Twogether Updates

HCS & TxHmL Webinars & FAQ’s (Recordings)

For Previously Recorded Webinars & FAQ’s

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


September 25th, 2022

TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar

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

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

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

Save the Dates

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

Standing Meeting Agenda

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

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

Email Questions to TxHmL Policy.


September 25th, 2022

HCS and TxHmL Updates Provider Webinar

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

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

Email questions about the webinar to your program policy inbox:

HCS Policy

TxHmL Policy


September 12th, 2022

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

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

Read the full alert.


July 15th, 2022

HCS and TxHmL Webinar Recorded From July 14th, 2022

July 12, 2022

Webinar topic includes:

  • Forms Submission and Processing in TMHP LTCOP

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

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

Email questions about the webinar to your program policy mailbox:


 

July 13th, 2022

IDD and PI Quarterly Webinars

 


May 5th, 2022

HCS and TxHmL FAQ Updates Available May 9 and May 23

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

HCS-TxHmL-FAQ-TMHP-TexasMedConnect

Read the full alert here.


Updated HCS and TxHmL COVID-19 FAQ

May 6th, 2022 

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


September 1st, 2022

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


 

August 15th, 2021

 HCS and TxHmL Webinar Recording Available

” WSC Transition into HHSC LTCR”

(From August 10th, 2021)

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

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

Read the HCS and TxHmL Transformation Webinar (PDF).

Listen to the webinar recording here.

.


May 23rd, 2021

June Infection Control Basics for HCS and TxHmL Providers Webinars

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

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

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

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

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


 

.March 16th, 2021 Updated

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

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

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


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

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

Listen to the webinar recording here.


March 4 Recording of Writing Acceptable Plans of Correction Webinar Available

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

Listen to the webinar recording here.


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

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

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

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

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

Listen to the webinar recording here.


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

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

Listen to the webinar recording here.


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

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

View the video training

ICF/IID Updates

September 25th, 2022

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

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

The letter provides guidelines to assisted living facilities,

intermediate care facilities for individuals with an intellectual

disability or related conditions, and nursing facilities about

the amelioration of administrative penalties assessed for state licensure

violations.

Read the provider letter details.


June 12th, 2022

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

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

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

The following rules expired June 6:

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

Here is a copy of the previous rule that expired:

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

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

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

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

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

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

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

Email questions to LTCR Policy.


April 29th, 2022

ICF Visitation Rules Update

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

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


April 10th, 2022

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

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

The revised rule:

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

April 10th, 2022

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

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

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

– New Requirements for Infection Prevention and Control Policies and Procedures

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

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

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

-ANE & Incident definitions

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

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


April 6th, 2022

COVID Screening in ICF’s

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

.ICFs must screen individuals:

•upon admission or readmission to the facility; and

•at least once a day.

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

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

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

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

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

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

Screening Criteria:

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

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

•other signs or symptoms of COVID-19, including

-chills,

-new or worsening cough,

-shortness of breath or difficulty breathing,

-fatigue,

-muscle or body aches,

-headache,

-new loss of taste or smell,

-sore throat,

-congestion or runny nose,

-nausea or vomiting,

-or diarrhea;

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

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

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


April 6th, 2022

Reporting Confirmed Case of  COVID-19 in ICF/IID

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

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

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


April 6th, 2022

COVID-19 Mitigation and Response Emergency Rule Updated

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

It became effective April 6, 2022.

The revised rule:

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

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

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

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


February 27th, 2022

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

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

Key changes to the rule are to:

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

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

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

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

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

Listen to the webinar recording.

Email LTCR Policy for the transcript.


February. 20th, 2022

Mar. 07 ICF COVID-19 Webinar with HHSC LTCR

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

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

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

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


February 13th, 2022

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

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

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

The rule requires ICF/IIDs to:

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

January 7th, 2022

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

Document   Version    Date    Change    Comments

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

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

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

Update your Infection Control Policies and other related policies accordingly. 

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


November 21st, 2021

HHSC Publishes PL 2021-38 Medicaid Bed Reallocation

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


November 4th, 2021

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

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

October 24th, 2021

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

Super important!!!!

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

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

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

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September 15th, 2021

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

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

September 5th, 2021

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

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


September 5th, 2021

ICF/IID Leave During COVID-19 Rule Reinstated

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

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

August 1st, 2021

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

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

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

Read the updated ICF FAQs (PDF).


March 24th, 2021

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

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

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

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


March 22nd, 2021

ICF COVID-19 March 22 Webinar Recording Available

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

Listen to the COVID-19 Q&A recording.

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


March 11th, 2021

Recording of ICF COVID-19 March 8 Provider Webinar Available

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

Listen to the COVID-19 Q&A recording.

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


February 8th, 2021

Draft ICF/IID Rule Changes

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

February 7th, 2021

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

Reminder to Provide Letter to Families

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

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

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

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

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

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

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


January 19th, 2021

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

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

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

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

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

Read the updated ICF FAQs (PDF).

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

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

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

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

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

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

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

Listen to the COVID-19 Q&A recording.

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


January 10th, 2021

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

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

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


HHSC Publishes Revised Reporting Guidance for Long-Term Care Providers

(PL 20-37)

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


November 22nd, 2020

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

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

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

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

ICF Provider Webinar

November 30, 2020

11 a.m. – 12:30 p.m.

Register for the COVID-19 webinar.


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

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

View the COVID-19 Q&A recording.

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


10/16/20

Important Information!

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

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

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

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

  • signs and symptoms of COVID-19;
  • infection control precautions; and
  • other applicable facility practices (e.g., the use of facemasks or other appropriate PPE, specified entries and exits, routes to designated visitation areas, and hand hygiene).

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

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

or

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


LTCR Form 2195

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

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

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

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

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

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

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

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

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

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

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

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

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

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


10/05/20

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

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

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


10/03/20

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

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

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

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

Phase I Visitation Rules, no longer in effect!

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

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

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

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

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

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

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

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


 

FAQ’s (June 2020)

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

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

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

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

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

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

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

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

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

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


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

See the following pdf link from HHSC

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


March 13th ICF FAQ’s  See link below:

Survey Operations Resume as of June 15th, 2020

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

Providers Must Log Residents’ Leave

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

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

 

Contact Information
If you have any questions about this letter, please contact the Policy, Rules and Training Section by email at

PolicyRulesTraining@hhsc.state.tx.us or call (512) 438-3161.


Provider Joint Training Opportunities

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

 


Survey Process for ICF Has Changed: Please Be Aware

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

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

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


Appendix Q of SOMA (Immediate Jeopardy) Changes

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

CMS clarifications letter

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

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

 

SOMA appendix Q Section  Immediate Jeopardy 

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


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

LON & Facility Size

Current Rates

Proposed Rates

SMALL

 

 

LON 1

$144.25

$150.31

LON 5

$160.74

$167.90

LON 8

$182.82

$191.85

LON 6

$223.88

$236.59

LON 9

$406.11

N/C

MEDIUM

 

 

LON 1

$118.04

$123.14

LON 5

$134.06

$140.24

LON 8

$158.90

$166.92

LON 6

$190.24

$200.79

LON 9

$385.84

N/C

LARGE

 

 

LON 1

$112.09

$116.30

LON 5

$119.64

$124.64

LON 8

$133.22

$139.44

LON 6

$179.40

$188.96

LON 9

$387.25

N/C

 

 

EVV (Electronic Visit Verification) Updates

September 25th, 2022

EVV Updates for HCS and TxHmL Program Providers and FMSAs

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

HHSC Notice

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

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

TMHP Notice

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

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

Email EVV Operations for questions.


September 25th, 2022

EVV Claims Matching Refresher for HCS and TxHmL

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

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

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

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

Click here for more information


September 18th, 2022

EVV Compliance Job Aids Updated

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

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

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

August 31st, 2022

Annual EVV Policy Webinars for Program Providers & FMSAs

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

July 28th, 2022

EVV Portal and Training Updates

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

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

Email questions to TMHP.


July 5th, 2022

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

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

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

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

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

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

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

Email EVV Operations for questions.


July 1st, 2022

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

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

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

Email EVV Operations for questions.


June 12th, 2022

EVV Portal and Training Updates

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

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

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

Email questions to TMHP.


June 6th, 2022

EVV Policy Handbook Revision and Training Updates

The Electronic Visit Verification Policy Handbook has been revised.

Revisions include:

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

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

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

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

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

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

Email HHSC EVV Operations for questions about this notice.


May 30th, 2022

EVV Claims Matching for HCS and TxHmL Will Resume July 1

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

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

Email EVV Operations for questions about this notice.


May 8th, 2022

EVV Portal and Training Updates

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

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

Email TMHP EVV Operations with questions


March 7th, 2022

EVV Notice for HCS/TxHmL Program Providers

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

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

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

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

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

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

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


March 3rd, 2022

EVV Policy Handbook Revisions Now Available

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

The handbook includes EVV standards and policy requirements for:

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

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

Email HHSC EVV Operations with questions.


February 28th, 2022

EVV Portal and Training Updates

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

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

For questions, email TMHP EVV Operations.


January 8th, 2022

EVV Policy Handbook Revisions – Jan. 7th, 2022

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

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

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

For questions, email HHSC EVV Operations.


November 21st, 2021

EVV Portal and Training Updates for November 2021

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

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

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

Email TMHP with questions about these updates.


November 18th, 2021

Revised EVV Policy Handbook Now Available

The Electronic Visit Verification Policy Handbook was revised.

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

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

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

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

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

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

Email questions to HHSC EVV Operations.


November 17th, 2021

EVV Visit Maintenance Unlock Request Updates

HHSC published EVV Visit Maintenance Unlock Request spreadsheet updates.

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

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

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

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

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

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

    Review the instructions on the spreadsheets for more information.

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


July 4th, 2021

EVV Visit Maintenance Policy Now Available

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

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

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


July 4th, 2021

HHSC EVV Webpage Updates Now Available

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

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


July 3rd, 2021

Revised EVV Visit Transaction Rejection Guide Now Available

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

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

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

Email TMHP with questions.


April 17th, 2021

EVV Policy Training for CDS Employers Now Available in Spanish

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

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

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

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

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

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


March 16th, 2021

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

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

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

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

For questions, email HCS Policy or CDS.


March 10th, 2021

Temporary EVV Policies for the Feb. 2021 Severe Winter Weather

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

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

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

Email questions to the HHSC EVV Mailbox.


February 7th, 2021

EVV Refresher Training on Feb. 19

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

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

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

Certificates of completion will not be issued.

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

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

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

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

Email HHSC EVV for questions.


Reminder:  Entering Schedules for EVV-Required Services

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

EVV is only required for the following services:

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

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


January 24th, 2021

EVV Portal and Training Updates for January

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

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

Email TMHP with questions about these updates.


January 24th, 2021

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

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

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

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

Email questions about EVV policy to HHSC EVV.


January 18th, 2021

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

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

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

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

Next Steps

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

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


January 10th, 2021

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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

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

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

December 20th, 2020

Cures Act EVV:

Preparing for Jan. 1, 2021 Implementation

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

Beginning Jan. 1, 2021:

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

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

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

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

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

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

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

Visit the HHS EVV website for more information.


November 28, 2020

HCS and TxHmL CARE Service Authorization instructions for EVV

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

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

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


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

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

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

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

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

Best Practices for Temporary EVV Policies for COVID-19

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

Contact your payer for questions or email HHSC EVV.

Visit the HHS EVV webpage.


HCS and TxHmL Program Providers Required to Select an EVV Vendor
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HCS and TxHmL Program Providers Required to Select an EVV Vendor

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

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

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

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

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


Deadline Approaching Soon!!

October 21, 2020

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

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

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

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

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

Contact EVV if you have questions about EVV requirements.


Oct. 11th, 2020

EVV Revised Policies Effective Oct. 1

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

Claims Matching Policy (PDF)

The policy:

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

Claims Submission Policy (PDF)

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

Email HHSC EVV with your questions.


Oct. 11th, 2020

Updated EVV Service Bill Codes Table Effective Oct. 1

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

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

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

Units Matching

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

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

Home and Community-based Services and Texas Home Living Programs

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

Email HHSC EVV for questions.


 

 

 

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

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

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

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

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

EVV is only required for the following services:

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

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

Additional Guidance on Day Habilitation Services

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

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

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


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

August 20th, 2020

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


CURES Act EVV Training is Underway for HCS/TxHmL Providers

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

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

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

To register, click the links below:

FMSAs

HCS/TxHmL

Additional Training Opportunities

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

Email TMHP for questions about registration or the EVV Portal.

Email questions about EVV training requirements.

