing Services Furnished by RHCs and FQHCs. Please see the Medicare FFS Billing FAQ document available at https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf. Please see Section II.L of the Interim Final Rule with Comment Period, “Medicare and Expanded Flexibilities for Rural Health Clinics (RHCs) Medicaid Programs; Policy and Federally Qualified Health Centers (FQHCs) During Regulatory Revisions in Response to the COVID-–19 Public Health Emergency (PHE)”(85 FR 19230, 19253), available at https://www.federalregister.gov/documents/2020/04/06/2020-06990/medicare-and-medicaid-programs-policy-and-regulatory-revisions-in-response-to-the-covid-19-public, for more information on regulatory changes for RHCs and FQHCs.
Webinar info: How to prevent infectious diseases and the spread of infectious diseases in ICF-Specifically COVID-19 (May 27th, 2020)
See the following pdf link from HHSC
https://hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/providers/long-term-care/icfiid-covid-updates-qa-webinar-may-27-2020.pdf
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.
PolicyRulesTraining@hhsc.state.tx.us or call (512) 438-3161.
Provider Joint Training Opportunities
Check out Joint Provider Trainings link from HHSC, for more info:
https://apps.hhs.texas.gov/providers/training/jointtraining.cfm#course_112
Survey Process for ICF Has Changed: Please Be Aware
You may check your SOMA (Surveyor’s Operational Manual for ICF in Appendix J) for these changes.
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_j_intermcare.pdf
http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2018Downloads/R178SOMA.pdf
Appendix Q of SOMA (Immediate Jeopardy) Changes
CMS clarifications letter
SOMA appendix Q Section Immediate Jeopardy
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_q_immedjeopardy.pdf
|
LON & Facility Size |
Current Rates |
Proposed Rates |
|
SMALL |
|
|
|
LON 1 |
$144.25 |
$150.31 |
|
LON 5 |
$160.74 |
$167.90 |
|
LON 8 |
$182.82 |
$191.85 |
|
LON 6 |
$223.88 |
$236.59 |
|
LON 9 |
$406.11 |
N/C |
|
MEDIUM |
|
|
|
LON 1 |
$118.04 |
$123.14 |
|
LON 5 |
$134.06 |
$140.24 |
|
LON 8 |
$158.90 |
$166.92 |
|
LON 6 |
$190.24 |
$200.79 |
|
LON 9 |
$385.84 |
N/C |
|
LARGE |
|
|
|
LON 1 |
$112.09 |
$116.30 |
|
LON 5 |
$119.64 |
$124.64 |
|
LON 8 |
$133.22 |
$139.44 |
|
LON 6 |
$179.40 |
$188.96 |
|
LON 9 |
$387.25 |
N/C |
NewTMHP Portal Enhancement Training Information HCS/TxHmL
June 15th, 2023
New Portal Enhancement Training Information:
From the TMHP website:
“Registration is now available for two training webinars to discuss the Long-Term Care (LTC) Online Portal enhancements for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs. The webinars are offered by the Texas Medicaid & Healthcare Partnership (TMHP).
A TMHP training services representative will conduct the webinars, which will include question-and-answer sessions. During the live webinars, attendees can access training materials and submit questions.
Note: Attendees should already be familiar with the LTC Online Portal. Those who are not familiar with the portal should complete parts 1 and 2 of the LTC Online Portal Training for HCS & TxHmL Waiver Programs Webinar in the TMHP Learning Management System (LMS) before participating in the enhancements webinar. A TMHP LMS account is required to access and view these recordings. Note that webinars are no longer accessible through Internet Explorer. The preferred browsers are Google Chrome or Microsoft Edge.”
For HCS and TxHmL Providers Webinar
Select one of the following dates to register:
Tuesday, June 20, 2023, 10 a.m.–11:30 a.m.
Tuesday, July 11, 2023, 10 a.m.–11:30 a.m. (repeat)
Note: The webinars will not provide billing training.
For information about TMHP billing, refer to the “Claims Resources” section of the 1915(c) Waiver Programs Reference Material web page.
For more information, email TMHPWebinarSupport@tmhp.com, or contact the TMHP LTC Help Desk at 800-626-4117 (select option 1 and then option 7).
