Twogether Updates

Reminder: Implementation Plan Form 2125 (HCS/TxHmL)

June 5th, 2023

Form 2125 from HHSC used int the HCS and TxHmL programs as the Implementation Plan form, was updated in Oct. 2022.  The form currently has a box to check this document if consent was obtained from the individual or LAR concerning receiving services via Synchronous Audio Visual Technology .

Per standards of care, any professional therapy service or nursing service delivered using synchronous audio-visual technology must be clinically appropriate, safe, and agreed to by the individual receiving services or by the LAR. Synchronous audio-visual technology requires consent from the individual or LAR. Verbal consent is permissible and should be documented in the individual’s record. Providers must ensure that the appropriate consent box on the IP is checked.

Important Reminder: Consent For Synchronous Audio-Visual Technology

June 5th, 2023

Just A Reminder About Consent For Synchronous Audio-Visual Technology

Revision 22-3; Effective Oct. 19, 2022

As appropriate for the individual and as permitted by service-specific requirements, the modalities for delivering services to an individual includes:

  • In-person
  • Synchronous audio-visual
  • Audio only

In addition to meeting service requirements, providers must defer to the needs of the individual receiving services, ensuring the mode of service delivery is accessible, person-centered, and not driven by provider convenience.

Per standards of care, any professional therapy service or nursing service delivered using synchronous audio-visual technology must be clinically appropriate, safe, and agreed to by the individual receiving services or by the LAR. Synchronous audio-visual technology requires consent from the individual or LAR. Verbal consent is permissible and should be documented in the individual’s record.

****In addition:  The Providers must ensure that the appropriate consent box on the IP is checked.  (if you don’t use the IP form and you have another version, this information will have to be included as part of your IP.)

Employment First Assessment Tool: Proposed Rules (HCS/TxHmL/CLASS/DBMD)

June 5th, 2023

 

IL 2023-22

Employment First Assessment Tool: Proposed Rules

The employment first assessment tool should be utilized to ensure individuals receiving services through HCS, CLASS, DBMD & TxHmL, who want to work receive employment services from TWC.
The Information Letter and proposed rules (informal comment period)  presented below are the result of SB 50 (Zaffirini), 87th Texas Legislature.
IL 2023-22, Employment First Uniform Assessment Tool As indicated in the Information Letter, upon adoption of the rules, Service Coordinators and Case Managers will be required to use the assessment tool to assess an individual’s desire to work.  Though not required now, until the rules are adopted, which will supposedly be by this fall.
**HHSC is encouraging Service Coordinators (HCS/TxHmL) and Case Managers to begin using the tool.

Home and Community-Based Services (HCS) and Texas Home Living (TxHmL) – During the completion of the Service Coordination Assessment (Form 8647), the service coordinator asks the person about their desire to work. Document the person’s response on Form 8647.

If the individual indicates a desire to work, the service coordinator must complete the Employment First Uniform Assessment and make a referral to Texas Workforce Commission or refer the person for employment services through the waiver program where the person is enrolled.

Employment First Uniform Assessment   Form 8401

The draft rules and instructions for submitting comments can be found at the following link under Draft Rules (see Project #22R102): https://www.hhs.texas.gov/regulations/policies-rules/health-human-services-rulemaking/comment-proposed-draft-rules

ISS (Individual Socialized Services) FAQ’s

June 5th, 2023

HHSC’s Response to Three Recent ISS-Related Questions From Providers

 

Question 1: May an Individualized Skills and Socialization (ISS) provider charge families for after-hour care?  Many times families cannot get off work at the time the program closes/services stop.  Some providers will keep their doors open until 5 or 6 (with staff present of course), until families get off work.  In these cases, the ISS providers charge families for that service.

HHSC’s Response: If the individualized skills and socialization provider is also the program provider, the program provider would not be allowed to charge additional fees outside of the established HCS Waiver Program Payment rates, located here. According to 40 TAC §9.178(o):

(o) The program provider must not assess charges against the individual’s personal funds for costs for items or services reimbursed through the HCS Program or through CFC.

 

Additionally, according to 26 TAC §263.2015:

The service limit for the combined total of on-site, off-site, and in-home individualized skills and socialization is:

  (1) 1560 hours during an IPC year;

  (2) six hours per calendar day; and

  (3) five days per calendar week.

 

If the individualized skills and socialization provider is a contractor of the program provider, the provider’s costs must be considered reasonable and necessary in regard to the Medicaid cost/accountability reports. Unless the program provider agrees to pay a higher amount, the individualized skills and socialization provider must provide the service at or below the direct services portion of the applicable HCS Program rate.

According to 40 TAC §9.177(b):

(b) The program provider must employ or contract with a person or entity of the individual’s or LAR’s choice in accordance with this subsection.

  (1) Except as provided by paragraph (2) of this subsection, the program provider must employ or contract with a person or entity of the individual’s or LAR’s choice to provide an HCS Program service or CFC service to the individual if that person or entity:

    (A) is qualified to provide the service;

    (B) unless the program provider agrees to pay a higher amount, provides the service at or below:

      (i) for any service except CFC ERS, the direct services portion of the applicable HCS Program rate; and

      (ii) for CFC ERS, the reimbursement rate; and

    (C) is willing to contract with or be employed by the program provider to provide the service in accordance with this subchapter.

As part of agreeing to provide the HCS Program service at the direct services portion of the applicable HCS Program rate, the individualized skills and socialization provider would not be allowed to charge an individual or family additional charges outside what is reimbursed through the HCS Program.  (This means, the provider can pay all of the direct and indirect portions of the rate to the ISS provider if they want to or more, but they don’t have to pay more than the direct portion of the rate if they don’t want to.  Many HCS/TxHmL providers choose to pay all of the rate amount, the direct and indirect side both, but most likely are not paying more than the total rate as this would not be feasible or affordable for many HCS providers.)

 

Question 2: According to the rules, a person may receive in-home ISS assuming certain criteria are met/justifications secured.  Provision of the service does not require a license.  If the person wants to also engage in off-site activities, such must be provided by a licensed ISS.  In these cases,

~Can (as an example) the HH provider obtain a license for off-site only and provide the service as long as the HH provider was not the person delivering the service?

HHSC’s Response: In accordance with the HCS Billing Requirements, Section 43102.7 a host home/companion care provider is prohibited from being the service provider of in-home individualized skills and socialization. There is no prohibition on the host home/companion care provider being a service provider of on-site or off-site individualized skills and socialization but those services cannot be provided in the individual’s residence. The host home/companion care provider would need to either be employed by an individualized skills and socialization provider or obtain an individualized skills and socialization license.

~  Can the individual (again one who has a justification for in-home ISS) attend an ISS just to participate in off-site ISS only, or must that service be provided in an off-site only licensed ISS ?

HHSC’s Response: Yes, an individual who has a justification to receive in-home individualized skills and socialization may choose to also receive off-site individualized skills and socialization at a facility that provides both on-site and off-site individualized skills and socialization. It is not required that they receive off-site through an off-site only licensed individualized skills and socialization facility.