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


 

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

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


 

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

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


Updated Timeline for Cures Act EVV Expansion     

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

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

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

For questions, contact EVV.



New EVV Proprietary System Onboarding Documents Available

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

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

Resources


Trainings Available:

EVV Policy Training (Provided by your payer)

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

EVV Aggregator and EVV Portal Training (Provided by TMHP)

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

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

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

 

Online, interactive EVV training courses are available

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

The HHS Learning Portal includes training about HHSC EVV Policy.

The TMHP Learning Management System includes training about:

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

October 27th IDD and PI Webinar with HHSC LTCR

September 24th, 2022

IDD & PI Webinar October 27th, 2022

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

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

Oct. 27, 2022
10–11 a.m.

Register for the IDD/PI Webinar

Deadline Coming Up Soon For Comments on HHSC Proposed TAC Rules

September 24th, 2022

Deadline for Comments on HHS Proposed Rules Due Oct. 17

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

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

Questions can be emailed to HHS Rules Coordination Office.

ISS Updates & Draft Rules (HCS/TxHmL)

September 24th, 2022

HHSC Moved Individualized Skills and Socialization Webpage

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

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


August 23rd, 2022

No Public Hearing on ISS Licensing Rules

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

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


Public Hearing on ISS Program Rules

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

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


August 13th, 2022

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

August 8th, 2022
ISS Resources page

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

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

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

Provider Communications


August 6th, 2022

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

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

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

Letter From Twogether Consulting To Providers-Update

September 18th, 2022

Sorry for the delay in this mid-month edition.  Things have been extremely busy with so many new things happening: CIMS system, TMHP issues with Claims, Draft Rules: HCS/TxHmL TAC and Draft Rules: New ISS services rules, updates to the billing requirements, and much more.  I was running a little behind on my updates and I wanted to make sure I didn’t forget any of the many changes that have recently occurred or are in process.

I am so happy so many of you stopped by our booth at the Private Provider’s Association of Texas Conference this past week. Please don’t forget to contact us back if any of you who wanted CM and nurse training and other services forgot to come by or schedule a follow-up consultation. It was a great turn out and we would like to thank Carole and Jaim over at PPAT for all their hard work and all the great sessions they put together for the conference.

Don’t forget to register for the upcoming PACSTX conference as well as the AAIDD Texas chapter conference.  (Both are in November of this year.)


April 28th, 2022

Update From Twogether Consulting!

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

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

 

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

 

Twogether Consulting is continuing to work to ensure minimal disruptions to our business while putting the safety and well-being of our providers, their individuals in the program, and our contractors as our highest priority. Please see below for specific information for 2022 Services:

  • In-person group trainings/conferencesAvailable as requested as of December 29th, 2021. Most of these classes have already been moved to online webinars or training, but we can come on-site if you need us to do so.  We also have pre-recorded sessions of some of these trainings as well if you prefer.
  • Online training (Webinars): Proceeding as planned.  We will be posting upcoming webinars to the website regularly on the homepage: www.twogetherconsulting.com 
    • Webinar Registration:  Click on calendars on our website at www.twogetherconsulting.com or https://events.time.ly/anatx6f
    • Recordings of Free Webinar Series:  https://www.gotostage.com/channel/3b0bd3b1a47c4e80be974f4bcfa54d7b
    • “Updates Page”  https://twogetherconsulting.com/updates/
    • We will continue to provide 1 on 1 webinar training and any general trainings done for a specific facility/ provider for Care Coordination, Nursing Services, Direct Support Staff, etc.…
    • We have pre-recorded sessions with handouts for those of you who can’t attend live sessions or can’t wait for a live session. They range from $45-$175 per session.  These range from 1 hr- 3.5 hrs per session.
    • “Pop-Up Webinars”:  We will occasionally send out invitations to some webinars to those of you who are already clients of Twogether Consulting or who are on our mailing listThese won’t be posted for the general public.  These will be fairly short notice and based on topics that we receive a large number of requests to provide.  They will also be limited registration.  (15-30 persons max).
    • Direct Support Staff Training Webinars:  We continue to offer DIT’s (Directive Inservice Trainings) for ICF as well as General Direct Support Training for HCS/TxHmL/ICF providers.  Here are just some of our training webinars currently available live and/or via pre-recorded sessions:  Abuse/Neglect/Exploitation, Direct Support Documentation (Service Delivery Logs/Residential Notes, Incident Reports, Behavioral Support Documentation and Data Collection, and Training Data Collection),  Elements of the Behavior Support Plan & The Importance of Your Documentation, Expectations From the Nurse of The DSP (Includes discussion of Medical Documentation as well-MARS, Medication Errors, Treatment Sheets, Significant Observations),  When and What to Report To The Nurse, SAM’s Training (Self-Administration of Medications Training To Staff-General Routes, Tasks, documenting), Preparing For Survey in the Group Home/Surveyor Expectations in the Group Home, Host Home/Companion Care Service Provider Responsibilities, What The Nurse Expects from the HH/CC Provider and/or CRA, and many other training webinars.
  • Consultant Support: Twogether Consultants continue to be available to assist with your HCS/TxHmL and ICF needs as usual.  We will provide anything you request of us, that we can off-site but also on-site now if requested..
  • Off-site Consultation:
    •  You may purchase a block of time for as-needed consultation:  Starting January 1st, 2022, our prices will go to $80/hr and we can offer blocks of time for more than 3 hrs at a slight discount if you pay online at: https://twogetherconsulting.com/services/off-site-services/
    • if there is an extensive project (anything over 6 hrs, we will discuss flat rate options or daily rates.)
    • We continue to provide as-needed off-site consultation including, but not limited to Development or assistance with policy and procedure, Monthly/Quarterly QA via Taskmaster Pro, or any other cloud-based services, Survey and Audit Prep, and you are welcome to contact us if you need us to QA or review documents through our secure cloud storage system. We also provide off-site case management and nursing consultation and mentoring for HCS/TxHmL and ICF programs,
    • And much more!
  • On-site Consultation:  This service is available as requested, but please understand we need ample time to schedule as we are backed up right now!:  
    • General On-Site Assistance is based on a daily flat fee (ranges from $550-$1050 per day), depending on your location and additional travel expenses.
    • On-site Training for groups is a daily flat fee however due to prep time, and additional costs for materials, # of attendees, the cost is a bit more (ranges from $850-$2800 per day).
  • The request for on-site is up to you and if you feel comfortable. We will of course respect any protocol you have for us if we do come on-site, including rapid testing for COVID (additional cost).
  • Concerning our ICF providers, we will follow the same guidelines ICF has provided at this time.
  • Remember for ICF we can still provide Directive Inservice Trainings (DIT) if necessary, but we prefer to provide these off-site via webinar, and most Regional Surveyors will accept a DIT via webinar, especially in these times. So please let us know. If this must be done in person, it must be for 8 or less attendees at a time. All attendees must be screened for possible Covid-19 symptoms.
  • Payments:  We prefer payment via our PayPal Invoices, with Credit Card/Debit/ or PayPal and Venmo.  You are also welcome to pay via check,  e-check, or request to pay with Venmo.  You may also use our online link below to pay:  https://twogetherconsulting.com/payments/
    • If you must pay by check, please let us know prior to mailing the check.  Thank you.  Send all checks to:

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

 

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

 

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

 

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

 

Thank you and be well,

Julie Andrews Blacklock/Owner & IDD Waiver Consultant

 

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

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

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

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

Read the full alert.

Crosswalk Billing Codes For DH -Sept. 2022 Update

September 17th, 2022

EVV Mismatches For DH

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

Concern and Issue

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

Which day habilitation bill codes do I use?

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

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

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

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

September 17th, 2022

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

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

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

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

Resources

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


February 27th, 2022

HCS and TxHmL Billing Changes In The Crosswalk for DH

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

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

For HCS program providers:

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

Contact the HCS Policy Box with questions.

HCS Administrative Penalties, Survey, & Billing Requirement Updates

September 17th, 2022

HHSC publishes revised PL 20-55

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

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


May 30th, 2022

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

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

Read PL 2021-26 here.


 

September 5th, 2021

Now Called Billing Requirements Not Billing Guidelines!!!!

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

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

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

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

Email questions to TxHmL Policy.


September 5th, 2021

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

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

Register for HCS/TxHmL training here.


September 5th, 2021

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

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


August 15th, 2021

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

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

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


April 26th, 2021

            HHSC’s WS&C Portal

 

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

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

Here are the handouts:

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


 

March 29th, 2021

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

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

Listen to the webinar recording here.


March 28th, 2021

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

A recording of the March 16, 2021 Clarification of Administrative Penalties and Related Processes for HCS and TxHmL Providers webinar is available for those unable to attend.

Listen to the webinar recording here.

January 10th, 2021


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

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

Listen to the webinar recording here.


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

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

Listen to the webinar recording here.


December 28th, 2020

Letter: PL 20-55  Administrative Penalties HCS & TxHmL

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


December 23rd, 2020

Upcoming HCS and TXHmL Webinars For:

“Hold Harmless” Period & Administrative Penalties & Amelioration

Hold Harmless Period Overview

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

Jan 5, 2021
2 p.m. – 4 p.m.

Here’s the link to record session:

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

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

Administrative Penalties and Amelioration

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

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


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

November 25, 2020

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


 Billing Guideline Changes

September 1, 2020

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

 


June 20, 2020

Survey Process:  Timelines

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

HHSC Provider User Guide (CARE)       

Please go to the following link:

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

.

Updated Webinar Resource Document & TMHP Account Setup Quick Reference Guide 

September 15th, 2022

Updated Webinar Resource Document and TMHP Account Setup Quick Reference Guide 

(HCS and TxHmL Waiver Program Providers)

From HHSC Alert September 12th, 2022

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

Important! (Avoiding HCS and TxHmL Overpayment of Services)

September 12th, 2022

Avoiding HCS and TxHmL Overpayment of Services

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

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

Read the full alert.

Read More Button

Revision To Billing Requirements

September 11th, 2022

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

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

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

Email questions to TxHmL Policy.


May 8th, 2022

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

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

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

Email questions to TxHmL Policy.

TMHP: HCS and TxHmL Waiver Programs: Trending Issue Support

August 31st, 2022

 

September 11th, 2022

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

-Termination Forms Submitted by LIDDAs

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

Read more on the following items:

Long-Term Care Online Portal Sessions Must Be Restarted Daily

Using the “Resubmit to SAS” Button

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

 


August 31st, 2022

Migration Trending Issue Support Vol 7:  

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

August 16th, 2022

HCS and TxHmL Waiver Programs:  Trending Issue Support Volume 6

Individual’s residential address in Individual Search

“Pending LA Review” status and action needed

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

HCS and TxHmL call queue

For  info on these trending issues see the following link:

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


August 13th, 2022

HCS and TxHmL Waiver Programs: Trending Issue Support  Volume 5

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

Here are the latest resolutions to trending issues below:

HCS and TxHmL Call Queue

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

Location Code Issue

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


See previous Volumes and info below:

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

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

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

HCS and TxHmL Waiver Programs: Trending Issue Support

Important Claims Submission Information for HCS and TxHmL Programs

LTC Online Portal Dashboard Accessibility Issue Resolved

IPC Forms 3608 and 8582 Issue Resolved

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

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

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

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

 


June 1st, 2002

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

 

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

View previous postings:

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

Sept. 7th, 2022

 September 1 Texas Medicaid CHIP COVID-19 Information Session

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

The audio from this session can be found here.

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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


April 28th, 2022

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

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

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

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

Listen to the webinar recording here.

Email LTCR Policy for the transcrip


February 27th, 2022

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

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

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

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

Listen to the webinar recording.

Email LTCR Policy for the transcript.


February 1st, 2022

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

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

This includes strategies to rapidly identify COVID-19 and:

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

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

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


January 27th, 2022

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

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

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

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

Listen to the webinar recording here.

Read the webinar slide presentation (PDF).

Email LTCR Policy for the transcript.

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

September 1st, 2022

Rising To The Challenge!