HCS Certification Rule-Transfer from Ch.9 to Ch.565 -June 21st, 2023
June 14th, 2023
New!
Assistance With Eligibility Issues Due To The End of Continuous Medicaid Coverage
June 15th, 2023
HHSC stated that If people are not able to obtain assistance from the community partners or 211, they can contact the Office of the Ombudsman 877-787-8999 or complete our online form . More information on the initiative can be found at: https://www.hhs.texas.gov/providers/medicaid-business-resources/end-continuous-medicaid-coverage-ambassador-toolkit
HCS Certification Principals Training Webinars & Recordings
June 14th, 2023
In case you have not seen the answers to some of the unanswered questions at the time of the Certification Principles series recorded in 2021, please note you can find those at the Q&A doc below.
HCS/TxHmL Certification Principles Webinar Series Participant Q&A
FYI Current as of 9/22/21*
August 12th, 2021
HCS/TxHmL Certification Principle Interpretive Guidance Series
Starting August 12, 2021, the HCS/ TxHmL Joint Training Program began presenting a series of nine webinars designed to provide interpretive guidance on the HCS and TxHmL Principles of Certification, as outlined in the Texas Administrative Code.
You may click on the links to previously recorded trainings below to watch any of the nine sessions on Certification Principles from the Texas Administrative Codes.
Certification Principle Trainings
These modules are designed to provide interpretive guidance on the certification principles found in TAC Title 40, Part 1, chapter 9.
E-mail LTCR Joint Training for a transcript of any of the recordings below.
HCS & TxHmL Webinars & FAQ’s (Recordings)
For Previously Recorded Webinars & FAQ’s
June 14th, 2023
July 19 IDD and PI Webinar with HHSC LTCR
HHSC Long-term Care Regulation will host a webinar for HCS, TxHmL, PI and ICF/IID providers regarding the latest information from LTCR.
Those using Internet Explorer may have difficulties registering for the webinar. If so, try using another browser, such as Google Chrome or Microsoft Edge.
July 19, 2023
10–11:30 a.m.
Register for the IDD/PI webinar.
February 5th, 2023
IDD and PI Quarterly Webinar with HHSC LTCR Recording Available
The January 26 recording of the Intellectual and Developmental Disability (IDD) Programs and Provider Investigations (PI) Quarterly Webinar with Long-term Care Regulation (LTCR) is available.
Listen to the webinar recording.
Read the IDD and PI Webinar (PDF).
Any questions or requests for transcripts may be emailed to LTCR Policy.
November 1st, 2022
HCS & TxHmL Updates Provider Webinar from Oct. 13
For: HCS/TxHmL program providers, LIDDA’s, and other interested parties
This webinar will provide information on the following:
- Substantial changes are being made to the HCS and TxHmL Program rules.
- IL 2022-49, assessments of HCS three-person residences, four-person residences and host home/companion care settings for compliance with the federal HCS settings rules.
HCS and TxHmL Program Updates Provider Webinar
Oct. 13
1–3 p.m.
September 25th, 2022
TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar
Medicaid and CHIP Services (MCS) will begin hosting monthly meetings for Providers and Financial Management Services Agencies (FMSAs) who use the Long-Term Care (LTC) Online Portal for the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver programs.
Texas Medicaid & Healthcare Partnership (TMHP) and Health and Human Services Commission (HHSC) staff from the following departments will be available to provide information and answer questions:
- Program Eligibility and Support (PES).
- Utilization Review (UR).
- Provider Claims Services (PCS).
- Contract Administration & Provider Monitoring (CAPM).
- Local Procedure Development and Support (LPDS).
Save the Dates
The webinars will be held on the following dates. We encourage Providers and FMSAs to invite staff who use the LTC Online Portal for HCS and TxHmL programs.
- October 2022: Wednesday, Oct. 5, 1–2 p.m. Register for the webinar.
- November 2022: Wednesday, Nov. 9, 10–11 a.m. Register for the webinar.
- December 2022: Thursday, Dec. 8, 1–2 p.m. Register for the webinar.