~  Can the program provider for an individual obtain an off-site only ISS license so the individual can participate in off-site ISS activities as long as the service provider of such is not the HH provider?  And if so, could the person providing the in-home ISS work for or contract with the provider to provide off-site ISS to the individual?

HHSC’s Response: Yes, a program provider may become a licensed off-site only individualized skills and socialization provider so that an individual can participate in off-site individualized skills and socialization activities. The service provider providing in-home individualized skills and socialization would be allowed to become an employee or contractor of the program provider owned off-site only individualized skills and socialization provider, as long as they met all other service provider requirements outlined in program rule and in the HCS Program Billing Requirements.

 

Question 3: Concerning ISS notes, it’s been reported by some providers that some HHSC or TMHP reviewers have told them that the ISS notes cannot be handwritten rather must be electronic.  Is that true?  And if so, where is that stated?

HHSC’s Response: There is no requirement that service delivery logs for on-site, off-site, or in-home individualized skills and socialization must be electronic over handwritten. HCS Policy does not specify the modality of service delivery log notes, only that the written documentation must be legible. According to Section 3810 of the HCS Billing Requirements:

3810 General Requirements

Revision 23-2; Effective April 1, 2023

(a)        Legible A program provider must have written, legible documentation to support a service claim.

 


January 13th, 2023

ISS FAQs:  Updated January 13th, 2023

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

August 23rd, 2022

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

For further questions, contact:

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

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

New Critical Incident Management Reporting System: Updates

June 2nd, 2023

Critical Incident Management Reporting System (CIMS) Incident Report Submission Status

HHSC has published IL 2023-19, Critical Incident Management Reporting System Incident Report Status. This letter is an update on the form submission status of critical incident reports entered into CIMS.

This Information Letter applies to:

  • Community Living Assistance and Support Services providers and case management agencies (CLASS)
  • Deaf Blind with Multiple Disabilities providers (DBMD)
  • Home and Community-based Services providers (HCS)
  • Texas Home Living providers (TxHmL)
  • Local intellectual and developmental disability authorities (LIDDAs).

Please contact MCS_CIMS@hhs.texas.gov with any questions.

 


October 13th, 2022

Please Don’t Forget To Sign Up For CIMS Training

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

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


August 11th, 2022

Critical Incident Management System (CIMS) Now Live

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

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

See IL 2022-23 for more information about CIMS.

This alert applies to:

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

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

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

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

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

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

Email questions to the MCS-CIMS inbox.


April 12th, 2022

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

 


April 10th, 2022

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

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

Tuesday, April 26, 2022
2:30 – 4 p.m.

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

From HHSC I-2022-23 revised letter: 

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


 

April 10th, 2022

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

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

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

Submit questions to LTSS_Policy@hhs.texas.gov


February 27th, 2022

HHSC Publishes New Reporting System for Critical Incidents Management

 (CIMS) See Letter (IL 2022-14)

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

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

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

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


HCS and TxHmL Webinar Slated for March 10th, 2022

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

  • Webinar topics include:

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

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

    Email questions about the webinar to your program policy mailbox:

 

IDD Ombudsman “Client’s Rights & Complaints”

May 28th, 2023

When to Call the IDD Ombudsman

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

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

A complaint may be reported to the IDD Ombudsman by anyone by calling 1-800-252-8154 between 8 a.m. and 5 p.m. Monday through Friday.

                                                                                                                  OR

Email: OmbudsmanIDD@hhsc.state.tx.us.

Online: Submit your question or complaint online

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

Fax: 888-780-8099

 


.

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

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

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

Or click on the links below to download a copy

Resources for people with intellectual or developmental disabilities:


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

 

Reminder: Complete Attestation & Reporting For HCBS Provider Retention Payments To Prevent Recoupment

May 27th, 2023

 Attestation and Initial & Final Reports

 HHSC’s Home and Community-Based Services (HCBS) Provider Retention Payments are part of the HHSC ARPA (American Rescue Plan Act) Spending Plan. These “Retention Payments” were meant to be a temporary rate add-on on eligible service claims with dates of service from March 1, 2022 to August 31, 2022, to agency providers and consumer-directed services (CDS) employers.

HHSC adopted 1 Texas Administrative Code Section 355.207 governing the ARPA HCBS Provider 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.

HHSC has updated the ARPA HCBS Provider Retention Payments Compliance List on the Provider Finance Department (PFD) website. The list of providers who have submitted an attestation and reporting requirements will be updated every 14 calendar days until the attestation is closed.

 Failure to comply will result in recoupment.  Please check HHSC’s most current HCBS Provider Retention Payment compliance list to be sure it accurately reflects your submissions. The list is available at:  https://pfd.hhs.texas.gov/sites/rad/files/documents/long-term-svcs/arpa-hcbs-list.pdf

If you are an eligible provider who is not yet in compliance, please visit the PFD website to access and complete the attestation and reports. The deadline for the attestation and reports is 90 calendar days after the federally-declared COVID-19 PHE expired.  The federally-declared PHE expired on May 11, 2023.  The deadline for the ARPA HCBS Provider Retention Payments attestation and reporting has been extended to August 9, 2023.

For more information regarding ARPA HCBS provider recruitment and retention payments, please visit the PFD website.

Webinar From ANCOR: What You Need to Know to Comply with Wage and Hour Laws Now that the Public Health Emergency Has Ended

May 10th, 2023

The PHE is Over, Now What?  What You Need to Know to Comply with Wage and Hour Laws Now that the Public Health Emergency Has Ended

 

Check out this webinar from ANCOR. This webinar does have a registration fee.  It is open to members and non-members of ANCOR!

Wednesday, May 24, 1-2 pm EDT

“The Impact of the PHE Unwinding On Wage and Hour Compliance”

A clock and a calendar.
Now that the public health emergency (PHE) has ended, providers are navigating how to unwind from emergency flexibilities and funding—both of which may have implications regarding compliance with wage and hour laws.
For example, many states included reimbursement rate increases or hazard bonuses for direct support professionals through time-limited Appendix Ks or American Rescue Plan Act funding, and the rules governing these pay increases may be viewed differently now compared to during the PHE.
Through the unwinding, it is critical that providers have a clear understanding of when to exclude and include increases from overtime pay calculations and remain in compliance when discontinuing the use of premiums.
To help you make sense of it all, this webinar will provide participants with a better understanding of the Fair Labor Standards Act, with emphasis on emerging topics from the unwinding of the PHE.

Presenters

  • Lydia Dawson, J.D., Director of Policy, Regulatory and Legal Analysis, ANCOR
  • Eileen Maguire, J.D., Attorney & Legal Advisor, Gilliland, Maguire & Harper, P.C.

TMHP: HCS and TxHmL Waiver Programs: Trending Issue Support

 

May 15th, 2023

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 20

Since May 2, 2022, Home and Community-based Services and Texas Home Living program providers, local intellectual and developmental disability authorities, and financial management services agencies, billing on behalf of Consumer-Directed Services, have been submitting claims and forms to the Texas Medicaid & Healthcare Partnership (TMHP).

DH & ISS Billing

On March 1, 2023, day habilitation was replaced with individualized skills and socialization (ISS). To bill for day habilitation prior to March 1 and ISS after March 1, refer to the following unit information and prorating instructions.