PPAT Fall Conference

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

 

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

They are:

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

 Advertising in the Conference Program

 Marketing your services in the Exhibit Hall

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

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

 

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

Read more…

Other Registration Options

Conference forms in pdf

Registration form in pdf

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

Initial Critical Incident Management Services (CIMS) User Account Email

August 31st, 2022
TMHP has stated that FEI Systems sent emails to required users who had yet to log into CIMS.  Some providers have indicated that they did not receive an email.  According to HHSC FEI Systems did send emails out using a DONOTREPLY/FEI email address.  If you did not receive this email, please check your spam mailbox.
If you did not receive it, email the CIMS mailbox for assistance at: MCS_CIMS@hhs.texas.gov

Initial CIMS User Account Email

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

This applies to:

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

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

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

TCDD: Deadline For RFA’s For Grants For Persons With Developmental Disabilities

August 23d, 2022

From our friends at the Texas Council for Developmental Disabilities!
Illustration of hand holding up a coin with text that says Funding Available
Last Chance to Apply!
The Texas Council for Developmental Disabilities (TCDD) has issued Requests for Applications (RFA) for four new grant opportunities. The deadline to apply for all four RFAs is this Friday, Aug. 26, 2022, by 11:59 p.m. CT.These grants will help expand inclusion, training, and cultural understanding for people with developmental disabilities (DD) in Texas communities. You can learn more about these RFAs on the TCDD Funding Available page and find details on how to apply for them.
Disability Cultural Humility Training for Elected Officials

TCDD has funding available for one project to develop a training program for elected officials in Texas to better understand people with disabilities. To increase the cultural humility of elected officials and their staff, the project will develop informational videos and materials and a comprehensive yet approachable training program. TCDD has approved funding for up to $150,000 per year for up to five years.

Learn More and Apply
Self-Advocates in Participatory Action Research 

Funding is available to develop Participatory Action Research projects for people with disabilities. All projects must focus on enhancing self-advocate opportunities to have a voice in research about disability issues and increasing connections between researchers and the community. TCDD has approved funding for $150,000 per year, per project, for up to three years. There is funding available for up to two projects.

Learn More and Apply
Civic Engagement for People with Disabilities 

TCDD has funding available to develop a civic engagement training program for people with disabilities. Programs must incorporate disability issues and language that reflect disability culture and strategies for participants to connect with peers, civic organizations, the media, and elected officials. The total funding amount is up to $100,000 per year for up to two years for one project.

Learn More and Apply
Treatment for Substance-Use Disorders 

Funding is available to promote statewide capacity building and systems change improvements in the prevention, identification, and treatment of substance-use disorders among individuals with DD. Projects should include the development of training modules on substance-use disorders for the use of providers specializing in DD as well as modules on DD for the training of substance-use disorder professionals. TCDD has approved funding for up to $150,000 per project, per year, for up to three projects.

Learn More and Apply
How to Apply

Proposals must be submitted through SM Apply. To learn more about TCDD’s RFAs, including the application process and what is required of grantees, visit the How to Apply webpage.

TCDD logo that features an outline of Texas with two-toned blue checkmark in the center, extending beyond the state outline, and a red dot just above the dip in the checkmark. To the right is text that says “Texas Council for Developmental Disabilities,” and “Inclusive. Innovative. Impactful.”
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ISS (Individual Socialized Services) FAQ’s-August 2022

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

Provider Enrollment & Management System (PEMS)

August 22nd, 2022

PEMS

The Texas Medicaid & Healthcare Partnership (TMHP) is experiencing an unusually high volume of calls and emails from providers with requests for Provider Enrollment and Management System (PEMS) assistance.

As a result, TMHP requests the following of providers requiring PEMS assistance:

  • TMHP encourages providers that request PEMS assistance to wait for a call back. Requests are being handled in the order they are received.
  • TMHP requests that providers not initiate a second request. Duplicate requests can cause delays.

***Note: Twogether Consulting advises those in the process of getting their HCS provider contract, who are not currently providers, to please call PEMS for “walkthrough services”.  Do not try to apply online as you do not have a contract # yet!.

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.


  • While waiting for PEMS assistance, providers should refer to the following PEMS educational materials that may assist with PEMS enrollment, re-enrollment, revalidation, change of ownership, and maintenance requests (maintaining and updating provider enrollment record information).

PEMS Training Materials Available on the TMHP Learning Management System (LMS)

The following training materials are available in the PEMS Learning Path on the TMHP LMS to help providers learn how to navigate and use PEMS:

  • PEMS webinar recordings
  • Provider Frequently Asked Questions (FAQ) about PEMS
  • The following computer-based training (CBT) modules:
    • “General Information”
    • “Resources”
    • “New Enrollment”
    • “Reenrollment”
    • “Provider Management”
  • PEMS Video Series
  • Video entitled “PEMS vs. PEP” (PEP is the old system and it stands for Provider Enrollment on the Portal)
  • “Quick Start Guide to Using PEMS”
  • “PEMS Best Practices Guide”

NoteProviders must have a username and password to access the above materials on the LMS. To learn how to obtain a username and password, click here.

Informational Videos Available on the TMHP YouTube Channel

The following videos are in the Provider Enrollment & Management System playlist on the TMHP YouTube channel:

  • “The Benefits of PEMS”
  • “Removal of TPI from Forms”
  • “TMHP Secure User Account”
  • “Message Dashboard in TMHP User Account”
  • “PEMS Dashboard Overview”
  • “PEMS Navigation Panel”
  • “Resolving Deficiencies”
  • “Start New Enrollment”
  • “Adding Attachments”
  • “Signing Agreements”

Providers who need help navigating the TMHP website can view the following videos on the TMHP Website Refresher playlist on the TMHP YouTube channel:

  • “TMHP Website: Overview”
  • “TMHP Website: Provider Manuals”
  • “TMHP Website: Provider Relations”
  • “TMHP Website: Provider Notifications”
  • “TMHP Website: My Account”
  • “TMHP Website: Topics”
  • “TMHP Website: Programs”
  • “TMHP Website: Provider Enrollment”
  • “TMHP Website: Resources”

Get More Information

Additionally, the following information related to PEMS is available on the TMHP website:

For more information, call the TMHP Contact Center at 800-925-9126 or the TMHP-CSHCN Services Program Contact Center at 800-568-2413.

AAIDD: Annual Texas Chapter Conference 2022

August 15th, 2022

REGISTRATION IS OPEN FOR THE AAIDD: Annual Texas Chapter Conference 2022!

 

 

 

 

For more information and registration please click on the link below

Texas AAIDD Conference Registration

Download The Brochure for Agenda, Speakers, Sponsors, and more

 

Reserve Your Room Today!

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Extreme Drought Conditions

August 14th, 2022

Extreme Drought Conditions

Texas is currently experiencing statewide drought conditions. Numerous water systems are stressed and may continue to experience issues as the drought progresses, and there are concerns about the impacts on long-term care facilities. Water may become limited, in addition due to the extreme heat Texas is using a record amount of electricity so we may be subject to rolling blackouts in the near future.   A/C systems are stressed and foundation problems such as cracking have occurred, due to the extreme heat and drought.

LTC providers should review their emergency preparedness and response plans to ensure people know what to do in an emergency related to drought. Confirm contingency strategies are in place and continue readiness for potential issues, including breakdowns associated with water supplies, power supplies and cooling systems.

A few tips from us at Twogether Consulting: 

-Don’t wait til the breakdown or disaster occurs, stock up here and there on bottle-watered supplies now, not during a water shortage occurs, and panic has set in at the stores.

-Maintain your A/C/Cooling systems:

  1. Change the filter regularly.  Probably every 2-3 months for most central A/C systems, but check the guidance for your system.  With the African dust being so severe, and little rain during the drought, more dust and dirt may be getting into your A/C filter, and trust me, it can shut them down quick this summer.
  2. Be sure to inform and train your staff at the group homes, if they are persons that need to complete this task.
  3. If you have maintenance staff, please have them maintain a regular schedule for changing A/C filters for the facility and the group homes.
  4. If you do not have maintenance staff or others taking care of filters.  If the filter is dirty, often that can cause your system to go down.

-If you own some of your own “group homes”, it may be a good idea to purchase homeowner’s insurance now, in case these types of breakdowns occur, as the cost will be much less than paying to fix or even purchase brand new A/C system. Many times they can get someone out to fix the equipment or appliance a lot faster as well with a minimal service charge for coming to fix it. .

-Do you have a backup place the individuals can go, in case the A/C does go out and you can’t repair it quickly?

-Do you have a few bigger size coolers (preferable with wheels for portability), in case the power goes out for a lengthy period of time and you need to ensure your food doesn’t spoil if possible?

-Purchase a backup generator (if feasible &/or appropriate)

-Have your staff check to see if batteries need replacements in flashlights in the group homes.

-Purchase some fans and portable plug-in coolers if A/C system goes out or may go out soon (if feasible &/or appropriate)


Read the news release about the counties currently under the Governor’s Disaster Declaration for Drought and the proclamation from the Governor (PDF).

Visit the HHSC Emergency Preparedness webpage for more information on emergency preparedness for LTC providers.

Email questions to LTCR Policy.

ISS (Individualized Skills & Socialization) Provider Webinar Recording

 

Recording of Individualized Skills and Socialization Provider Webinar

August 13, 2022

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

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

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

Register now for the July 19 webinar.

Register now for the Aug. 22 webinar.

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

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

Email questions about the webinar to your program policy inbox:

New Critical Incident Management Reporting System: Updates

August 11th, 2022

Critical Incident Management System (CIMS) Now Live

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

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

See IL 2022-23 for more information about CIMS.

This alert applies to:

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

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

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

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

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

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

Email questions to the MCS-CIMS inbox.


April 12th, 2022

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

 


April 10th, 2022

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

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

Tuesday, April 26, 2022
2:30 – 4 p.m.

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

From HHSC I-2022-23 revised letter: 

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


 

April 10th, 2022

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

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

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

Submit questions to LTSS_Policy@hhs.texas.gov


February 27th, 2022

HHSC Publishes New Reporting System for Critical Incidents Management

 (CIMS) See Letter (IL 2022-14)

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

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

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

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


HCS and TxHmL Webinar Slated for March 10th, 2022

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

  • Webinar topics include:

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

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

    Email questions about the webinar to your program policy mailbox:

 

Revised LTC (Long-Term Care) Region Boundaries

August 8th, 2022

New LTC Boundaries for Survey and Investigation purposes In effect as of August 1st, 2022

See new map

HHSC has published Provider Letter 2022-18 – New Regional Boundaries for Long-term Care Providers (PDF).

The letter indicates that HHSC Long-term Care Regulation has redrawn regional boundaries for survey and investigation purposes effective August 1, 2022.

All LTC providers are affected by the new regional boundaries.

Former  Region 7 is now separated into two new regions: Region 8 and 11.

Read the PL details.

 

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

August 4th, 2022

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

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

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

 

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

 

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


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

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

Offsite Investigations Requirements Same As Onsite

July 30th, 2022

HHSC Reminds LTC Providers of Offsite Investigation Requirements (PL 2022-15)

HHSC has published Provider Letter 2022-15 – Offsite Review Responsibility Requirements (PDF).

The letter reminds facilities and agencies that they have the same obligation to respond to an investigation that HHSC conducts virtually and offsite as they do during an investigation that HHSC conducts in-person and onsite.

Read the PL details.

How to Adjust a Previously Adjusted Claim: For Dates Beginning May 1st, 2022 (HCS/TxHmL)

July 30th, 2022

The TexMedConnect User Guide has instructions for adjusting a previously submitted claim with dates of service on May 1 or later. However, the guide does not have instructions for adjusting a previously adjusted claim.

The user guide will be updated to include these instructions. In the meantime, follow the steps in the full alert for adjusting a previously adjusted claim in TexMedConnect.

Read the full alert.

Non-Waiver Services on The IPC Must Be Entered Into LTC Online Portal (HCS Providers)

July 30th, 2022

Entering Non-Waiver Services in the LTC Online Portal in the HCS Program

Effective immediately, Home and Community-based Services Program providers are responsible for entering all non-HCS Program and non-Community First Choice services into the HHSC data system.

Non-HCS and non-CFC services data are entered in the “Non-Waiver” services tab of the individual plan of care in the Long-term Care Online Portal. During a meeting to develop or revise an IPC, the service coordinator must provide information to the HCS Program provider about all non-HCS and non-CFC services and supports a person receives.

Per 40 Texas Administrative Code Section 9.159(c), an IPC must be based on a person’s person-directed plan. The IPC must specify the type and amount of each HCS service, CFC service (except CFC support management), and the non-HCS and non-CFC services and supports provided during the IPC year.

The service coordinator is still responsible for entering non-HCS and non-CFC services in the LTC Online Portal for HCS services delivered through the Consumer Directed Services option

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July 15th, 2022


July 1st, 2022


June 16th, 2022


June 1st, 2022


May 17th, 2022


May 2nd, 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.