Standing Meeting Agenda
- Trending issues – discuss trending issues and solutions to increase successful processing of forms.
- Updates on LTC Online Portal for HCS and TxHmL – provide relevant updates.
- Questions and Answers – HCS and TxHmL Providers and FMSAs will have the opportunity to ask questions* regarding LTC Online Portal for HCS and TxHmL.
*To comply with HIPAA requirements, questions that include any identifying information for a specific individual will not be allowed during the monthly meetings.
Email Questions to TxHmL Policy.
September 25th, 2022
HCS and TxHmL Updates Provider Webinar
HHSC will host the HCS and TxHmL Services Program Updates Provider Webinar on Oct. 13 for HCS and TxHmL program providers, local intellectual and developmental disability authorities, and other interested parties.
This webinar — offered on Thursday, Oct. 13, from 1–3 p.m. — will provide information on the substantive changes made to the HCS and TxHmL Program rules. Both webinars will provide the same information, so program providers and LIDDAs can register for the time that works best for them.
Email questions about the webinar to your program policy inbox:
September 12th, 2022
Updated HCS and TxHmL Waiver Programs FAQ Document Now Available- Sept. 2022
The Home and Community-based Services and Texas Home Living Waiver Programs Frequently Asked Questions document has been updated.
July 15th, 2022
HCS and TxHmL Webinar Recorded From July 14th, 2022
Webinar topic includes:
- Forms Submission and Processing in TMHP LTCOP
HCS and TxHmL Webinar
July 14, 2022
2:30 – 4 p.m.
Click link below to register to watch recording of this session.
Register for the webinar
Email questions about the webinar to your program policy mailbox:
July 13th, 2022
IDD and PI Quarterly Webinars
May 5th, 2022
HCS and TxHmL FAQ Updates Available May 9 and May 23
The Home and Community-based Services and Texas Home Living Waiver Programs Frequently Asked Questions document has been updated.
HCS-TxHmL-FAQ-TMHP-TexasMedConnect
Updated HCS and TxHmL COVID-19 FAQ
May 6th, 2022
Read the revised Updated COVID-19 FAQs for HCS and TxHmL Providers (PDF).
September 1st, 2022
HHSC has revised the Updated HCS and TxHmL COVID-19 FAQ (PDF)
August 15th, 2021
HCS and TxHmL Webinar Recording Available
” WSC Transition into HHSC LTCR”
(From August 10th, 2021)
Long-term Care Regulation hosted a webinar for HCS and TxHmL program providers to discuss upcoming HHSC organizational changes, introduce LTCR survey operations leadership, and answer questions about the Waiver Survey and Certification unit’s transition into LTCR survey operations.
A recording of August 10, 2021, HCS and TxHmL Transformation Webinar with HHSC Long-Term Care Regulation is available for those who could not attend.
Read the HCS and TxHmL Transformation Webinar (PDF).
Listen to the webinar recording here.
.
May 23rd, 2021
June Infection Control Basics for HCS and TxHmL Providers Webinars
This webinar will review basic infection control concepts such as hand hygiene, standard and transmission-based precautions, and steps to prevent the spread of infectious disease.
Registration for each class is limited to 50 participants.
June 3
10 – 11:30 a.m.
Register for the June 3 webinar.
June 10
10 – 11:30 am
Register for the June 10 webinar.
June 17
10 – 11:30 a.m.
Register for the June 17 webinar.
June 24
10 – 11:30 a.m.
Register for the June 24 webinar.
.March 16th, 2021 Updated
Updated COVID-19 Frequently Asked Questions for HCS and TxHmL Providers
HHSC has published an updated Frequently Asked Questions about COVID-19 for Home and Community-based Services and Texas Home Living providers.
Read the Updated COVID-19 FAQs for HCS and TxHmL Providers (PDF).
March 19 Recording of Clarification of Administrative Penalties and Related Processes Webinar Available
A recording of the March 19, 2021 Clarification of Administrative Penalties and Related Processes for HCS and TxHmL Providers webinar is available for those unable to attend.
Listen to the webinar recording here.