Units:

· Day habilitation is a daily unit with a maximum of 260

· ISS is an hourly unit with a maximum of 1560

· 260 daily units of day habilitation equal 1560 hourly units of ISS

· The 1560 ISS unit maximum covers the extra day for leap year

Prorating instructions:

1. Determine how many days were used for day habilitation. (Example: 55 days used)

2. Subtract the number of days used for day habilitation from 260 (or the number of days requested) to determine the remaining days. (Example: 260 – 55 days used = 205 remaining days)

3. Multiply the remaining days by 6 (derived from dividing 1560 by 260) to determine how many hours remain to bill as ISS. (Example: 205 remaining days * 6 = 1230 ISS hours)

Other areas discussed were:

Dental Claims Units:  Providers must bill dental claims with the dollar amount as the units.

Example: If the billed amount is $100, enter “100” as the number of units.

If previous claims were paid incorrectly because the dollar amounts were not billed as units, providers can rebill correctly by performing adjustments on the paid claims. Refer to the “Adjustments” section of the Long-Term Care (LTC) User Guide for TexMedConnect for assistance.

Submitting Transfer Forms:  To avoid delays when submitting forms after transfers, the receiving providers should obtain confirmation that a transfer Individual Plan of Care (IPC) form is in Processed/Complete status before proceeding to the subsequent form

 

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

 


HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 19

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 18


January 28th, 2023

HCS and TxHmL Waiver Programs:  Trending Issue Support, Volume 17

Trending Support Issues, Vol. 17: Access to PDF R&S and 835 Electronic R&S Reports, R&S Report Information and Videos

Click on link below for full report

https://www.tmhp.com/news/2023-01-27-hcs-and-txhml-waiver-programs-trending-issue-support-volume-17

Highlights from Vol. 17

Providers are encouraged to use both the PDF version and the American National Standards Institute (ANSI) 835 electronic version of their Remittance and Status (R&S) Reports.

Providers can view and save the PDF version of their R&S Reports through TexMedConnect. The PDF files are available for 90 days following the publication date of the R&S Reports.

To access their ANSI 835 electronic R&S Reports, providers must submit an Electronic Data Interchange (EDI) Agreement and set up ANSI 835 access. In addition, providers must use an approved third-party billing software vendor from the following list. Providers can retrieve their ANSI 835 electronic R&S Reports dating back to when their submitter number was linked to their contract number.

Providers should refer to the 835 Long Term Care Companion Guide for more information about the 835 Electronic R&S Reports.

In addition:

Providers can refer to the Remittance and Status (R&S) Reports for LTC Providers Quick Reference Guide (QRG) for more information.

Additionally, a three-part educational video series is available on TMHP’s HCS and TxHmL YouTube playlist and discusses the following topics:

  • General R&S Report information and instructions for account administrators on how to set permissions for users to access R&S Reports (Part 1).
  • How to read and understand the first section of the R&S Report: Non-Pending Claims (Part 2).
  • How to read and understand the second, third, and fourth sections of the R&S Report: Pending Claims, Financial Summary, and EOB Codes and Descriptions (Part 3).

 

Approved 3rd party biller list

Don’t forget our friends at Millin Billing are on this list. Contact us at info@twogetherconsulting.com for assistance with getting a demo and discount on your rate.


January 15th, 2023

HCS and TxHmL Waiver Programs:  Trending Issue Support, Volume 16

Trending Support Issues, Vol. 16:  IPC Use as a Template button and Location Code Field on Individual Movement and IPC forms

https://www.tmhp.com/news/2023-01-13-hcs-and-txhml-waiver-programs-trending-issue-support-volume-16

**When creating IPC renewals, the Use as Template button can now be used to populate form data from the original form into the new form.  This is incredibly helpful to providers now and less time-consuming.

*Another major issue that slowed down transfers I believe with LIDDA’s and also caused glitches for providers, in terms of wrong locations noted in the dropdown menu and then not being able to revise those location errors was also addressed.  See “fix” below:

Effective January 13, 2023, a text box will replace the location code drop-down box on the following IMT and IPC form fields:

· IPC transfers (3608/8582) field 39a: Receiving Program Provider Location Code

· IMTs field 18Location Code

· IMT Individual Update fields 122Current Location Code and 123: New Individual Location Code

· IMT LA Reassignment field 111: New Location Code

The manually entered text will be validated upon submission to ensure that the submitted location code is valid for the provider. This enhancement will improve the overall system performance related to the location code fields.

The following item-by-item (IBI) guides have been updated to reflect enhancements:

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


January 12th, 2023

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


HCS and TxHmL Waiver Programs:  Trending Issue Support, Volume 14

Trending Support Issues, Vol 14:  PEMS Revalidation and Enhancements to updating effective date of some forms  : https://www.tmhp.com/news/2022-12-30-hcs-and-txhml-waiver-programs-trending-issue-support-volume-14

 


December 16th, 2022

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

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

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


November 20th, 2022

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

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

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


HCS and TxHmL Waiver Programs: Migration Trending Issue Support, Volume 11

The following is a list of common form submission statuses with descriptions and actions needed:

  • Pending DADS Review
    • Description: The form is pending Texas Health and Human Services Commission (HHSC) long-term care (LTC) staff review.
    • Action: 
      • Forms 8578, 3608, and 8582: For Change LON on Existing Assessment, renewals and revisions, the submitter may need to submit a review packet to the HHSC Utilization Review (UR) department. For questions and to provide supplemental documentation, submitters can contact the HHSC UR department at 512-438-5055 or email deskURLONIPC@hhs.texas.gov.
      • 8578, 3608, 8582, and 3615 Forms: For questions and to provide supplemental documentation about enrollments, transfers, or continuation of suspensions, LIDDAs can contact HHSC Program Eligibility and Support (PES) at 512-438-2484.
      • 3616 Termination Forms: For questions and to provide supplemental documentation, providers and LIDDAs can contact HHSC Program Eligibility and Support (PES) at 512-438-2484.
  • Suspensions Pending….. read more

 


October 17th, 2022

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

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

October 7th, 2022

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

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

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

 

-Preventing claim denials for invalid date spans

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

F0126: Claim line items cannot span current fiscal years.

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

F0326: Incorrect number of days billed for this service.

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

 


September 11th, 2022

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

-Termination Forms Submitted by LIDDAs

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

Read more on the following items:

Long-Term Care Online Portal Sessions Must Be Restarted Daily

Using the “Resubmit to SAS” Button

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

 


August 31st, 2022

Migration Trending Issue Support Vol 7:  

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

August 16th, 2022

HCS and TxHmL Waiver Programs:  Trending Issue Support Volume 6

Individual’s residential address in Individual Search

“Pending LA Review” status and action needed

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

HCS and TxHmL call queue

For  info on these trending issues see the following link:

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


August 13th, 2022

HCS and TxHmL Waiver Programs: Trending Issue Support  Volume 5

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

Here are the latest resolutions to trending issues below:

HCS and TxHmL Call Queue

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

Location Code Issue

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


See previous Volumes and info below:

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

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

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

HCS and TxHmL Waiver Programs: Trending Issue Support

Important Claims Submission Information for HCS and TxHmL Programs

LTC Online Portal Dashboard Accessibility Issue Resolved

IPC Forms 3608 and 8582 Issue Resolved

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

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

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

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

 


June 1st, 2002

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

 

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

View previous postings:

Direct Care Careers Connect Coming Soon!