April 6th, 2022


March 20th, 2022


March 1st, 2022


February 20th, 2022


February 2nd, 2022


January 17th, 2022


January 2nd, 2022


December 18th, 2021


December 2nd, 2021


November 17th, 2021


November 1st, 2021


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


October 3rd, 2021 


September 16th, 2021


September 2nd, 2021


August 15th, 2021


August 2nd, 2021


July 18th, 2021


July 5th, 2021


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May 15th, 2021


May 2nd, 2021


Newsletter Library

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

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

April 18th, 2021

April 18th, 2021 PDF Version

 

OneTwoStream! • Streaming, Podcasting, Influencer Marketing Guides | Share logo, Youtube logo, Youtube channel ideas

 

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.

FAQ’s For ARPA Retention Payments for HCBS & TxHmL

From HHSC:

“The FAQ document has been updated to reflect additional questions that were received during the June 8, 2022 webinar.

Some questions were similar so HHSC combined the main themes of questions received and provided the answer/response below. The FAQ has also been updated to reflect an extension of the deadline for the attestation and initial report. It was July 1, 2022 and has been extended to August 15, 2022.

If you have a question not addressed by this document, please contact: PFDLTSS@hhs.texas.gov.

If you have questions about the HHSC HCBS ARPA spending plan, please contact Medicaid_HCBS_Rule@hhsc.state.tx.us. The webinar recording, which includes a step-by-step walk-through of the attestation and reporting, is available here: https://attendee.gotowebinar.com/recording/8631581217532733954

HHSC is providing a temporary rate add-on for certain home and community-based services delivered between March 1, 2022 and August 31, 2022. Information regarding the temporary rate add-ons can be viewed here: https://pfd.hhs.texas.gov/long-term-services-supports.”

Below is the full FAQ document

https://pfd.hhs.texas.gov/sites/rad/files/documents/long-term-svcs/2022/2022-hcbs-arpa-faq.pdf

ARPA Retention Payments Now Beginning: For Claims Processed in CARE from March 1st-April 30th, 2022

July 27th, 2022

American Rescue Plan Act HCBS & TxHmL Provider Retention Payments

HCBS ARPA Payments in CARE/HCBS Enhanced FMAP Payments in CARE

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

HCS and TxHmL claims processed on the ID CARE system for dates of service between March 1–April 30, 2022, meeting the eligibility requirements for receiving the ARPA rate add on, will begin to be processed toward the end of July.

Providers will receive three new reports that will include the ARPA add on payments.

NOTE: These same reports are currently being received for regular claim payments under a different Report ID.

Here are the 3 new ARPA reports are provided below:

Approved To Pay Report:          HC064110.TXT

Claims Detail Extract:               GC063979.TXT

Remittance and Status Report:  HC064112.TXT

All providers receiving these ARPA payments will see these new reports delivered every Tuesday morning to their current folders. HHSC is processing payments at the client ID level. Due to the volume of claims, not all providers will receive ARPA payments each week. These ARPA payments will not be viewable within the ID CARE online system at this time but will be reflected in reports.

Questions about the HCBS spending plan can be sent to medicaid_hcbs_rule@hhsc.state.tx.us.

Questions about rates, attestation or reporting:   pfd-ltss@hhs.texas.gov.

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

July 18th, 2022

Monthly Reporting Required

REMINDER FROM HHSC: Completion of the Senate Bill 809/Rider 143 Monthly Report is REQUIRED of all participating providers, regardless of whether a provider or facility has received additional federal funding during the reporting month.

All participating providers must complete the Senate Bill 809/Rider 143 Monthly Report every month, even if they did not receive additional federal funds during the reporting month. The reports are due no later than 5 p.m. on the 1st day of the month following each reporting period. (For example, the report for July 2022 data will be due by 5 p.m. on August 1, 2022.)

HHSC regularly updates the list of healthcare institutions who must submit reports in compliance with Senate Bill 809 or Rider 143. The list can be found here under the SB 809/Rider 143 COVID-19 Reporting Healthcare Institution List dropdown.

Note: this list is derived at a point in time (currently as of July 1, 2022) and not all-inclusive as providers may enroll or change at various times. The list will be updated every Friday by close of business. Any provider that is identified as a “Health Care Institution” as defined in Section 74.001 of the Civil Practice and Remedies Code is required to complete the reports. The list has been updated to align with licensing agencies.

For more information about the Senate Bill 809/Rider 143 Monthly Report, please review this list of frequently asked questions and responses and visit the HHSC Provider Finance Department Communications web page.

If you have question(s) about the content of the report or need technical assistance, please email the HHSC Provider Finance Department at HHSC_PFD_Survey@hhs.texas.gov with “COVID-19 Federal Funds Report” in the subject line.


January 9th, 2022

Reminder: SB 809 / Rider 143 COVID-19 Reporting

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

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

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

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


 

December 30th, 2021

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

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

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

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


 

December 14th, 2021

Very Important Hanging Sign Clipart Images

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

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

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


November 30th, 2021

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

November 14th, 2021

PROVIDER REPORT GRACE PERIOD

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

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

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

 

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

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

For questions about the reporting process, email HHSC Provider Finance Survey for assistance at: HHSC_RAD_Survey@hhs.texas.gov

Information and FAQs Please visit the HHSC Provider Finance Department Communications web page for more information about the report.  Then click on “Monthly SB 809/Rider 143 COVID-19 Reporting.”

Read More….


October 3rd, 2021

Don’t Forget, The 1st  Monthly Ongoing Provider Report is Due October 15th, 2021!

The ongoing SB 809 and Rider 143 report and further information—including a PDF version of the report questions—are available on the HHSC Provider Finance Department website, and may be accessed on the main webpages for Acute Care ServicesHospitals and Clinic Services, and Long Term Services and Supports. Please note that this Microsoft Form link is separate from the initial report that covered the period of January 31, 2020 – August 31, 2021.

Grace Period

HHSC is granting a “grace period” to allow providers time to come into compliance if they fail to meet any deadlines between October 1, 2021, and November 30, 2021. While the deadlines to report will not change, HHSC will take no action against a provider as long as the provider submits all required reports due between October 1, 2021, and November 30, 2021, prior to the end of the grace period. The grace period ends December 1, 2021.


 

Sept. 18th, 2021

FAQ’s For Compliance With SB809 & Rider 143: Monthly Provider Reporting Requirements Concerning COVID-19 Funding

Introduction:

The 87th Texas Legislature directed the Health and Human Services Commission (HHSC) to report federal COVID-19 funding from specific health care institutions, and certain costs those providers have spent related to COVID-19 public health emergency. HHSC has developed a monthly report to obtain the information required by Rider 143 (.pdf) (2022-23 General Appropriations Act, Senate Bill (S.B.) 1, 87th Legislature, Regular Session, 2021 (Article II, HHSC, Rider 143) and S.B. 809 (.pdf) (87th Legislature, Regular Session, 2021).

Frequently Asked Questions (FAQ):

View the HHSC created list of “frequently asked questions ” (FAQ) (.pdf) with the answers to common questions to assist providers in completing the report.

Reporting: 

The initial report located here includes funding and cost data covering the period January 2020 through August 2021 and is due October 1, 2021. The subsequent reports will be ongoing and will cover a single month; each monthly report will be due on the 15th of the month following the end of the month (for example, the report for October 2021 data will be due November 15, 2021.

You will receive a confirmation once your report has been fully completed and submitted.

A pdf version of the report is available here (.pdf) for review prior to submitting the report.

If you are unable to meet the reporting deadline please contact the Provider Finance Department at HHSC_RAD_Survey@hhs.texas.gov for assistance.

Failure to submit:

Failure to complete and/or submit the required monthly report(s) on time will result in:

  1. A report to the Department of State Health Services or HHSC Regulatory Services and potential adverse actions on your licensure and/or
  2. HHSC may initiate payment holds for providers who fail to submit the required monthly reports.

HHSC is granting a “grace period” to help providers come into compliance if they fail to meet any deadlines between October 1, 2021, and November 30, 2021. While the deadlines to report will not change, HHSC will not any of the actions listed above against a provider as long as the provider submits all the required reports due between October 1, 2021, and November 31, 2021. The grace period ends December 1, 2021.

List of Some Of The Providers Required to Complete Reports: 

Here are some of the following entities that are required to complete the report:

  • Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID);
  • Community Living Assistance and Support Services (CLASS) or Case Management Agency (CMA) Providers;
  • Deaf-Blind with Multiple Disabilities (DBMD) Providers;
  • Home and Community-Based Services (HCS) Providers;
  • Texas Home Living (TxHmL) Providers;

Please email the HHSC Provider Finance Survey for assistance at HHSC_RAD_Survey@hhs.texas.gov.


September 18, 2021

As required by Senate Bill (SB) 809 and Rider 143 of the 87th Legislature (regular session)(copied below), HHSC will begin collecting information on the total value and uses of COVID-19 related Federal funds through monthly reports. The first report is due October 1, 2021. Reminder of Publication of Proposed Rules

HHSC published proposed rules related to SB809 and Rider 143 in the Texas Register on August 13, 2021, pages 4928-4931. The comment period ends September 3, 2021.

 

Rider 143

Reporting Requirement: COVID-19 Funding to Nursing Facilities and Hospitals. Out of funds appropriated above in Strategy B.1.1, Medicaid Contracts and Administration, the Health and Human Services Commission (HHSC) shall develop a report detailing the total value and uses of COVID-19-related Federal Funds, including Provider Relief Funds, provided directly to nursing facilities and hospitals contracting with HHSC since the beginning of the public health emergency. The report should include any temporary rate increases provided to nursing facilities related to the COVID-19 pandemic. Any facilities that do not provide information requested by the commission necessary to complete the report shall be identified in the report. The first submission of the report shall also include a description of any requirements implemented for nursing facilities in response to the COVID-19 pandemic, the cost to nursing facilities to implement the requirements, and recommendations on whether or not the requirements should be continued after the end of the public health emergency. HHSC shall submit the report to the Governor, Legislative Budget Board, and any appropriate standing committee in the Legislature on December 1st and June 1st of each fiscal year. The format and content of the report shall be specified by the Legislative Budget Board and posted on the HHSC website. Appropriations in Strategy A.2.4, Nursing Facility Payments, for fiscal year 2023 are contingent on the submission of the reports due December 1, 2021 and June 1, 2022.

Please look for forthcoming announcements from HHSC regarding these important reporting requirements. For more information, please contact HHSC Provider Finance.

Prepare for Ending Continuous Medicaid Coverage Now-Before The Public Health Emergency Ends

July 14th, 2022

Important Medicaid Coverage-Don’t Wait-Please Respond to Medicaid Letters- Changes To Occur in Medicaid Coverage
After Public Health Emergency Ends

This information letter gives service coordinators, case managers, and providers information to help individuals prepare for ending continuous Medicaid coverage. HHSC requests providers support the information campaign –Don’t Wait –Respond and Update! –by communicating with individuals and incorporating campaign materials into Medicaid operations.  In otherwards, our individuals currently covered, may not automatically be qualified as covered once PHE ends.  Act now and respond to all Medicaid letters telling you that your individual may not qualify when PHE ends.  Shout out to all SC’s and Case Managers!

PL-2022-39

https://www.hhs.texas.gov/sites/default/files/documents/il-2022-39.pdf

16th Annual AccessAbility Fest and AbilitySTRONG Parade on Saturday, October 1st, 2022 at Hemisfair (San Antonio, Tx)

July 10th, 2022

Date: October 1st, 2022 (San Antonio, Tx) 

2022 AccessAbility fest & abilitySTRONG Parade

REGISTRATION IS NOW OPEN!

It’s time to REGISTER!  At disABILITYsa, we are excited to host the 16th Annual AccessAbility fest and abilitySTRONG Parade on Saturday, October 1st, 2022 at Hemisfair.

Early bird discounts end on August 15th, 2022!

* Sponsorship Opportunities * Exhibitor Registration * Parade Entries * Program Partners * Information Only * and more! *

You will have a front-row seat to share your programs, resources, and opportunities to every individual, caregiver, and other providers in attendance. Every attendee will be able to interact through the AccessAbility fest gateway to resources, opportunities and recreation for individuals facing barriers to independence and inclusion due to a physical, developmental, sensory, and/or mental health challenge.

SATURDAY, OCTOBER 1ST, 2022 Schedule of Events
9:00am – 10:00am
abilitySTRONG Parade
9:00am –  2:00pm
Resource Festival
10:30am 
Main Presentation/Ceremony

The deadline to REGISTER as an exhibitor and be guaranteed an exhibitor booth is Friday, September 2nd, 2022 at 5pm.

We look forward to you joining us for our 16th Annual AccessAbility fest, should you have any additional questions you are welcome to email lisa@disabilitysa.org or call the office at 210-704-7262 or email Kameron Chicoine at kameron.exceptionalkids@gmail.com.