March 4 Recording of Writing Acceptable Plans of Correction Webinar Available
A recording of the March 4, 2021 Writing Acceptable Plans of Correction webinar for HCS and TxHmL program providers is available for those unable to attend.
Listen to the webinar recording here.
Feb 25. HCS & TxHmL Provider Responsibilities: Death Notifications & Investigation Reports Webinar
This webinar will provide information about program provider responsibilities for reporting abuse, neglect and exploitation and providing notifications of death.
Feb. 25
1-3 p.m.
Register for the webinar.
Jan. 5 Recording Webinar Available – HCS and TxHmL Changes to Survey Process and Hold Harmless Period Overview
A recording of the Jan. 5, 2021, HCS and TxHmL Changes to Survey Process and Hold Harmless Period Overview webinar is available for those unable to attend.
Listen to the webinar recording here.
Jan. 7 Recording of HCS and TxHmL Administrative Penalties and Amelioration Available
A recording of the Jan. 7, 2021 HCS and TxHmL Administrative Penalties and Amelioration webinar is available for those unable to attend.
Listen to the webinar recording here.
DSHS Video on Long-term Care Facilities COVID-19 Infection Prevention and Control Now Available
The Department of State Health Services has published a recorded training for long-term care providers on COVID-19 precautions to take and how to accomplish them.
Registration is Open: 2023 Quality in Long-Term Care Conference-August 22nd and 23rd (Austin, Tx)
June 10th, 2023
HHS, in collaboration with The University of Texas Steve Hicks School of Social Work, will host an informative two-day, free conference on quality in long-term care.
Aug. 22-23
This year’s theme is, “Making a Commitment to Person-Centered Long-Term Care.”
The conference offers presentations from nationally and internationally recognized experts.
Topics include:
- Caring for people with dementia.
- Infection prevention and control.
- Long COVID considerations in long-term care
- Current health care trends.
Cutting-edge advances in long-term care, aging and disability services.
The conference is free to attend, and continuing education credit will be available for various healthcare disciplines.
Renaissance Austin Hotel
9721 Arboretum Blvd.
Austin, TX 78759
For more information about this event, visit the registration webpage or email UT Steve Hicks School of Social Work
mySchedules Training Webinars & Other Resources From MITC
May 13th, 2023
“The labor shortage has made it more important than ever to manage available resources effectively. Allowing existing employees to view and request open shifts can be a big help to over-stressed managers.”
Our friends at MITC have asked us to share some information on one of their very important resources, scheduling software for your shift staff in group homes and employees in general. Please check all their info below and feel free to go to their website for more info on their other products for IDD providers and service providers. https://mitcagencies.com/
myScheduling is just one of the tools from MITC that might be helpful to both IDD providers (i.e. HCS, TxHmL and ICF) as well as Day Hab/ ISS (Individualized Skills and Socialization) and Supported Employment Providers
Check out some of their previously recorded videos at the links below.
Make Scheduling Easier! Let Employees Request Extra Work 01/12/23
Scheduling for Group Homes and In-Home Programs 03/02/23
How a Provider with 2,000 Employees Deployed mySchedules 04/13/23
Download These Fact Sheets:
Integrating mySchedules with Kronos and Other Time and Attendance Systems
Integrating Maps and Mileage into Scheduling
Encouraging Employees to Request Extra Hours
UPCOMING EVENTS & WEBINARS
Managing Group Homes? Calculate Your Payroll Savings Opportunities
With payroll costs rising, agencies need better control over time and attendance. These seven features all help to minimize unauthorized attendance. The latest time and attendance software provides agencies methods to not only collect payroll but also control payroll.
Use this spreadsheet to estimate your potential savings.
Not all these new features will work for every agency, but customers using some of these features are telling us it is saving them thousands of dollars a year. Don’t miss out!
- Stop employees clocking-in early using schedules
- Stop employees clocking-in early using job restrictions
- Stop employees clocking-in on block-out dates
- Stop employees clocking-in in overtime without permission
- Stop employees clocking-in if client is over authorization
- Worried about buddy punching and fake employees? Use two-factor authentication
- Track whether managers and employees are colluding to inflate payroll
Email agencysuccessteam@
“MITC’s Staff and Client Solutions are designed specifically for providers serving the I/DD and behavioral health communities.