May 15th, 2023

New Tool To Help Providers & Direct Support Staff/Community Attendants With Employment!

HHSC is launching Direct Care Careers Connect to help community attendants and employers connect beginning June 1, 2023.

The online platform will allow community attendants to list work history, skills, certifications, trainings, and other job qualifications. Employers will be able to post job descriptions, job specifications, and other information to help find quality candidates. Employers can also contact job candidates about posted positions.

HHSC does not play a role in the hiring process.

HHSC invites community attendants and employers to use this new online platform at no cost. Alternative terms for community attendants can include: attendant; care attendant; caregiver; direct care staff; direct service worker; direct support; home care attendant; home health aide; patient care assistant; personal care assistant; personal care attendant; special caregiver; care assistant; direct support professional; or direct care staff.

(Host Home/Companion Care Providers would seem to fall under this, but I am unclear at this time. I would contact the email below to ask.)

Email any questions to HHSCOfficeofDisabilityServicesCoordination@hhs.texas.gov.

Long-Term Care Provider Webinar Recording on the End of Continuous Medicaid Coverage (ALF’s, NF’s, ICF’s & HCS)

May 15th, 2023

Recording Available of Webinar For LTC Provider Webinar on the End of Continuous Medicaid Coverage!

HHSC hosted additional live webinars in March and April of 2023, to inform providers about the end of continuous Medicaid coverage.

The webinar provided information about how long-term care providers (including nursing facilities, assisted living facilities, home and community support services agencies, Medicaid waiver providers, and intermediate care facilities for individuals with intellectual and developmental disabilities) can assist their Medicaid clients as continuous Medicaid coverage ends.

This is from the March 29 webinar. A recording is available here.

Email questions to: update@hhs.texas.gov

Entering IPC Revisions to Add Individual Skills and Socialization

May 15th, 2023

Reminder for HCS and TxHmL Providers  Concerning ISS on IPC’s

HCS & TxHmL program providers, and LIDDA authorities who are submitting an Individual Plan of Care (IPC) revision to add Individualized Skills and Socialization (ISS) on the IPC plan year.

When entering IPC revisions, if you update the effective date in field 12a, you must click the search icon located next to the date field. This will allow the individual’s data to refresh and prepopulate from the web service based on the new effective date.

Contact the Texas Medicaid and Healthcare Partnership Long-Term Care Help Desk at 800-626-4117 or 800-727-5436 for assistance with submitting forms.

Links to Long-Term Care Bulletins

Image result for Bulletin free clipart

 

See links to the 2023 editions below:

May 2023 Long-Term Care (LTC) Provider Bulletin

February 2023 LTC Bulletin No. 93 (456.32 KB)

 

Visit the TMHP LTC homepage regularly for news, reminders, training opportunities and other important program updates.

For questions, see the LTC Provider Resources Guide.


See links to the 2022 editions below:


See link to August 2021 edition below:

The August 2021 Long-Term Care (LTC) Provider Bulletin has been published on the LTC homepage on TMHP.com.

Visit the TMHP LTC homepage regularly for news, reminders, training opportunities, and other important program updates.

For questions, see the Provider Resources section of the bulletin.


See link to February 2021 edition below:

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


See link to November 2020 edition below:

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

Guidance for HCS, HCSSA, ICF, and TxHmL Providers Related to Cooperation with HHSC Provider Investigations (PL 2023-11)

May 14th, 2023

 Guidance Related to Cooperation with HHSC Provider Investigations (PL 2023-11)

HHSC has published PL 2023-11 Cooperation with HHSC Provider Investigations (PDF). The letter reminds providers that they must cooperate with Health and Human Services Commission Provider Investigators who are conducting investigations of abuse, neglect, and exploitation.

Clarification on HCS and TxHmL IPCs status in “Pending DADS Review”

May 14th, 2023

Reminder

Last updated on 12/7/2022

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) billing on behalf of consumer-directed services (CDS) have been submitting forms and claims to the Texas Medicaid & Healthcare Partnership (TMHP). In response to questions and concerns related to the processing of Individual Plan of Care (IPC) forms, HHSC is clarifying required actions by submitters and how they parallel to processes in Intellectual Disability (ID) Client Assignment and Registration System (CARE).

Renewal and Revision IPCs

Renewal and Revision IPCs in either “Pending DADS Review” or “Pending Coach Review” require action from the submitter. This is typically the submission of supporting documentation. The IPC will not be reviewed until action is taken. This is the same process in place for “Exceeds” flags in ID-CARE.

A packet submitted to UR must include:

A packet may include, depending on the services requested:

  • Comprehensive Nursing Assessment (Form 8584 or a form with all of the same elements) for nursing hours
  • Occupational Therapy (OT) evaluation, treatment plan or assessment (include orders) for OT hours
  • Physical Therapy (PT) evaluation, treatment plan or assessment (include orders) for PT hours
  • Speech/Language Therapy evaluation, plan or assessment (include orders) for Speech hours
  • Dietary evaluation for Dietary hours (include orders)
  • Dental treatment plan, if applicable
  • Behavior Support Plan for Behavioral Support hours that meets HHSC criteria
  • PAS/HAB Assessment (form 8510) for PAS/HAB hours
  • Transportation Plan (form 3598) for Transportation hours
  • Audiology Treatment plan (and orders), if applicable
  • Cognitive Rehabilitation Therapy plan, if applicable (in HCS)
  • Support Consultation plan, if applicable (in HCS)
  • Social Work plan, if applicable (in HCS)
  • All documentation for Adaptive Aids, if requesting, including the following:
  • All documentation for Minor Home Modifications (3 bids based on the specs, specs from licensed professional recommendation), if requesting (please see Section 6200 of the HCS Billing Requirements).

 

Enrollment and Transfer IPCs

Enrollment and transfer IPCs remain in “Pending DADS Review while the enrollment or transfer is being processed.

Enrollment IPCs may require additional documentation to be submitted to Program Eligibility and Support (PES). If an enrollment requires additional documentation, PES will contact the LIDDA who submitted the enrollment IPC.

Transfer IPCs always require a “transfer packet” to be submitted to PES. If a transfer packet requires additional documentation, PES will contact the LIDDA who submitted the transfer IPC.

A “transfer packet” submitted to PES must include:

  • Request for Transfer of Waiver Program Services (form 3617)
  • HCS Only: Individual Plan of Care (IPC) – HCS/CFC (form 3608)
  • TxHmL Only: Individual Plan of Care – TxHmL/CFC (form 8582)

If an enrollment or transfer requires utilization review, Utilization Review (UR) will contact the LIDDA who submitted the enrollment or transfer packet.

 

Packet/Documentation Submission Details

The most efficient mode of submission for HCS/TxHmL documentation is through the IDD Operations Portal. To learn how to register and use the IDD Operations Portal or for answers to any questions, please visit https://hhs.texas.gov/doing-business-hhs/provider-portals/resources/idd-ops-portal or email IDD_Ops_Portal@hhsc.state.tx.us. Packets may also be submitted via fax at 512-438-4249.