CLICK LINK TO REGISTER: https://hipaa.jotform.com/221468522820150

“Person-Centered Thinking” Training Available Online from IntellectAbility: Please Take Note HCS/TxHmL/ ICF Providers

Juliy 11th, 2022

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/

 

TAC 9.177 (d) A program provider must:

  (1) conduct initial and periodic training that ensures staff members and service providers are qualified to deliver services as required by the current needs and characteristics of the individuals to whom they deliver services, including the use of restraint in accordance with §9.179 of this subchapter (relating to Certification Principles: Restraint); and

  (2) ensure that a staff member who participates in developing an implementation plan for CFC PAS/HAB completes person-centered service planning training approved by HHSC:

    (A) by June 1, 2017, if the staff member was hired on or before June 1, 2015; or

    (B) within two years after hire, if the staff member was hired after June 1, 2015.

Quality in Long-Term Care Conference: August 11th-12th (Austin, Tx)

July 11th, 2022

Hurry, Hurry this onference is filling up quickly!

2022 qltcc

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.

2022 QLTCC

“Resilient, Responsive and Ready”

Aug. 11–12

Renaissance Austin Hotel

9721 Arboretum Blvd.

Austin, TX 78759

Register for the conference.

Continuing education credits for multiple disciplines will be provided for this event from nationally and internationally recognized experts.

For more information about this event, visit the registration webpage or email UT Steve Hicks School of Social Work.

Error in HHSC Reminder Notice-Due Date For SB 809 Data

July 11th, 2022

Error in HHSC Reminder Notice re:  Due Date for June 2022 SB 809 Data
Earlier today, HHSC issued a reminder notice about the COVID-19 monthly reporting requirement (SB 809).
The notice inadvertently stated that July 2022 data was due August 1, 2022.
The notice should have stated that the June 2022 data will be due August 1, 2022.

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

July 11th, 2022

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

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

Read PL 2022-13, Version 2 here.

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


July 5th, 2022

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

HHSC Long-term Care Regulation updated the COVID-19 Response Plan and FAQ documents on June 24. The updates remove instructions on how to ask for emergency staffing from HHSC.

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

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


May 7th, 2022

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

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

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

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


February 20th, 2022

Updated HCS COVID-19 Response Plan and FAQ Documents – Feb. 18

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

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

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


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

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

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

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

The rules became effective Feb. 17, 2022.


January 7th, 2022

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

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


September 23rd, 2022

HCS COVID-19 Mitigation & Expansion of Visitation Rules: 

Revision Response Plan

 

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


Update:   April 17th, 2021

HHSC Publishes HCS Expansion of Reopening Visitation Rules

Original Published:  March 25th, 2021

3.0 HCS Expansion of Reopening Visitation Rule

To read more, please click on the link below: 

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

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

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

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

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

Visitor Limitations: (Indoor and Outdoor)

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

3.3.1 Indoor Visitation

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

3.3.2 Outdoor Visitation

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

3.3.3 Limitations for Visitation

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

 

Limited Visitation Designation and Attestation

4.0 Limited Visitation Designation and Attestation Requirements

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

4.1 Essential Caregiver Visits

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

4.2 Limited Visitation without Attestation Form

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

 

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


HHSC Publishes HCS Expanded Visitor Attestation Rules & Guidance Letter

September 25th, 2020

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

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


 

 

 

HCS Emergency COVID-19 Mitigation Rules 

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

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

COVID-19 Resources

COVID-19 Resources

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.

COVID-19 Provider Information

COVID-19 Client Information

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.

COVID-19 Provider Information

COVID-19 Client Information

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


April 10th, 2022

April 7, 2022 MCS COVID-19 Stakeholder Information Session

Thank you for your interest in listening to the April 7 Texas Medicaid CHIP COVID-19 Information Session.

The audio from this session can be found here.

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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


 

January 9th, 2022

January 6, 2022 MCS COVID-19 Stakeholder Information Session

The audio from this session can be found here.

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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


 

December 30, 2021

COVID-19 Cases Rise – Guidance for LTC Providers

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

Please review the following guidelines and rules:

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

Find COVID-19 resources on:

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

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

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

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

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

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


 

December 30th, 2021

Dec. 13 ICF COVID-19 Webinar Recording Available

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

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

Listen to the webinar recording here.

Email LTCR Policy for the transcript.


 

December 29th, 2021

COVID RESOURCES FOR HCS/TXHML

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

Additional Guidance and Resources

 

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

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

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

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

Resources

 


November 5th, 2021

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

 

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

The audio from this session can be found here.

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

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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


 

September 15th, 2021

Oct. 4 ICF COVID-19 Webinar with HHSC LTCR

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

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

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


September 15th, 2021

Sept. 13 ICF COVID-19 Webinar Recording Available

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

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

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


August 30th, 2021

LTC Providers May Request COVID-19 Emergency Support

For Emergency Staffing Support:

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

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

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

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

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

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

The emergency plan must include:

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

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

Long-term care providers can request:

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

To Request Support:

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

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

HHSC LTCR staff may request supporting documentation to verify need.


 

August 15th, 2021

LTC Provider COVID-19 Resource Contacts Have Changed

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

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

LTC providers can now order COVID-19 therapeutics directly.


 

July 18th, 2021

August 2 ICF COVID-19 Webinar with HHSC LTCR

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

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

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


July 16th, 2021

July 6 ICF COVID-19 Webinar Recording Available

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

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

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


 

Illustration of two people looking at a computer screen

May 2021
Building COVID-19 Vaccine Confidence Webinar

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

 

May 12th, 2021

Quality In LTC Conference Online

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

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


From HHSC May Newsletter

COVID-19 updated resources, see link below:

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


May 6th, 2021

APR 29 MCS COVID-19 Stakeholder Update

The audio from this session can be found here.

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information


 

April 17th, 2021

March 18, 2021 MCS COVID-19 Stakeholder Information Session

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

The audio from this session can be found here.

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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


April 17th, 2021

Reminder: Providers Can Request Free COVID-19 Testing Kits

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

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

March 28th, 2021

Free BinaxNOW COVID-19 POC Tests Available for LTC Providers

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

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

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

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

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

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


March 22 ICF COVID-19 Webinar with HHSC LTCR

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

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

ICF Provider Webinar

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


Helpful Vaccination Information

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

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

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

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

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

 

CDC   Coronavirus Disease 2019 (COVID-19)

Resources For Posters For The Facility For Staff & Individuals

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


 

 


 

 


AADMD Webinar Series to Return in January 2021

Catch up on the webinars you may have missed.


 

https://open.texas.gov/


Texas HHS Home

HHSC COVID-19 Provider Information

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


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

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

The webinar will review the November 2020 updates.

Long-term Care Facility Webinar

November 24, 2020

10:00 – 10:45 a.m. CST

See Recording below

Register for the Webinar.


 

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

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

View the video training.


Coalition of Texans with Disabilities

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


ANCOR’s COVID-19 Resource Center

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

CDC information for persons with IDD

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

Resources from HRS

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

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

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

 

December 22, 2020

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

 

Risk/Benefit Return to Activity Form


 

Shared Article From IntellectAbility: “Long-haul COVID in People with IDD”

Thought this was great info. and wanted to share-

From IntellectAbility

Long-haul COVID in People with IDD

“People with intellectual and developmental disabilities (IDD) are at a greater risk of infection and poorer COVID-19 related health outcomes than the general population. Prevalence of comorbidities, living in congregate settings, and difficulties practicing preventative measures contribute to this risk; however, the inability to effectively communicate symptoms of illness may be the most significant hurdle to identifying and managing symptoms of COVID-19 infection, especially for those experiencing the lasting effects of long-haul COVID.”

Read more

 

Download this 10-page document for more info on symptoms in individuals with  “Long-haul COVID-19” issues

Technical Issues Resolved: FY 2023 Contract Amendment Open Enrollment July 1, 2022 – August 1, 2022

July 4th, 2022

The Provider Finance Department (PFD) Open Enrollment Portal experienced technical difficulties. Those issues have been resolved. The portal is now available for providers to complete Open Enrollment for the Attendant Compensation Rate Enhancement and Direct Care Staff Enhancement programs and Liability Insurance Rate Add-ons for Nursing Facilities.

The PFD portal is available. Please click here to access the portal. The PFD portal will be open from July 1, 2022 to August 1, 2022. For questions, contact HHSC Provider Finance Department: CostInformationPFD@hhs.Texas.gov.

The Texas Health and Human Services Commission (HHSC) announces Open Enrollment for the following programs:

  • Attendant Compensation Rate Enhancement Program for Community Living Assistance and Support Services (CLASS) — Direct Service Agency (DSA)
  • Home and Community-based Services (HCS)
  • Texas Home Living (TxHmL)
  • Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID)
  • and  several other waivers and LTC programs

For this state fiscal year (SFY) 2023, enrollment will be open until Aug 1, 2022. Title 1, Texas Administrative Code (TAC) Sections 355.112 and 355.308 states if the last day of open enrollment is on a weekend day, state holiday, or national holiday, the next business day will be considered the last day requests will be accepted. This enrollment pertains only to providers contracted with HHSC as described in 1 TAC Sections 355.112 and 355.308.

Providers contracted directly with a Managed Care Organization (MCO) will continue to enroll for rate enhancement through that MCO. They may not enroll through the process discussed below without a fee-for-service contract with HHSC.

Providers who participate in this optional program receive additional funds to provide increased wages and benefits for attendants or direct care staff. They must comply with enhanced staffing or spending requirements on future cost or accountability reports.

To request participation or an increase in level, complete an online Enrollment Contract Amendment (ECA) by 5:00 p.m. on August 1, 2022. The ECA must be completed online. No faxes, mail, or emails will be accepted. This letter does not include any forms. The ECA, all instructions, and worksheets are available on the HHSC Provider Finance Department Website at: https://pfd.hhs.texas.gov/long-term-services-supports.


July 5th, 2022

Use the following instructions to access these resources:

1.   Open the Provider Finance Long-term Services & Supports website;

  1. select the appropriate program;
  2. scroll down to the heading “Rate Enhancement – Attendant Compensation” or “Rate Enhancement – Direct Care Staff Compensation” (for Nursing Facility); and
  3. click on “View 2023 Rate Enhancement.”

Access the ECA by clicking on “Enrollment Contract Amendment Form” under “Other Documents Important to the 2023 Enrollment Information.”

In the same “Other Documents” section, instructions for completing the ECA are available by clicking on “Enrollment Contract Amendment Instructions.” It is important to review the instructions prior to completing the ECA.

The Open Enrollment Video is available under “View 2023 Rate Enhancement” on the Provider Finance Department website. There are no rate enhancement webinars for fiscal year 2023.

For more information, please visit the Provider Finance website.

HCS and TxHmL (CDS Services): Trending Issue Support, Volume 4

July 5th, 2022

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 Texas Medicaid and Healthcare Partnership.

TMHP has received feedback from providers indicating more support is needed. Read the full alert.

Joint Training From HHSC For Providers

Texas Health and Human Services

July 5th, 2022

Joint Training Page Available for HCS and TxHmL Program Providers

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

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

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


July 2022 LTCR 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.

Provider Information Validation on LTC Claims is Now Published: ICF/IID Programs

July 5th, 2022

 Information Validation on LTC Claims IL 2022-35

IL 2022-35 is posted on the HHS nursing facility and Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions webpages.

Effective June 10, provider information on long-term care claims is being validated using data stored in the National Plan and Provider Enumeration System and the Texas Medicaid and Healthcare Partnership Provider Enrollment and Management System.

This enhancement ensures the consistency of provider information and helps avoid claim rejection. Attending provider information is validated on NF and ICF/IID claims. Referring provider information is validated on hospice claims.

Email questions to the Managed Care Initiatives and ICF/IID Questions inboxes.

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

July 5th, 2022

COVID-19: HHSC Publishes In-Home Day Habilitation Information for Program Providers (Replaces IL 2022-32)

IL 2022-36 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 2022-36 In-Home Day Habilitation Information for Program Providers for COVID-19 (PDF). This replaces IL 2022-32.

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

Email questions to HCS Policy.


May 30th, 2022

The extension for temporary policy for In-Home DH goes through June 30th, 2022 now. 

COVID-19: HHSC Publishes In-Home Day Habilitation Information for Program Providers (IL 2022-32)

IL 2022-32 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 2022-32 In-Home Day Habilitation Information for Program Providers for COVID-19 (PDF). This replaces IL 2022-28.

It extends the temporary guidance through June 30, unless the COVID-19 public health emergency ends sooner. HHSC will provide guidance if there are any changes.