MITC’s solutions are perfect for agencies that manage group homes, HCBS, or day, vocational, and supported employment programs! Because we’ve worked with thousands of agencies like yours, MITC delivers the most cost-effective solutions that lead to lower payroll costs, higher performance, and compliance with state and DOL regulations.”
Reminder: Implementation Plan Form 2125 (HCS/TxHmL)
June 5th, 2023
Form 2125 from HHSC used int the HCS and TxHmL programs as the Implementation Plan form, was updated in Oct. 2022. The form currently has a box to check this document if consent was obtained from the individual or LAR concerning receiving services via Synchronous Audio Visual Technology .
Per standards of care, any professional therapy service or nursing service delivered using synchronous audio-visual technology must be clinically appropriate, safe, and agreed to by the individual receiving services or by the LAR. Synchronous audio-visual technology requires consent from the individual or LAR. Verbal consent is permissible and should be documented in the individual’s record. Providers must ensure that the appropriate consent box on the IP is checked.
Important Reminder: Consent For Synchronous Audio-Visual Technology
June 5th, 2023
Just A Reminder About Consent For Synchronous Audio-Visual Technology
Revision 22-3; Effective Oct. 19, 2022
As appropriate for the individual and as permitted by service-specific requirements, the modalities for delivering services to an individual includes:
- In-person
- Synchronous audio-visual
- Audio only
In addition to meeting service requirements, providers must defer to the needs of the individual receiving services, ensuring the mode of service delivery is accessible, person-centered, and not driven by provider convenience.
Per standards of care, any professional therapy service or nursing service delivered using synchronous audio-visual technology must be clinically appropriate, safe, and agreed to by the individual receiving services or by the LAR. Synchronous audio-visual technology requires consent from the individual or LAR. Verbal consent is permissible and should be documented in the individual’s record.
****In addition: The Providers must ensure that the appropriate consent box on the IP is checked. (if you don’t use the IP form and you have another version, this information will have to be included as part of your IP.)
ISS (Individual Socialized Services) FAQ’s
June 5th, 2023
HHSC’s Response to Three Recent ISS-Related Questions From Providers
Question 1: May an Individualized Skills and Socialization (ISS) provider charge families for after-hour care? Many times families cannot get off work at the time the program closes/services stop. Some providers will keep their doors open until 5 or 6 (with staff present of course), until families get off work. In these cases, the ISS providers charge families for that service.
HHSC’s Response: If the individualized skills and socialization provider is also the program provider, the program provider would not be allowed to charge additional fees outside of the established HCS Waiver Program Payment rates, located here. According to 40 TAC §9.178(o):
(o) The program provider must not assess charges against the individual’s personal funds for costs for items or services reimbursed through the HCS Program or through CFC.
Additionally, according to 26 TAC §263.2015:
The service limit for the combined total of on-site, off-site, and in-home individualized skills and socialization is:
(1) 1560 hours during an IPC year;
(2) six hours per calendar day; and
(3) five days per calendar week.
If the individualized skills and socialization provider is a contractor of the program provider, the provider’s costs must be considered reasonable and necessary in regard to the Medicaid cost/accountability reports. Unless the program provider agrees to pay a higher amount, the individualized skills and socialization provider must provide the service at or below the direct services portion of the applicable HCS Program rate.
According to 40 TAC §9.177(b):
(b) The program provider must employ or contract with a person or entity of the individual’s or LAR’s choice in accordance with this subsection.
(1) Except as provided by paragraph (2) of this subsection, the program provider must employ or contract with a person or entity of the individual’s or LAR’s choice to provide an HCS Program service or CFC service to the individual if that person or entity:
(A) is qualified to provide the service;
(B) unless the program provider agrees to pay a higher amount, provides the service at or below:
(i) for any service except CFC ERS, the direct services portion of the applicable HCS Program rate; and
(ii) for CFC ERS, the reimbursement rate; and
(C) is willing to contract with or be employed by the program provider to provide the service in accordance with this subchapter.