 

Questions

For questions about review packets, submitters can contact HHSC UR department at 512-438-5055 or email deskURLONIPC@hhs.texas.gov.

For questions about enrollments or transfers, submitters can contact PES at 512-438-2484 or email enrollmenttransferdischargeinfo@hhs.texas.gov.

Upcoming Provider Webinar

HHSC will discuss this topic during the December 8th, 2022, TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar.

Please click on this link to register for this webinar.

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

Pay Increase For Community Attendants & Direct Care/Support Workers: 

May 13th, 2023

Community Attendants & Direct Care/Support Workers:

Direct care/support workers & community attendants are a huge part of the Medicaid long-term services and supports system. Without these persons working with our individuals, HCS, TxHmL, CLASS, ICF and other programs would not be able to provide services. The long-term services and supports system in Texas would simply not exist without a workforce of direct care/support workers. The Texas House and Senate have passed their budgets and are now in a conference committee to finalize the ‘Texas’ budget for the state fiscal year 2024 through 2025. (Prior to this meeting the Senate ad House have not been in agreement on how much the increase of funding will be)

The Senate version of the state budget raises attendant wages by almost 40 percent. And while it is still not the $17 per hour we were initially asking for, it would still be a large increase from what providers have at this time and it would really help with staff retention and attracting more DCS/DSW workers to these programs.  Numerous Texans with disabilities rely on direct care/support workers every day.  Without these workers, many of them could not remain in their community and might end up placed in more restrictive settings like institutions such as an SSLC (State Supported Living Center).

 

Please take time to call:

mySchedules Training Webinars & Other Resources From MITC

May 13th, 2023

“The labor shortage has made it more important than ever to manage available resources effectively. Allowing existing employees to view and request open shifts can be a big help to over-stressed managers.”

Our friends at MITC have asked us to share some information on one of their very important resources, scheduling software for your shift staff in group homes and employees in general.  Please check all their info below and feel free to go to their website for more info on their other products for IDD providers and service providers.  https://mitcagencies.com/

myScheduling is just one of the tools from MITC that might be helpful to both IDD  providers (i.e. HCS, TxHmL and ICF) as well as Day Hab/ ISS (Individualized Skills and Socialization) and Supported Employment Providers

Check out some of their previously recorded videos at the links below.

Make Scheduling Easier! Let Employees Request Extra Work 01/12/23

Scheduling for Group Homes and In-Home Programs 03/02/23

How a Provider with 2,000 Employees Deployed mySchedules 04/13/23

 

Download These Fact Sheets:

mySchedules

Integrating mySchedules with Kronos and Other Time and Attendance Systems

Client Scheduling

Integrating Maps and Mileage into Scheduling

Encouraging Employees to Request Extra Hours


UPCOMING EVENTS & WEBINARS


“MITC’s Staff and Client Solutions are designed specifically for providers serving the I/DD and behavioral health communities.
MITC’s solutions are perfect for agencies that manage group homes, HCBS, or day, vocational, and supported employment programs!  Because we’ve worked with thousands of agencies like yours, MITC delivers the most cost-effective solutions that lead to lower payroll costs, higher performance, and compliance with state and DOL regulations.”

 

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

May 13th, 2023

May 2023 MCS COVID-19 Stakeholder Information Session

Thank you for your interest in listening to the May 2023 Texas Medicaid CHIP COVID-19 Information Session.

The audio from this session can be found here.

The presentation can be found here.

This is the last scheduled stakeholder recording for COVID-19 updates.

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


January 12th, 2023

 January 12 Texas Medicaid CHIP COVID-19 Information Session.

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

 The audio from this session can be found here.

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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


December 1st, 2022

December 1 Texas Medicaid CHIP COVID-19 Information Session.

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

 

The audio from this session can be found here.

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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


November 8th, 2022

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

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

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

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

COVID-19 Provider Information

COVID-19 Client Information


Sept. 7th, 2022

 September 1 Texas Medicaid CHIP COVID-19 Information Session

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

The audio from this session can be found here.

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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


April 28th, 2022

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

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

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

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

Listen to the webinar recording here.

Email LTCR Policy for the transcrip


February 27th, 2022

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

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

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

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

Listen to the webinar recording.

Email LTCR Policy for the transcript.


February 1st, 2022

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

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

This includes strategies to rapidly identify COVID-19 and:

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

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

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


January 27th, 2022

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

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

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

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

Listen to the webinar recording here.

Read the webinar slide presentation (PDF).

Email LTCR Policy for the transcript.

EVV (Electronic Visit Verification) Updates

June 2nd, 2023

EVV Resources Updates

HHSC has updated three Electronic Visit Verification resources that are located on the EVV webpage:

  • EVV Training Requirements Checklists
  • Getting Started with EVV
  • Program and Service Requirements for Schedules

EVV Training Requirements Checklists

The EVV Required Training Checklists (PDF) is a resource for those required to use EVV due to all previous and upcoming EVV implementations (personal care services and home health care services). This resource was updated with the following:

  • Aligns with EVV Policy Handbook revisions
  • Lists training course names
  • Describes required trainings
  • Defines EVV Portal users, EVV system users and billing staff
  • Includes link to sign up for GovDelivery
  • Has interactive (fillable form) features to help document completed trainings

Getting Started with EVV

Getting Started with EVV is a guide that lists steps and resources to start using EVV. HHSC has created a single-page guide for each of the following stakeholders:

Program and Service Requirements for Schedules

The document, Program and Service Requirements for Schedules (PDF), is a resource that describes requirements related to using schedules in the EVV system. HHSC added managed care organization programs to the document.

Email EVV Operations for questions.


May 13th, 2023

Reminder:  EVV Claims Matching for HCS and TxHmL Will Begin for Dates of Service Starting May 1, 2023

This is a reminder that Electronic Visit Verification claims matching for Home and Community-based Services and Texas Home Living will begin on May 1, 2023. EVV claims with dates of service of May 1, 2023, and after that do not have an EVV visit match will deny.

For more information about billing updates for HCS and TxHmL, including resources to help avoid future payment denials or recoupments, reference the notice located on the EVV web page“EVV Claims Matching for HCS and TxHmL Will Begin for Dates of Service Starting May 1, 2023”.

Email EVV Operations for questions.


April 3rd, 2023

Session 4 ORR Schedules Added to TMHP EVV Proprietary Systems Web Page

HHSC created the Session 4 Operational Readiness Review, which is a special abbreviated Electronic Visit Verification Proprietary System Operator onboarding path that supports additional PSO ORRs. This additional path allows program providers and financial management services agencies to onboard with a previously approved proprietary system or a proprietary system that is participating in the Session 3 Standard Path ORR.

The Texas Medicaid and Healthcare Partnership has updated the EVV ORR section of the EVV Proprietary Systems web page to include ORR schedules, requirements and information about the Session 4 ORR.

Email the TMHP EVV PSO inbox for questions.