Email questions to HCS Policy.


October 3rd, 2021

HHSC Publishes In-Home Day Habilitation Information for Program Providers for COVID-19 (IL 2021-45)

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

HHSC has published a revision to this guidance in IL 2021-45 In-Home Day Habilitation Information for Program Providers for COVID-19 (PDF). This replaces IL 2021-39. It extends the temporary guidance through Oct. 31, 2021 unless the public health emergency ends sooner. HHSC will update if there are any changes.

Section 4320 permits day habilitation to be provided to an individual in the individual’s residence only if justified because of the individual’s medical condition or behavioral issues or because the individual is of retirement age. Section 3710 prohibits one service provider from providing different service components or subcomponents at the same time to the same individuals.
Below are descriptions of the temporary policy changes.
See page two for the current policy under Sections 4320 and 3710. Effective March 13, 2020, through November 30th, 2021:
●HCS or TxHmL program providers may provide day habilitation to an individual in the individual’s permanent or temporary residence without having the justification required by Section 4320. This includes individuals residing in their own homes or family homes.
●HCS program providers may, if an individual in the HCS Program is receiving day habilitation in the individual’s temporary or permanent residence, allow the individual’s service provider of residential support, supervised living, or
●host home/companion care to provide day habilitation to the individual at the same time the service provider provides residential support supervised living, or host home/companion care to the individual.  For more information please read information letter IL 2021-45 

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

July 4th, 2022

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

Initial report is now due by August 15, 2022.

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

HHSC is providing funds to agency providers and consumer-directed services employers to support recruitment and retention efforts for direct care staff delivering HCBS services. Payments made under this section can include one-time financial compensation directed toward direct care staff, including lump-sum bonuses, retention bonuses, and paid time off to receive a COVID-19 vaccination or to isolate after receiving a positive COVID-19 test.

Providers who may be eligible to receive funds are:

 

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

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

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

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

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

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

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

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


 

June 2nd, 2022

Don’t Forget!

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

Initial report is due by July 1, 2022.

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

HHSC is providing funds to agency providers and consumer-directed services employers to support recruitment and retention efforts for direct care staff delivering HCBS services. Payments made under this section can include one-time financial compensation directed toward direct care staff, including lump-sum bonuses, retention bonuses, and paid time off to receive a COVID-19 vaccination or to isolate after receiving a positive COVID-19 test.

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

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

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

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

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


 

May 19th, 2022

HCS/TxHmL providers:

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

See rates and new codes listed in link below:

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

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

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

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

 

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

Q: What are the ARPA HCBS Provider Retention Payments?

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

Q: What Services are eligible for Provider Retention Payments?

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

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

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

May 19th, 2022

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

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

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

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

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

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

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

LTC Services & Supports Page: Provider Finance Department

July 3rd, 2022

Overview

The Provider Finance Department (PFD) develops reimbursement methodology rules for determining payment rates or rate ceilings for recommendation to the Health and Human Service as Commission (HHSC) for Medicaid payment rates and non-Medicaid payment rates for programs operated by the Health and Human Services Commission (HHS) and the Department of Family and Protective Services (DFPS). PFD develops payment rates or rate ceilings in accordance with these rules and agency policy guidelines.

For more information please click on this link below for the website

https://pfd.hhs.texas.gov/long-term-services-supports

Metrocare: 2022 Conference for Intellectual & Developmental Disabilities (August 12th, 2022) Dallas, Tx

June 23rd, 2022

2022 Conference for Intellectual & Developmental Disabilities

Innovating, Developing & Defining the Future of Service Delivery

August 12, 2022

Norris Conference Centers – Dallas Northpointe Centre

(Located in: Brightwood College in Dallas:  12005 Ford Rd #200, Dallas, TX 75234)

The exhibitor information is available now. See link below.  Registrant information to be posted later this month.

Please click on this link for Exhibitor Information

HHSC Grant Available: Intermediate Care Facilities – COVID-19 in Healthcare Relief 

Grant Clipart

June 23rd, 2022

This is a notice to potential applicants that Request For Applications (RFA) No. HHS0011334 has been posted. This notice is from Texas Health and Human Services Commission (HHSC) Procurement and Contracting Services (PCS).

The RFA and related attachments can be located on the HHS Grants Website: https://apps.hhs.texas.gov/pcs/HHS0011334/  

Refer to the RFA for the required submission method(s), Deadline for Submitting Questions or Requests for Clarification, and Deadline for Submission of Applications.

Grant Name:

Intermediate Care Facilities – COVID-19 in Healthcare Relief 

RFA Number:

HHS0011334 

RFA Executive Summary:

The Health and Human Services Commission (HHSC or System Agency) is accepting applications for the Intermediate Care Facilities – COVID-19 in Healthcare Relief RFA.

The purpose of this Request for Applications (RFA) is to distribute funding for Critical Staffing Needs to Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition (ICFs/IID) in Texas that have been affected by the COVID-19 pandemic.

Applicants should reference the RFA Article II, Scope of Project, for further detailed information regarding the purpose, background, eligibility criteria, eligible activities and other requirements of this funding.

IMPORTANT: Download the complete RFA package and all associated documents from the HHS Grants Website. Read and review all documents in the RFA package carefully before completing and submitting an Application.

Questions or requests for clarification regarding the RFA must be addressed to the Sole Point of Contact detailed in the RFA and submitted before the Deadline for Submitting Questions or Requests for Clarification. The Sole Point of Contact, and their contact information, are identified in the RFA package.

Submit the Application in the form and manner described in the RFA package, on or before the Deadline for Submission of Applications (date and time). The required submission method(s) are outlined in the RFA.

HHSC
Kristen Thatcher, CTCD /Grants Technical Advisor 

Procurement and Contracting Services

Revised Guidance for COVID-19 Flexibility for Registered Nursing Services Provided by Telehealth for HCS & TxHmL

June 23rd, 2022

Please see the recent alert below from HHSC.  This has been brought to my attention just recently, however, I find it in conflict with the billing guidelines/requirements prior to even COVID-19, which allows for nurses to complete assessments per video chat  So, most likely they will revise billing requirements.  But know, it was in place prior to the Pandemic.

Revised Guidance for COVID-19 Flexibility for Registered Nursing Services Provided by Telehealth for  HCS & TxHmL

During the COVID-19 pandemic, flexibilities were put in place to allow comprehensive nursing assessments to be provided by telehealth (synchronous audio-visual technology).

This revised guidance applies to:

  • Home and Community-based Services
  • Texas Home Living

At the end of the COVID-19 public health emergency, this flexibility will end, and a registered nurse will be required to complete the comprehensive nursing assessments in person.

HHSC is notifying providers now so they can prepare for in-person activities as soon as the COVID-19 public health emergency ends. HHSC will notify providers of that date as soon as the federal government determines the end date. HHSC will be making updates to waiver handbooks to reflect this policy. Until handbook updates are completed, this interim guidance will serve as official HHSC policy.

For questions, email one of the policy mailboxes below:

 

ICF/IID Providers: Update on SB 8 ARPA Grants

June 17th, 2022
This message will only address the ICF/IID grants. As of May 31st, 2022, there was little else shared by HHSC, other than what was posted on its website on May 19, 2022. There was however information shared during the HHSC IDD Coordination Workgroup meeting shortly after that.
1.  Eligibility Criteria for the SB 8 Grants:   According to HHSC, application for the grants will be through an open procurement process which prohibits HHSC from disclosing any details.
HHSC responded, “The lists posted on the website are based on the eligibility criteria outlined in the list at:  https://apps.hhs.texas.gov/documents/SB8-Grant/rfa-tier-ii-competitive-award-process.pdf
Example:   The ICFs/IID will be updated to include those that are certified, but not licensed.  [This answer was in response to a question as to why not all community-based ICFs/IID were included in the list.]
“As mentioned on the website, compliance with SB 809/Rider 143 will not disqualify a facility from being eligibility; however, pursuant to SB 8, those providers will be “prioritized….Providers who are required to submit the reports and are compliant with all SB 809/Rider 143 reporting will receive one extra point on the scoring of their RFA application. Applicants’ compliance will be determined by HHSC on the 15th calendar day after the respective RFA solicitation posts.” [To review your compliance status, click on SB 809/Rider 143 COVID 19 Reporting Healthcare Institution List (updated June 6, 2022) at:  https://pfd.hhs.texas.gov/long-term-services-supports]

“As mentioned on the website, providers who believe they are eligible based on the criteria and are not listed on the eligibility list should contact Provider Finance Department before the solicitations are posted.  Providers should contact us at ProviderFinanceDept@hhs.texas.gov. “

2.  Distribution of the $178.3 million appropriated via SB 8  among the ALFs, ICFs/IID, Home Health, and Community Attendant Providers:   It seems HHSC provided ICFs/IID significantly less funds than ALFs and Home Health Agencies.  ICFs/IID received $2,952,861;  ALFs received $46;149,888 Home Health Agencies received $54,932,075.
Though recognized there are more ALFs and Home Health Agencies than ICFs/IID, if the intent is to distribute or award the grants equally across each eligible applicant/facility, each ICF/IID facility would receive only $3,800, whereas each ALF and Home Health Agency would receive $23,000 and $17,583 respectively to provide one-time staff recruitment and retention bonuses.  Notes:  a) The number of eligible applicants under the category of community attendant providers is not yet posted, though approximately $73 million of the $178.3 million is being provided to this category/provider type. b) Noo information to confirm whether the intent is to award the funds equally across facilities. It is hoped the RFA will provide information about this.
During the IDD Coordination Workgroup meeting, HHSC stated that when the ICF/IID RFA is posted (June 23rd), providers will have an opportunity to submit the above question through the formal Q&A process.  HHSC will also host an applicant conference.  HHSC would not announce the date for the applicant conference, but it’s assumed that information will be included in the RFA.
3.  Posting of the Request for Applications (RFAs):  The RFA for ICFs//ID will be posted June 23rd, it is anticipated that HHSC will issue a notice once posted.  In the event providers want to periodically check the status, click on the link below for ICF/IID.  
When the RFAs post, please read them carefully for the requirements, required submission method, formal Q &A period, application conference, and application deadline.
  • Request for Applications (RFA) No. HHS0011334 for Intermediate Care Facilities – COVID-19 in Healthcare Relief is scheduled to post on June 23, 2022 to this website: https://apps.hhs.texas.gov/pcs/rfa.cfm

TWC- Eight-Week Training For Supported Employment Providers

June 17th, 2022

Employment First Training Series

Amerigroup and the Association of People Supporting Employment First (APSE) are hosting a free, eight-week training series on competitive integrated employment and Employment First. The training is intended for Supported Employment providers throughout the state of Texas. It is not required for providers that maintain the TWC-VR Supported Employment credential. The kickoff for the training series is June 29, 2022. For more information about the training, visit the Vocational Rehabilitation Providers’ Resources website. To register, send an email to info@apse.org.

Cool new TWC provider locator tool

Instructions on how to use provider locator tool:  https://www.twc.texas.gov/files/partners/vr-provider-locator-documentation.docx

HHSC IDD Coordination Workgroup Updates From June 15th, 2022 Meeting: Enhanced FMAP Add-On Rates/ARPA Discussion

June 16th, 2022

Yesterday afternoon the HHSC IDD Coordination Workgroup met.  Though many topics were covered, below is the information discussed on HCBS Enhanced FMAP.  Here is a general summary of updates discussed, as follows: State-controlled ARPA, Transition of DHs to ISS, and TMHP migration issues.  Below is their discussion on ARPA funds.
Note:  Continue to look for further FAQ’s on some of these issues and training to come from HHSC in the near future.
HCBS Enhanced FMAP: 
Note:  Though not stated below, the HCBS enhanced FMAP add-on rates are already being added to claims providers submit via TMHP and previous claims submitted either via TMHP (beginning May 1st) or CARE (between March 1st and the May 1st go-live date).  Providers will be able to track receipt of the add-on rates via R & S reports, 
See slides 12-16on this link to the HHSC presentation for further details.
 Questions & HHSC Responses

1.  An updated FAQ was promised as of May 23rd, 2022, and there is still no evidence of this FAQ update.  When will this occur?