As part of agreeing to provide the HCS Program service at the direct services portion of the applicable HCS Program rate, the individualized skills and socialization provider would not be allowed to charge an individual or family additional charges outside what is reimbursed through the HCS Program. (This means, the provider can pay all of the direct and indirect portions of the rate to the ISS provider if they want to or more, but they don’t have to pay more than the direct portion of the rate if they don’t want to. Many HCS/TxHmL providers choose to pay all of the rate amount, the direct and indirect side both, but most likely are not paying more than the total rate as this would not be feasible or affordable for many HCS providers.)
Question 2: According to the rules, a person may receive in-home ISS assuming certain criteria are met/justifications secured. Provision of the service does not require a license. If the person wants to also engage in off-site activities, such must be provided by a licensed ISS. In these cases,
~Can (as an example) the HH provider obtain a license for off-site only and provide the service as long as the HH provider was not the person delivering the service?
HHSC’s Response: In accordance with the HCS Billing Requirements, Section 43102.7 a host home/companion care provider is prohibited from being the service provider of in-home individualized skills and socialization. There is no prohibition on the host home/companion care provider being a service provider of on-site or off-site individualized skills and socialization but those services cannot be provided in the individual’s residence. The host home/companion care provider would need to either be employed by an individualized skills and socialization provider or obtain an individualized skills and socialization license.
~ Can the individual (again one who has a justification for in-home ISS) attend an ISS just to participate in off-site ISS only, or must that service be provided in an off-site only licensed ISS ?
HHSC’s Response: Yes, an individual who has a justification to receive in-home individualized skills and socialization may choose to also receive off-site individualized skills and socialization at a facility that provides both on-site and off-site individualized skills and socialization. It is not required that they receive off-site through an off-site only licensed individualized skills and socialization facility.
~ Can the program provider for an individual obtain an off-site only ISS license so the individual can participate in off-site ISS activities as long as the service provider of such is not the HH provider? And if so, could the person providing the in-home ISS work for or contract with the provider to provide off-site ISS to the individual?
HHSC’s Response: Yes, a program provider may become a licensed off-site only individualized skills and socialization provider so that an individual can participate in off-site individualized skills and socialization activities. The service provider providing in-home individualized skills and socialization would be allowed to become an employee or contractor of the program provider owned off-site only individualized skills and socialization provider, as long as they met all other service provider requirements outlined in program rule and in the HCS Program Billing Requirements.
Question 3: Concerning ISS notes, it’s been reported by some providers that some HHSC or TMHP reviewers have told them that the ISS notes cannot be handwritten rather must be electronic. Is that true? And if so, where is that stated?
HHSC’s Response: There is no requirement that service delivery logs for on-site, off-site, or in-home individualized skills and socialization must be electronic over handwritten. HCS Policy does not specify the modality of service delivery log notes, only that the written documentation must be legible. According to Section 3810 of the HCS Billing Requirements:
3810 General Requirements
Revision 23-2; Effective April 1, 2023
(a) Legible A program provider must have written, legible documentation to support a service claim.
January 13th, 2023
ISS FAQs: Updated January 13th, 2023
August 23rd, 2022
Frequently Asked Questions HHSC shared during the ISS draft rules webinar on August 23rd, 2022.
These are questions received during the ISS webinar on July 19th, 2022
Q1: Will current day hab providers be grandfathered into the new
program? Or do they have to be program provider to have a day hab
contract with HHSC?
A1: No, Day Hab Providers are not grandfathered into the Individualized Skills and
Socialization program. Any provider who is interested in delivering Individualized
Skills and Socialization services must obtain a Day Activity Health Services or DAHS
– Individualized Skills and Socialization service category license, even those who
are currently providing day habilitation services.
Q2: Are the off-site activities generated from the individual PDPs or does the
ISS facility plan the activities?
A2: Off-site activities are generated from the individual’s Individual Plan of Care
and Individual Program Plan in the DBMD waiver program. In TxHmL and HCS, an
Individualized Skills and Socialization provider must provide off-site Individualized
Skills and Socialization in accordance with an individual’s PDP, IPC, and
implementation plan.
Q3: If the in-home service provider does not need to be an ISS
provider, does that mean that they can be a parent?