January 12th, 2023

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

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

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

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

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

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

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

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

IL-2023-03


January 2nd, 2023

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

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

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

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

HHSC will continue posting related updates.

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

For other EVV questions, email the EVV Operations inbox.

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


December 17th, 2022

EVV Training Updates

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

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

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

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

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

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

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

Email EVV Operations for questions.


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

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

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


EVV Guidance on Program and Service Requirements for Schedules

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

Email HHSC EVV Operations for questions.


December 1st, 2022

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

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

  • STAR+PLUS
  • STAR Kids
  • STAR Health

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

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


December 1st, 2022

HCS and TxHmL Updates

The effective dates were updated for HCS and TxHmL services.

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

For questions, email EVV Operations.


October 16th, 2022

Potential Electronic Visit Verification Changes Coming in 2023

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

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

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

Notification of contract award is anticipated in March 2023.

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

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

Email questions about this solicitation to Andrick Reese.


September 25th, 2022

EVV Updates for HCS and TxHmL Program Providers and FMSAs

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

HHSC Notice

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

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

TMHP Notice

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

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

Email EVV Operations for questions.


September 25th, 2022

EVV Claims Matching Refresher for HCS and TxHmL

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

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

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

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

Click here for more information


September 18th, 2022

EVV Compliance Job Aids Updated

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

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

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

August 31st, 2022

Annual EVV Policy Webinars for Program Providers & FMSAs

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

July 28th, 2022

EVV Portal and Training Updates

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

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

Email questions to TMHP.


July 5th, 2022

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

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

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

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

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

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

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

Email EVV Operations for questions.


July 1st, 2022

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

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

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

Email EVV Operations for questions.


June 12th, 2022

EVV Portal and Training Updates

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

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

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

Email questions to TMHP.


June 6th, 2022

EVV Policy Handbook Revision and Training Updates

The Electronic Visit Verification Policy Handbook has been revised.

Revisions include:

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

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

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

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

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

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

Email HHSC EVV Operations for questions about this notice.


May 30th, 2022

EVV Claims Matching for HCS and TxHmL Will Resume July 1

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

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

Email EVV Operations for questions about this notice.


May 8th, 2022

EVV Portal and Training Updates

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

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

Email TMHP EVV Operations with questions


March 7th, 2022

EVV Notice for HCS/TxHmL Program Providers

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

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

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

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

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

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

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


March 3rd, 2022

EVV Policy Handbook Revisions Now Available

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

The handbook includes EVV standards and policy requirements for:

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

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

Email HHSC EVV Operations with questions.


February 28th, 2022

EVV Portal and Training Updates

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

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

For questions, email TMHP EVV Operations.


January 8th, 2022

EVV Policy Handbook Revisions – Jan. 7th, 2022

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

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

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

For questions, email HHSC EVV Operations.


November 21st, 2021

EVV Portal and Training Updates for November 2021

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

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

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

Email TMHP with questions about these updates.


November 18th, 2021

Revised EVV Policy Handbook Now Available

The Electronic Visit Verification Policy Handbook was revised.

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

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

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

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

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

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

Email questions to HHSC EVV Operations.


November 17th, 2021

EVV Visit Maintenance Unlock Request Updates

HHSC published EVV Visit Maintenance Unlock Request spreadsheet updates.

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

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

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

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

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

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

    Review the instructions on the spreadsheets for more information.

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


July 4th, 2021

EVV Visit Maintenance Policy Now Available

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

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

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


July 4th, 2021

HHSC EVV Webpage Updates Now Available

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

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


July 3rd, 2021

Revised EVV Visit Transaction Rejection Guide Now Available

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

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

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

Email TMHP with questions.


April 17th, 2021

EVV Policy Training for CDS Employers Now Available in Spanish

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

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

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

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

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

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


March 16th, 2021

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

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

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

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

For questions, email HCS Policy or CDS.


March 10th, 2021

Temporary EVV Policies for the Feb. 2021 Severe Winter Weather

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

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

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

Email questions to the HHSC EVV Mailbox.


February 7th, 2021

EVV Refresher Training on Feb. 19

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

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

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

Certificates of completion will not be issued.

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

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

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

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

Email HHSC EVV for questions.


Reminder:  Entering Schedules for EVV-Required Services

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

EVV is only required for the following services:

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

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


January 24th, 2021

EVV Portal and Training Updates for January

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

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

Email TMHP with questions about these updates.


January 24th, 2021

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

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

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

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

Email questions about EVV policy to HHSC EVV.


January 18th, 2021

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

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

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

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

Next Steps

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

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


January 10th, 2021

Letter Notification Stock Illustrations – 8,275 Letter Notification Stock Illustrations, Vectors & Clipart - Dreamstime

EVV Notification Requirement for HCS/TxHmL Program Providers 

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

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

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

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


January 4th, 2021

Resources Stock Illustrations – 88,491 Resources Stock Illustrations, Vectors & Clipart - Dreamstime

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

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

December 20th, 2020

Cures Act EVV:

Preparing for Jan. 1, 2021 Implementation

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

Beginning Jan. 1, 2021:

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

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

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

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

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

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

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

Visit the HHS EVV website for more information.


November 28, 2020

HCS and TxHmL CARE Service Authorization instructions for EVV

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

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

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


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

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

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

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

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

Best Practices for Temporary EVV Policies for COVID-19

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

Contact your payer for questions or email HHSC EVV.

Visit the HHS EVV webpage.


HCS and TxHmL Program Providers Required to Select an EVV Vendor
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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

Termination of Waiver Services Due to Denial of Medicaid Eligibility

May 12th, 2023

Important Reminder:  Denial of Medicaid Eligibility

HHSC has published IL2023-16 Termination of Waiver Services Due to Denial of Medicaid Eligibility.

On Dec. 29, 2022, Congress passed the 2023 Consolidated Appropriations Act, which separated continuous Medicaid coverage requirement from the Public Health Emergency declaration. The requirement for states to maintain continuous Medicaid coverage ended as of March 31, 2023. States may begin disenrolling members effective Apr. 1, 2023.

HHSC must conduct a full redetermination and allow members 30 days to respond to renewal packets or requests for information. If an individual enrolled in a waiver program is no longer eligible for Medicaid, the individual’s waiver program services will also end. This IL also includes information on how to help individuals prevent the loss of waiver services and how to monitor loss of Medicaid eligibility.

If you have questions about the termination of Medicaid eligibility, please call 2-1-1 or email update@hhs.texas.gov.

If you have questions about the termination of an individual’s CLASS, HCS, or TxHmL services, please call the IDD Program Eligibility and Support message line at (512) 438-2484.

If you have questions about the termination of an individual’s DBMD program services, please call the IDD Utilization Review message line at (512) 438-4896.

Infection Control Resources (2023 Update)

May 2nd, 2023

Infection Control Resources from HHSC

Resources Created by HHSC

Center for Disease Control and Prevention (CDC)

 

Statewide Program for Infection Control & Epidemiology (SPICE)

 

World Health Organization

Agency For Healthcare Research & Quality

A Unit Guide To Infection Prevention for Long-Term Care Staff

National Association of County & City Health Officials  (NACCHO)

Infection Prevention and Control Resource Library  (Provides Best Practices, Tools, Teaching Materials, and specific information just for COVID-19)

Revision To Billing Requirements

May 1st, 2023

HHSC Publishes Revision 23-2 of the HCS and TxHmL Program Billing Requirements

Just an update, as of April 1st, 2023 Billing Requirements have been updated, if you missed the prior alert from HHSC.