It is the intent of HHSC to have the updated FAQ document posted online and a list of accepted attestations by June 17, 2022.  HHSC stated that stakeholders submitted 290 questionsin the chat/question box during a recent private June 2022 webinar on the enhanced FMAP. It also stated that the recording of the webinar and handout  (which is attached for your review) will also be posted.  These items, along with other items already posted (such as the rates, current FAQs, etc.) will be available under the section titled Announcements – subsection ARPA HCBS Provider Retention Funds at:  https://pfd.hhs.texas.gov/long-term-services-supports

~  While many of the requirements related to the funds appear to apply equally across the programs to which the funds will be applied, there are nuances specific to each provider type. Though some comments and answers were prefaced with the program type to which the answer applied, many were not.   As the result, it would be helpful if:

a)  When adding the questions and answers to the FAQs, if HHSC identified which program(s) the questions and answers apply to.

HHSC did not answer this in its response or address at ths time.

b) HHSC would conduct separate webinars for each program for which the funds will be applied.  This would assist providers in better understanding the requirements related to the program they operate.  Though not inclusive, following is one example of why a separate webinar for each eligible program-type would be helpful:  The presenter stated that on the attestation form providers are to report the number of direct care/attendant and nurse positions and number of vacant positions – not FTEs.  Others heard this differently with some of the opinion that this only applies to one of the programs to which the funds are available with all other programs needing to report “total (not inclusive of direct care and nurses) staff positions and vacancies” across their operations.

The number of positions reported on the initial report and final report is dependent on the identifier utilized by the provider.  If a provider will report using their NPI that is associated with a number of contracts, the provider should report the number of direct care and nurses across their organization for eligible services.  If a provider reports using a specific contract, then the provider should report the number of direct care and nurses associated with that contract for the eligible services.

2.  What are the expectations for reporting that the funds were spent in accordance with the rules?  HHSC stated that the cost reports will not be used to determine compliance.

 In addition to the response immediately below, HHSC responded,  that the attestation form providers must sign and submit serves as the vehicle to confirm compliance, similar to how compliance is confirmed with the COVID add-on funds providers are receiving. In other words (or so it appears), HHSC will not audit for compliance or require any reporting of how one spends the funds through cost reports or an accountability report See slide 10 on the link above to the handout from the meeting with HHSC, for further details and HHSC’s ability to recoup funds if the attestation form and initial and final reports providers must complete are not submitted.  The attestation form MUST be signed by July 1, 2022.

The attestation form is available at:https://www.surveymonkey.com/r/2QG7NSB

~  If cost reports will not be used, then how will HHSC determine compliance, and, more importantly, base recoupment for misuse of funds?

HHSC is using the attestation and reports to confirm compliance with the HCBS ARPA Spending Plan.  The reports will only collect position information and will be utilized for informational purposes only.  The adopted TAC Rule 355.207 provides additional information on potential recoupments based on fraud or disallowed costs from CMS.

~  Will the provider be held accountable for how an entity, such as a DH, spends the funds?  It is the provider who must attest to how the funds are used, thus at risk of recoupment.  Providers do not have authority to ensure the DH spends the funds as required.

Other than the responses above, this was not answered in HHSC’s response. 

3.  Related to the above, the HHSC presenters at the meeting seemed to indicate a more restrictive use of the funds than specified in the rules.  355.207 (c)(2) seems to state otherwise :” A provider must agree to use at least 90 percent of payments made under this section for recruitment and retention efforts for direct care staff delivering HCBS services as defined in subsection (b) of this section. Payments made under this section can includefinancial compensation directed toward direct care staff, including lump-sum bonuses, retention bonuses, and paid time off to receive a COVID-19 vaccination or to isolate after receiving a positive COVID-19 test. Funds under this section can be used to pay payroll and unemployment taxes and workers’ compensation necessary to implement the financial compensation for HCBS direct care staff.”   The words ‘can include’ imply there are other recruitment and retention activities for which the 90% may be used, and also parallels

HHSC’s response in the preamble to the adopted rule which states the funds, though not limited to, may be used to make payments for lump-sum bonuses, retention bonuses, paid time off for a vaccination, etc.’

The above issue was further complicated by a comment made by HHSC in today’s Senate Finance Committee.  HHSC indicated that the funds could be used to cover overtime and hazard pay (both of which providers would appreciate) which contradicts a statement made during the meeting with HHSC.HHSC’s responses to stakeholder comments when the rule was published in the Texas Register as adopted.  The requirement that providers use HCBS ARPA funds for one-time financial compensation for direct care staff is consistent with the Centers for Medicare and Medicaid’s approval of HHSC’s spending plan. While 1 TAC 355.207 does allow for additional flexibilities for use of funds related to broader recruitment and retention efforts, HHSC is encouraging providers to prioritize one-time financial compensation for direct care staff to align with Federal approvals.

During this meeting with HHSC, they stated that a provider could spread out bonuses provided to staff.  In other words, one could provide a bonus now, then periodically provide additional bonuses.  See also slide 8 the link to the HHSC presentation above..

~  Please clarify how the funds must be used? The updated FAQs provide additional examples of allowable uses. Providers are prohibited from using funds in a way that will result in a decrease to hourly wages after the add-on period ends.

HHSC stated that the updated FAQs will address this question further by offering examples.

~  Are the payments restricted to only staff specifically hired as direct care/attendant, or can bonuses be paid to administrative staff who have been (and continue to serve) serving as a direct care to fill vacant positions?  Many providers report that their administrative staff have either left or are leaving because they are tired of filling in as a direct care, and, more importantly can be paid more elsewhere.

In accordance with the HCBS ARPA Spending Plan and TAC 355.207, the funding is for direct care staff.

~  Similar to the above, one of the COVID flexibilities has allowed a family member to provide CFC and respite services.  In many cases, families are still serving in this capacity.  In other cases,such as those in which the families have returned to work, the provider has hired a direct care worker to perform these services.  In either case, can the funds be used to provide bonuses to the family member who either has been serving in this capacity or continues to provide the service?

HHSC is requiring providers to spend 90% on direct care workforce, in compliance with the HCBS ARPA Spending Plan.

4.  Must providers accrue the funds first over the course of the payment period, then spend them as was stated during the webinar?

It’s assumed the presenter did not intend this to be a requirement, but that is not what many providers heard on the call.  Similarly, it appeared that HHSC told providers that the payments had to be one-time payments rather than a one-time amount spread out over a period of time. HHSC encourages providers to accrue the funds but there is no set spending period for providers.

~  Please clarify the intent of the statement made during the webinar.

Other than the two responses below and the response above , this request was not answered in HHSC’s response.  During yesterday’s call HHSC emphasized the yellow highlighted statement above. 

~  If the statement made during the meeting is the intent, will a provider be told what portion of the ARPA funds was paid to them after 8/31/2022?

Claims paid through TMHP will indicate the bonus amounts on the R&S.

~  Regardless of whether providers can begin spending now or must wait until all funds are received, what is the date by which the funds must be spent?  HHSC presenters seemed to indicate there was no such date.

There is no set date by which funds must be spent.

5.  Can providers opt-out?

There is no mechanism for providers to opt-out.

6.  Though HHSC has issued several notices regarding the funds, attestation funds, etc., there are providers that are still not aware of the funds or that the add-ons have begun.  Notices already sent/posted appear to be generic which can lead to confusion.  In other words, if the specific programs are not mentioned in the notice, some providers may think the notice does not apply to them.  Example:  Some providers think reference to HCBS does not include them.   Are there any plans for HHSC to issue program-specific notices about the funds?

HHSC can send out notices that list all applicable programs and services.

Reminder To Providers About ARPA Provider Rentention Payments

June 12th, 2022

Potential Long-Term Care Remittance and Status Report Delays

Due to the Home and Community-Based Services American Rescue Plan Act Provider Retention Payments (Add-On) for personal attendant and nursing services, rates are being updated.

Refer to Information Letter No. 2022-30 for additional information.

From TMHP

“Because of the Home and Community-Based Services (HCBS) American Rescue Plan Act (ARPA) provider retention payments (add-on) for personal attendant and nursing services, rates are being updated. Refer to Information Letter No. 2022-30 for additional information.

Providers do not need to take any action because these claims will be systematically adjusted during the regular adjustment process. Providers should confirm claim status and paid amounts on the Remittance and Status (R&S) Report.

Potential delays are expected in the generation of all provider R&S Reports on Wednesdays for the next few weeks because of the high volume of adjustment claims that will be systematically generated. Therefore, R&S Reports will be available later in the day, and providers may expect to see more records on the R&S Reports because of these adjustments.

For additional questions, contact the TMHP LTC Help Desk at 800-626-4117, option 1, then option 7.”

HCS & ICF Emergency & Disaster Preparation Updates

June 3rd, 2022

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

Memorandum Summary

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

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

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

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

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

Read more……

 


September 13th, 2021

Very Important Updates on Emergency & Disaster Preparedness During the Pandemic

Resources Listed Are From CMS & HHSC 

See Info For ICF Facilities Below

 

 

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

Emergency Preparedness Participant Workbook

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

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

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

 

HCS/ICF Provider Job Openings & Job Positions Desired

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

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

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

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

Julie Blacklock/ Owner

 

Current Job Postings (See below)


Position Reposted: 6/3/22

Mark I Residential HCS  (Austin, Tx)

Mark Henson-CEO/Owner

Ph:  512-789-4079

Email: mrk1res@swbell.net 

Location:  Austin, Texas

Starting Pay:  $50,000 (Salary negotiable with experience)

Position: HCS Case Manager (Need immediately, approximately 15-20 client max caseload/primarily medically fragile individuals in Group Homes. Very flexible schedule.  Some work can be done from home.

Job Qualifications:

Previous experience in case management  working with individuals with intellectual and developmental disabilities, is preferred.

However, we will consider other experience with IDD serivces.  i.e.. HCS, TxHmL or ICF program or other DD program.  Degree not required.

However, if you have a degree in psychology, child life & development, social services, or similar degree and no experience, we will consider for the position.  HCS Case Management/Care Coordination training and mentoring will provided for the position.  Must be comfortable working with individuals with special needs and those with high medical needs. Contact us for more information.  Feel free to send inquries and resume to email address. 


Position Posted:  06/03/22

1 Care Premier Services LLC  (Houston, Tx)
Registered Nurse (RN)  HCS Program

RN position is available!
For more information, click on this Indeed link


Position Reposted: 06/03/22

A TREASURE OF DREAMS, INC.  (Friendswood, Tx)   Home and Community-based Services (HCS) Provider                                                                                            www.atreasureofdreams.org

Contact:  Kate Wills (President/Executive Director)
Office:  281-482-3163  Cell:  713-670-4673
Fax 1:  281-482-3162   Fax 2: 713-481-6206

Seeking Full and Part-Time RN positions on a contract basis for an HCS Program. The RN MUST HAVE HCS EXPERIENCE. The RN will complete nursing assessments annually and as needed, medication training, delegations to unlicensed staff, special needs training, medical specific training, review medical documents and provide triage/post-hospital assessments when needed to individuals residing in the group home setting.

$40 per billable hour    Salary: $40.00 per hour

Primary responsibilities include:

  • Nursing Assessments (annually and as needed)
  • RN Delegations
  • Staff Trainings
  • Annual Meetings
  • Face-to-face assessment/post-hospital visits
  • New med/1st dose
  • On-call
  • Immediate follow-up following physician’s appointments with nursing assessment revision if necessary
  • Medication monitoring Medication reconciliation/monthly cycle meds

 

 

 

TMHP & HHSC Response to Common Migration Issues

TMHP & HHSC Response to Common Migration Issues:   Click on link below

TMHP Migration Complaints-HHSC Responses-060222

 

You can contact TMHP directly to submit your questions/ issues/requests for assistance using the  template below and using the following email address:   HCS_TxHml@tmhp.com
-Subject: HCS/TxHmL Question/Issue (and a short description of the issue or question)
-Point of Contact (POC) Name:
-National Provider Identifier (NPI)/Contract Number:
-POC Phone Number:
-POC Email Address:
-Client ID:
*Reason for Email:  *Examples are “Unable to bill claims”, “Cannot complete account set-up steps”, etc. Please provide as much information on the issue as possible.
~   Link to TMHP Webpage to Search for Updates on Migration Issues:  The following are the links related to recent news and HCS/TxHmL-specific news

STATUS OF HCS RATES!

Status of HCS Rates as of June 3rd  2022

Provider Rate Updates for HCS and TxHmL Providers

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

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

Read the full alert.

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

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


Status of HCS Rates as of January 17th, 2022

HCS and TxHmL Day Habilitation Rates, Respite Rates and Other Concerns

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

 

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

May 25th, 2020

COVID-19 Temporary Rate Increases for In-Home DH in the HCS Programs:  Effective April 1st, 2020

The payment rate add-ons for the HCS waiver only apply to providers delivering in-home day habilitation services to persons with intellectual disabilities or related conditions residing in three or four-bed group homes and receiving Supervised Living or Residential Support Services. These rate increases will apply to the current day habilitation rates so that providers delivering services in group homes can maintain hourly direct care staff wages due to reduced client-to-staff ratios.