A3: A person who meets the Service Provider Qualifications for In-Home
Individualized Skills and Socialization, including a parent of an adult child
can provide Individualized Skills and Socialization.
Q4: What is the enhanced staffing rate? How does that work?
A4: An enhanced staffing rate is available in the HCS and TxHmL Programs
for an individual who requires more service provider support than the
individual would receive with the individual’s assigned LON. The requirement
for additional support may be because of the individual’s mobility, medical,
or behavioral needs. The program provider may request the enhanced
staffing rate for an individual with an LON 1 or LON 5 in the HCS Program, or
any LON in the TxHmL Program.
Q5: If the PDP do not specify how often a client needs to go out, will that be up
to the discretion of the individualized skills organization to decide how often
they go out?
A5: It is the individual’s choice for how they choose to receive off-site Individualized
Skills and Socialization and off-site Individualized Skills and Socialization must align with
the individual’s PDP, IPC, IP, and in DBMD the individual’s IPP.
Q6: Do we need to provide meals and snacks? Have a paid nurse on site? Can it
be an LVN?
A6: An Individualized Skills and Socialization provider does not need to provide meals
and snacks to the individuals, but they must provide personal assistance for an
individual who cannot manage personal care needs including eating during an
Individualized Skills and Socialization activity. An Individualized Skills and Socialization
provider must also be able to provide assistance with medications and the performance
of tasks delegated by a registered nurse.
Q7: Is there going to be an open enrollment period for ISS with times of the year
that are closed, or is it an open enrollment?
A7• An individual in the HCS, TxHmL, and DBMD Program can add Individualized Skills
and Socialization to their IPC at any point during the plan year. It is the individual’s or
their LAR’s choice if they would like to receive individualized skills and socialization.
• Any provider who is interested in delivering Individualized Skills and Socialization
services must obtain a Day Activity Health Services or DAHS – Individualized Skills
and Socialization service category license. The provider may apply at any time once
the online licensure portal (TULIP) is operational. HHSC anticipates that the license
application process will be available late November or December.
Q8: Are staffing ratios minimum or maximum? Will providers be reimbursed if
they go over the ratio?
A8: The staffing ratios described in the rule indicate that they are “no higher than” i.e.,
they describe the maximum ratio of individuals to service providers of Individualized
Skills and Socialization. To receive reimbursement and avoid recoupment of funds,
Individualized Skills and Socialization services (on-site, off-site, or in-home) must be
provided in accordance with the HCS, TxHmL, or DBMD Program rules.
Q9: Will ISS providers be required to have RNs as part of staff now that
medication management is part of the program? Additionally, our day hab does
not currently enroll individuals that need help with toileting or feeding needs,
will the program require that we do enroll these LONs individuals?
A9: If an individual receiving Individualized Skills and Socialization needs assistance
with medication or other nursing tasks, the HCS program provider’s nurse must ensure
the Individualized Skills and Socialization service providers are delegated/trained to
deliver the service. Individualized Skills and Socialization providers like day habilitation
providers can refuse to accept a person for services.
Q10: Is there any guidance regarding scheduling? For example, is the service
only Monday-Friday, etc.
A10: There is not a requirement for how many hours per day an Individualized Skills
and Socialization provider needs to provide services. There is a service limit for the
combined total of on-site, off-site, and in-home Individualized Skills and Socialization for
HCS and TxHmL of 1560 hours during an IPC year, six hours per calendar day, and five
days per calendar week.
Q11: Does an HCS, TxHmL or DBMD provider have to apply to be licensed as ISS
provider?
A11: An active day habilitation site could choose not to participate in Individualized Skills and
Socialization and not apply for a license. They would no longer be able to provide day
habilitation to individuals in HCS, TxHmL, and DBMD after March 1, 2023, since day hab will
no longer be a service at that point. Any provider who wishes to deliver Individualized Skills
and Socialization services will be required to have a Day Activity and Health Services –
Individualized Skills and Socialization license. A provider must obtain a temporary license
prior to delivering Individualized Skills and Socialization services and may choose to do so at
any time once the licensing system is available. HHSC Long-term Care Regulatory will issue a
provider a final license after conducting an on-site visit that results in final approval of the
license.