Revision 23-2 is effective April 1, 2023. All revisions are outlined in the Revision 23-2 Section of each document.

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

Email questions to TxHmL Policy.


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.

Joint Training From HHSC For Providers

Texas Health and Human Services

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.


May 1st, 2023

May 2023 HCS/TxHmL Provider Training Opportunities

Hurricane and Flooding Readiness for ICFs
Wednesday, May 3
10 a.m.–noon
Register here for webinar.

Infection Control in LTC
Thursday, May 4
6 p.m.–8 p.m.
Register here for webinar.

Individualized Skills and Socialization Basic Program Overview
Monday, May 8
11 a.m.–noon
Register here for webinar.

Hurricane and Flooding Readiness for HCS and TxHmL Providers
Wednesday, May 10
10–11:30 a.m.
Register here for webinar.

Nursing Scope of Practice in Long-Term Care Communities
Thursday, May 18
10–11:30 a.m.
Register here for webinar.

Hurricane and Flooding Readiness for HCS and TxHmL Providers
Thursday, May 18
3–4:30 p.m.
Register here for webinar.

Individualized Skills and Socialization Basic Program Overview
Monday, May 22
11 a.m.–noon
Register here for webinar.

Hurricane and Flooding Readiness for ICFs
Wednesday, May 31
2–4 p.m.
Register here for webinar.

 

**Writing Acceptable Plans of Correction of HCS and TxHML (course description)Texas Department of Family and Protective Services

Tuesday, May 30, 20239:00 AM – 4:00 PM
2017 N Frazier, Suite C
Room:65
Conroe, TX 77301
(24 MAX)  (Live session)  Registration    

 


April 2023 HCS/TxHmL Provider Training Opportunities

Most Cited Deficiencies for HCS & TxHmL Providers
Wednesday, April 12
11:30 a.m.–12:30 p.m.
Register here for webinar

Individualized Skills and Socialization Basic Program Overview
Wednesday, April 12
4–5 p.m.
Register here for webinar

Writing Acceptable Plans of Correction of HCS and TxHmL
Thursday, April 20
9 a.m.–4 p.m.
Marshall, TX
Register here for in-person class

Individualized Skills and Socialization Program Basic Overview (1 hour) (course description)

Friday, April 28, 20233:00 PM – 4:00 PM

Register here for webinar

 


February 2023 HCS/TxHmL Provider Training Opportunities

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

Wednesday, February 8, 2023 11:30 AM – 12:30 PM

Register here for webinar

Administrative Penalties and Related Processes in HCS & TxHmL Settings (course description)

Tuesday, February 28, 20231:30 PM – 2:30 PM

Register here for webinar


Dec. 2022 HCS/TxHmL Provider Training Opportunities

Emergency Preparedness 101 for HCS and TxHmL Providers

Tuesday, Dec. 1311:30 a.m.–12:30 p.m.

Register here for webinar

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

Wednesday, Dec. 211–2 p.m.

Register here for webinar

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

9 a.m.–4 p.m.Nacogdoches, Texas

Register here for in-person class


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

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

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

Register for webinar

 

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

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

Register for webinar

 

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

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

Register for webinar

 

Emergency Preparedness 101 for HCS Program Providers (course description)

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

Register for webinar


July 2022 HCS/TxHmL Provider Training Opportunities

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

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

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

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

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

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

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

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

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


July 5th, 2022

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

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

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

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

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

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

May 1st, 2023

COVID-19 Update to Temporary Change to HCS and TxHmL Policy for Respite, CFC PAS/HAB Service Provider

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

This change has given greater access to needed services for people living in their own home or family’s home. A person’s spouse or the person’s parent, if the person is under 18, is not allowed to be a paid service provider of these services in accordance with the HCS, TxHmL and CFC Billing Requirements.

This temporary policy change is effective March 27, 2020, through Aug. 31, 2023. HHSC will provide guidance if anything changes.

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

  • The Texas Administrative Code, Title 26, Part 1, Chapter 263 and Chapter 262.
  • HCS and TxHmL Rules, Section 9.177 (n) and (o), and Section 9.579 (r) and (s).
  • The HCS Program Billing Requirements and the TxHmL Program Billing Requirements Section 3400 for service provider qualifications and the CFC Billing Requirements for HCS and TxHmL Program Providers.

 

October 4th, 2022

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

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

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

HHSC has published a revision to this guidance in IL 2022-51 In-Home Day Habilitation Information for Program Providers for COVID-19 (PDF). This replaces IL 2022-48.

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

Email questions to HCS Policy.


May 30, 2022

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

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

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

This temporary policy change is effective March 27, 2020 through October 31st, 2022, unless the COVID-19 public health emergency ends sooner. HHSC will provide guidance if anything changes. Program providers must complete the required background checks for all service providers. They must follow:


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.

ISS Program Basic Overview Webinar

April 27th, 2023

HHSC Long-term Care Regulation will be providing recurring one-hour webinars for Individualized Skills and Socialization providers. These webinars will cover the basics of a license application, and an overview of the survey process.

Additional topics will include reporting abuse, neglect, exploitation or incidents to HHSC. All sessions are duplicates and offer multiple opportunities to facilitate provider attendance.

Friday, April 28
3–4 p.m.
Click here to register.

Monday, May 8
11 a.m.–noon
Click here to register.

Monday, May 22
11 a.m.–noon
Click here to register.

 

In addition, see following webinar with handout

TMHP Portal Town Hall Webinars And FAQ’s

April 17th, 2023

HCS and TxHmL Town Hall Webinars and FAQs


May & June Save the Dates For Town Hall Webinar Meetings

The webinar 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.

May 2023

 

June 2023

Standing Meeting Agenda
  • Trending Issues — discuss trending issues and solutions to increase successful processing of forms.
  • Training and Information Sharing — provide relevant training and updates.
  • Questions and Answers — HCS/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.
Providers and FMSAs are encouraged to submit questions that they would like addressed during the webinar as part of the registration process.

 


April 14th, 2023

March Webinar 2023

February Webinar 2023

January Webinar 2023

To Read More….


January 16th, 2023

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

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

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

 


Other Important Contacts:

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

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


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

Program Eligibility and Support (PES)

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

Did You Miss The Last HCS & TxHmL Town Hall Meeting?

April 14th, 2023

April 12, 2023 town hall meeting

  • April topics included:
    • Using the Provider Location Update (PLU) Form for moves/updates
    • Entering Individualized Skills and Socialization in TMHP
    • Highlighting Individualized Skills and Socialization Available Resources
  • Questions and Answers – HCS/TxHmL Providers and FMSAs will have the opportunity to ask questions* regarding the LTC Online Portal for HCS and TxHmL.

You can register for the recorded session at: https://register.gotowebinar.com/register/91533672855255893

PDF handout


The next meeting is May 10, 2023.  We will keep you posted on registration for this webinar.