Per 355.205 – Emergency Rule for Emergency Temporary Reimbursement Rate Increases and Limitations on Use of Emergency Temporary Funds for Medicaid in Response to Novel Coronavirus (COVID-19), HCS providers receiving increased funding associated with add-on payments for COVID-19 must submit an attestation affirming that the rate increases will be used only in the manner prescribed above. HCS providers who receive add-ons but fail to complete the required attestation will be subject to recoupment of the associated payment add-ons. The attestation form can be here. Please utilize Chrome (Preferred Browser), Firefox or Safari.

The temporary COVID-19 rate increases were effective April 1, 2020, and is estimated to conclude at the end of the federally-declared public health emergency (PHE). The PHE is anticipated to end on July 15, 2022, unless the PHE is withdrawn before this date or extended. The official PHE notifications can be viewed here.

Where To Find TMHP Updates: “Fixes”, Errors, & More”

Here is the TMHP page that you can check for updates on fixes, errors discovered and other updates on TMHP issues in HCS. Not sure everything will be sent in provider alerts on our normal Sunday emails we get from HHSC.  Sounds like they won’t, so check periodically.

https://www.tmhp.com/news?created=2&title=HCS&program_id=56&topic_id=All&category_id=All

Here is the main page if you have any issues and you can search for HCS LTC issues

Helpful Idea: IPC & ID/RC Submissions into TMHP

May 25th, 2022

Tip

So a provider mentioned that it might be a good idea to just have a stamp made that says “ENTERED” on the top and underneath it the letters “DLN” with a box next to it to write in the DLN #. This way, every time someone enters their ID/RC’s and IPC’s,  into TMHP for renewal, revision, etc.. and then you click  “submit” you can write down the “DLN” on the document.  The provider will have to know what DLN # goes with which entry.

Dashboard Accessibility Issue Resolved in the LTC Online Portal

May 30th, 2022

LTC Online Portal Dashboard Accessibility Issue Resolved

An accessibility issue with the Long-Term Care Online Portal Dashboard has been resolved.

“I have received quite a few calls about this issue.  And unfortunately, that made it also very difficult to get a status on claims billed for many providers. So hopefully the issue is now truly resolved.”

From HHSC:

“Home and Community-based Services and Texas Home Living waiver programs providers and local intellectual developmental disability authority agencies can access the LTC Online Portal Dashboard by ensuring that they have the correct user permissions.”

Read the full alert here.

If you have any questions about accessing the LTC Online Portal Dashboard, contact the TMHP LTC Help Desk by calling 800-626-4117, selecting Option 1, & then selecting Option 7.

Important! Preparing for Fee-for-Service Claims Billing Closeout IL 2022-31

May 30th, 2022

In Case You Don’t Have Enough To Worry About…..

HHSC Publishes Information on Preparing for Fee-for-Service Claims Billing Closeout IL 2022-31

IL 2022-31 (PDF) is posted to the HHS site.

Just some thoughts: Understand, that this also might mean a period of time where regular payments will be delayed a few weeks, right when the fiscal year closeout occurs at end of August.  Hopefully not, but it has been an issue in past years with CARE. Please be sure to take care of all claims that you can possibly bill, by 8/31/22!!!  

From HHSC:

“IL 2022-31 is for providers to prepare for the Aug. 31 end of fiscal year closeout. It is important for providers to promptly submit claims to be paid by HHSC for any unbilled services. HHSC will publish additional details regarding cutoff dates for fiscal year 2022 in an upcoming HHSC information letter when they are available.”

Submit questions about this project by calling Texas Medicaid and Healthcare Partnership at 800-626-4117, Option 1. Invalid or inappropriate recoupments should be immediately reported to HHSC Provider Recoupments and Holds by calling 512-438-2200, Option 3.

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

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 June 30, 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:


 

February 28th, 2022

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

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

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

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

Email questions to HCS Policy


February 28th, 2022

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

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

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

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

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


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

Emergency Preparedness Guidance and Trainings

Twogether Consulting

May 29th, 2022

2022 Hurricane Season Emergency Preparedness with COVID-19

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

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

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

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

Please refer to your program’s rules for more important information regarding emergency preparedness.

Hurricane and Flooding Readiness for HCS/TxHmL
Wednesday, June 1
1:45–3 p.m.
Register for the training.


August 15th, 2021

August and September 2021 LTCR Provider Training Opportunities

Long-Term Care Regulatory providers are invited to attend the following trainings hosted in August and September. Visit the Joint Training Opportunities page to register and learn more about each of these events.

Emergency Preparedness in Long-Term Care Facilities
August 18
1:30 p.m.
Register for the webinar.

August 25
1:30 p.m.
Register for the webinar.

September 13
1:30 p.m.
Register for the webinar.

September 23
1:30 p.m.
Register for the webinar.


July 4th, 2021

Hurricane and Flooding Readiness Webinars for LTC Providers

Home & Community-based Services:

Wednesday, July 21
2 -3:30 p.m.
Register for the webinar.

Intermediate Care Facilities:

Wednesday, July 21
10 -11:30 a.m.
Register for the webinar.

July 2021 LTCR Provider Training Opportunities

Long-Term Care Regulatory providers are invited to attend the following trainings hosted in July.  Visit the Joint Training Opportunities page to register and learn more about each of these events.

Emergency Preparedness in Long-Term Care Facilities

July 21
1:30 p.m.
Register for the webinar.

July 28
1:30 p.m.
Register for the webinar.


July 3rd, 2021

CMS Provides Guidance on Full-Scale Emergency Preparedness Exercises

ICF Providers, please make sure you see this.

The Centers for Medicare and Medicaid Services issued Quality Safety & Oversight Memo QSO-20-41-ALL Revised (PDF). The memo gives more guidance to providers on full-scale exercise requirements that are part of CMS regulations for emergency preparedness.
The following provider types are exempted from completing a required full-scale exercise for the 2021 cycle based on a provider’s activation of their emergency plan.

  • Nursing facilities
  • ICFs-IID
  • Home health agencies
  • Inpatient hospice providers

This exemption does not apply to the exercise of choice.
Providers should still follow all other emergency preparedness guidance in the March 26, 2021 State Operations Manual, Appendix Z (PDF).

TMHP: Very Important Information! Rejected Claims Submissions Between May 2nd and May 13th, 2022

May 23, 2022

Very Important!

Please see information from TMHP below:

Some Rejected Claims May Be Resubmitted

Some Home and Community-based Services (HCS) and Texas Home Living (TxHmL) claims that were submitted to Texas Medicaid & Healthcare Partnership (TMHP) between May 2, 2022, and May 13, 2022, were rejected in error. HCS and TxHmL claims that were rejected with the following explanations of benefits (EOBs) may now be resubmitted for processing:

Explanation of Benefits Description
F0155 Unable to determine appropriate Fund Code for Service billed, verify Medicaid Eligibility.
F0174 Claim is for a Service Group that is mutually exclusive with Service Group for previous claim.
F0286 Can only bill for incremental (0.50, 0.75, and whole) units for specified services.

Billing Dates of Service

Claims cannot be submitted on the same day as the date of service; providers should wait until the following day to submit their claim. Providers that submit claims for current or future dates may have their claim rejected, and will receive the following EOB:

Explanation of Benefits Description
F0198 Cannot bill for future Service Dates or current date.

Top Claims Rejections and Steps to Avoid Claim Rejections

HCS and TxHmL providers might see one of the following EOBs when a claim is rejected:

Explanation of Benefits Description
F0138 A valid service authorization for this client for this service on these dates is not available.
F0268 A valid service authorization for this client for these service dates is not available, or claim dates cannot overlap more than one service authorization.
F0077 Billing Code was not submitted or cannot be determined.
F0277 National Code is missing, invalid, or not billable with Procedure Code Qual.
F0325 Line Item Control Number-Required HHMM (military format.)

To avoid having claims rejected, HCS and TxHmL providers should take the following steps before submitting claims to TMHP:

  1. Check the TexMedConnect Medicaid Eligibility Service Authorization Verification (MESAV) to get client Service Auth/Level/Client Hold/Eligibility information. The following client information should be verified:
    • Services authorized for the client.
    • Service dates authorized for the client.
    • Levels authorized for the client.
  2. Use the HCS and TxHmL Bill Codes Crosswalk to check for important claims information, such as the Line Item Control Number (LICN).

Important: HCS and TxHmL claims should be submitted to TMHP for dates of service on or after May 1, 2022. Claims with dates of service before May 1, 2022, should be submitted using the HHSC Client Assignment and Registration (CARE) system.

 

For more information about submitting claims to TMHP, providers can refer to the following provider education resources:

Note: To access the TMHP Learning Management System (LMS), users must have an account. Users can register for an account here. New TMHP LMS users can access the Learning Management System (LMS) Registration and Navigation Job Aid for Providers located on the LMS homepage, or send an email to TMHP Training Support for support creating an LMS account or navigating the LMS.

For additional questions about submitting HCS and TxHmL claims to TMHP, contact the TMHP LTC Help Desk at 800-626-4117, Option 1, then Option 7.

 

Tip from Twogether Consulting:  If you are not getting a timely response from the Help Desk, or are unable to find answers to your TMHP Claim Submission Issues, please email:  Provider.relations@TMHP.com 

COVID-19 in Healthcare Relief Grants (For ICF/IID Programs)

COVID-19 in Healthcare Relief Grants

Senate Bill (SB) 8, 87th Legislature, 3rd Called Session, 2021, appropriates funding for the Health and Human Services Commission (HHSC) to issue awards to support Texas healthcare providers affected by the COVID-19 pandemic. These awards include funding for Rural Hospitals, Nursing Facilities, Assisted Living Facilities (ALFs), home health agencies (HHA), Intermediate Care Facilities for Individuals with Intellectual and Developmental Disabilities or related conditions (ICFs/IID), and providers of Community Attendant Services.

HHSC has published new information regarding the COVID-19 in Healthcare Relief Grants for the competitive award processes (“TIER 2”) here. HHSC encourages prospective Request for Application (RFA) applicants to review this information outlining general eligibility criteria, RFA application requirements, and anticipated solicitation posting dates for each of the respective RFAs.

Eligible applicants should rely on the final information published in each RFA Solicitation. Each RFA may have additional or different information than what is provided on the website.

IPC User Guides for HCS and TxHmL Waiver Programs

More Help Available For Persons Entering IPC’s Into TMHP!

More information about submitting and revising Individual Plans of Care is available in the Long-Term Care Online Portal User Guides for Home and Community-based Services and Texas Home Living Waiver Programs. These user guides are available for the following programs that submit IPC forms 3608 and 8582 in the Texas Medicaid and Healthcare Partnership LTC Online Portal:

  • HCS and TxHmL providers.
  • Local intellectual and development disability authorities.
  • Financial management services agencies billing on behalf of Consumer Directed Services employers.

Read the full alert here.

HCS / TxHmL / LIDDA: Updates For Submission of Claims

May 8th, 2022

 HCS and TxHmL Must Submit Claims and Forms to TMHP Beginning May 2, 2022

Home and Community-based Services (HCS) providers, Texas Home Living (TxHmL) providers, local intellectual and developmental disability authorities (LIDDAs), and financial management services agencies (FMSAs) billing on behalf of Consumer Directed Services (CDS) employers must submit claims and forms to Texas Medicaid & Healthcare Partnership (TMHP) beginning May 2, 2022, for dates of service on or after May 1, 2022.

Steps to Prepare

Program providers, LIDDAs, and FMSAs are strongly encouraged to set up the following accounts if they have not already done so:

  • Claims Submission Account:
    • TexMedConnect or
    • Electronic Data Interchange (EDI)
  • Long-Term Care (LTC) Online Portal
  • TMHP Learning Management System (LMS)

Failure to set up the necessary accounts can lead to delays in payment after implementation. Program providers, LIDDAs, and FMSAs can find resources for creating the necessary accounts and the time frames it could take to create those accounts in the following table.

read more…


April 28th, 2022

Claims Submission

Reminder: HCS and TxHmL Must Submit Claims and Forms to TMHP Beginning May 2, 2022

Reminder: HCS and TxHmL Programs can Submit 837P Professional and 837D Dental Claims Using EDI or TexMedConnect

For additional questions, providers can refer to the HCS and TxHmL Waiver Programs Frequently Asked Questions (FAQ), send an email to hcs_txhml@tmhp.com, or contact the TMHP EDI Help Desk at 888-863-3638.