Q12: In the examples of ratios given, there was not an example that included an ICF
client. What are the expectations when mixing ICF clients with waiver clients?
A12: If a person is not in the TxHmL, HCS, or DBMD Program and is receiving services by a
staff member who is also providing on-site Individualized Skills and Socialization to an
individual in the DBMD Program or off-site to an individual in the HCS, TxHmL, and DBMD
Program, the appropriate HCS, TxHmL, and DBMD staffing ratio must be applied, and that
individual must be included in the staffing ratio.
Q13: If someone’s PDP says they need XX hours in the community, but we do
not have the manpower, are we still able to work with the client?
A13: Waiver providers can engage the Individualized Skills and Socialization
providers in the development of the implementation plan by identifying free or low-
cost activities (affordable by the individual) the Individualized Skills and Socialization
providers can offer within their community and match well with the individual’s
interests. Off-site Individualized Skills and Socialization is provided in a community
setting chosen by the individual from among available community setting options.
Community settings are settings accessible to the general public within an
individual’s community.
Q14: Day hab allowed for 5-hour minimum days, so now under ISS is it going
to be required to be 6 direct services timer?
A14: The service limit for the combined total of on-site, off-site, and in-home
Individualized Skills and Socialization for HCS and TxHmL is:
(1) 1560 hours during an IPC year;
(2) six hours per calendar day; and
(3) five days per calendar week.
Individuals can receive less than six hours per calendar day.
Q15: If the individual/LAR choses not to utilize the ISS program, will
they still be able to receive funding from TxHmL/HCS?
A15: The individual or LAR can choose to receive in-home Individualized
Skills and Socialization if the individual meets the policy for in-home
delivery. Individuals living in three and four person residences would need
to participate in employment or day activity with natural supports if the
LAR or individual does not choose to receive individualized skills and
socialization and does not meet the policy guidance for in-home
individualized skills and socialization. Access to HCS and TxHmL waiver
services is not dependent upon receiving individualized skills and
socialization.
Q16: Can we have a combination of HCS waivers and private pay? Does private
pay also need to be in the community?
A16: Individualized Skills and Socialization providers will have a choice about how to
conduct business. They will be allowed to accept all payor sources, or they may choose
to accept only waiver (HCBS) or non-waiver. The HCBS settings regulations do not apply
to ICF/IID, private pay or general revenue and therefore, day habilitation can continue
to be provided without changing the service to individualized skills and socialization;
however, if a provider wants to serve individuals in the waiver programs, the provider
must do so as a licensed individualized skills and socialization provider after March 1,
2023. Individualized skills and socialization has both on-site and off-site services that
must be offered to individuals in the waivers.
Q17: Will ISS provided in the client’s home require EVV verification for HCS and
TxHmL funded clients? If the client lives in a group home or a Host
Home/Companion Care home, will the EVV verification be required?
A17: In-home Individualized Skills and Socialization provided in the individual’s own
home or family home will require the use of EVV verification, similar to in-home day
habilitation today. If the individual lives in a 3-person or 4-person residence, or a host
home/companion care residence, EVV verification will not be required.
Q18: Will we need a separate license for each day hab our individuals
attend including any families that provided in-home day hab due to
their LON and medical need?
A18: Each physical location that provides on and off-site Individualized Skills
and Socialization services will require its own license and application process.
In-home services will not require a license.
Q19: Can you give a few examples of offsite locations?
A19:Visits to the museums, libraries and parks are examples of off-site
Individualized Skills and Socialization activities if they are chosen by the
individual, integrate the individual into the community, and promote the
development of skills and behavior that support independence and personal
choice.
For further questions, contact:
HCSPolicy@hhs.texas.gov
TxHmLPolicy@hhs.texas.gov
LTCRPolicy@hhs.texas.gov
HHSC will conduct a public hearing on the proposed HCS, TxHmL and DBMD ISS program rules on September 7, 2022 from 8:00 am. until Noon. To register for the virtual hearing, go to: https://attendee.gotowebinar.com/register/927810115195515152