Next session they will discuss the “Enrollment Process” and Location Code Issues


 

Some highlights during the April 13th, 2023 Town Hall Session: 

Use the Frequently Asked Questions document:
Frequently Asked Questions Home and Community-based Services (HCS)
Texas Home Living (TxHmL) Waiver Programs

 

2022 Cost Reporting:

➢WHERE: 2022 Cost Report Units of Service Information for HCS and TxHmL Programs

➢HOW: 2022 Cost Report Units of Service Tool Information for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Programs

➢WHO: Contact PFD-LTSS@hhs.texas.gov or (737) 867-7817, if there are questions after reviewing the above notifications

▪Refer to the HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 19 notification for updates including avoiding overbilling for service components limited to 1 unit per day, valid IMT suspension reasons for temporary discharge and billable units on IPC form accommodation for leap year.

Accessing and Using Your Remittance and Status (R&S) Reports
Web R&S (Portal*) report remains available for 90 days after posting. After 90 days, reports are automatically removed from the website and are no longer available to the user.
ER&S report can be downloaded from the FTP server up to 30 days after the report is posted. Once downloaded, it is no longer available for other users. Previously downloaded reports can be recovered by calling the TMHP EDI Help Desk at 888-863-3638, option 4. Turnaround time is by two weeks. Providers can also contact the EDI Help Desk to get credentials to access the FTP server.

BEST PRACTICE: Download and reconcile R&S Reports on a weekly basis, as a claim is reported only once in the Non-Pending section of the R&S Report, after it is finalized.

 

Purpose of PLU Form  (Provider Location Update)

1)To Add location:•Used to create a location. •The address of the new location should not be the same as any existing location codes.  •Location codes must be unique.
2) To Update location: •Only the Location Type and Location effective date is updateable. •The effective date can be changed to a future date but not for today’s date.

3) To End location: •Used when the location does not have any residents and needs to be closed.  •Ensure all individuals have been assigned to a new location before ending a location. If a service location is ended by the provider, it cannot be reopened.  •The provider must add the ended location as a new location to reopen it.

 

 

Avoiding delays in billing when submitting forms for transferred clients

BEST PRACTICE: Review the data auto-populated on the subsequent form (especially the Program Provider section) to ensure that the correct provider is displayed.

 

Common Location Submission Issues

1. When creating a location, the wrong location effective date was entered on the form, and the form moved to ‘Processed/Complete’ status.
a)To correct this:
•Do not end that location and try to add it again.
•Instead, submit a new PLU with the action type ‘Update Location’ to change the effective date.

b)In the event you are still not able to change the effective date, then, you can reach out to UR if this was related to a renewal/ revision. Or reach out to PES if it was related to a transfer.

 

2. Handling PLU forms that are in ‘Pending Dads Review’ status. •Just like any other forms in this status, HHSC will need additional documentation.

For PLU, supplemental documentation must be submitted by email to Survey Operations at HCSFourPersonResidenceRequests@hhs.Texas.gov

 

3. Location Capacity issues with submitted forms:

•Best practice is to check the location Capacity.
•To look for the location capacity information you will use CARE Screen C84 to get the general information.

•This will prevent the forms from being stuck for a long time till the verification is complete.

ISS Info

For information on Provider Training, Webinars, Resources, and more
see:
Texas Health and Human Services Individualized Skills and Socialization website

•Send HCS/TxHmL/DBMD Policy Individualized Skills and Socialization
Questions to: HCSPolicy@hhs.Texas.gov , TxHmLPolicy@hhs.Texas.gov ,or DBMDPolicy@hhs.Texas.gov

•Send Licensure Policy and Rules Questions to:
LTCRPolicy@hhs.Texas.gov

 

Things to know before billing ISS:
1) You will be authorized for 1,560 hours (max) during an IPC year.
2) Can only bill up to six hours per calendar day.
3) Can only bill five days per calendar day (Although you can trade out weekend days for equal amount of weekdays, i.e. Mon, Tues, Weds. Sat and Sun.)
4) Cannot date span on claims.
5) Must use HCPCS code H2014 and bill per hour.
6) Use the bill code crosswalk to see the codes and modifiers needed for the particular Individualized Skills and Socialization service.
7) Rate information can be found at this website Long term Services & Supports |Provider Finance Department (texas.gov)   Select the appropriate Service from the left side menu.

 

 

ISS Units

•Individual Skills and Socialization is an hourly unit, max 1560

•260 DH days= 1560 ISS hrs

•1560 (max) covers the extra day for Leap Year

 

 

As of January 1, 2023, you will automatically get Individualized Skills and Socialization
authorization if you were already getting day habilitation authorization.
•This information can be verified on the MESAV.
•These units for individualized skills and socialization will not be visible on the current
IPC form nor on the dashboard until a revision or renewal IPC is entered.

Any new IPC forms submitted with the effective date on or after 3-1-2023, will have the Individualized Skills and Socialization service (23 or 23V) and not Day Hab (10C) service in the drop-down list.
•If submitting an IPC transfer which has Day Hab and the effective date is on or after 3-1-2023,

You will first need to submit a Revision IPC to end Day Hab.) Once the revision is in a ‘Processed/Complete’ status, then the Transfer IPC can be submitted.

 

Tips for data entry

•Editing an auto-authorization on a revision
•Select Revise IPC
•On Prov/Ind tab, select – begin date, end date, residential type and implementation dates in the drop-down menus

•Make changes on IPC/Cost tab

 

Prorating

•Determine how many days have already been used for dayhab
Subtract that from 260 (or the number of days requested for dayhab)
260 –55 (days utilized) = 205
•Multiply remaining days by 6 to determine how many hours needed of Individual Skills and Socialization

205 X 6 = 1230

TMHP Training Resources For HCS/TxHmL Providers (Videos, FAQ’s, Quick Check Guides, CBT training)

April 11th, 2023

**Please also check the HCS/TxHmL joint training website from HHSC, for periodic related webinars. 

Training Resources

(Videos, FAQ’s, Quick Check Guides, CBT training)

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

Suggested training resources include:

For more information, email tmhptrainingsupport@tmhp.com

HCS/TxHmL Resources: ISS Provider in San Antonio

March 30th, 2023

I wanted to share the website for one of the ISS providers in the San Antonio area as they do also offer competitive employment for individuals and have employment assistance (EA) and supported employment (SE). Hope this is a good resource from some HCS/TxHmL providers in their area.

https://www.texasfoundationofhope.org/

 

 2845 Thousand Oaks Dr.

San Antonio, TX 78232

(210) 265-3351

txfoundationofhope@gmail.com

Office Hours:

Monday – Friday  9:00 AM to 5:00 PM

HCS TAC 9.174 (23) Service Delivery: On-Site Residential Expectations Including Hot Water Temps & Locks On Bedroom Doors

March 30th, 2023

Review of this important section in 9.174 Service Delivery

9.174  (23)  (concerning HH/CC, RSS, SL on-site expectations including locks on bedrooms and hot water temps in the home)

(23) ensure that, for an individual receiving host home/companion care, residential support, or supervised living:

 

(A) the individual lives in a home that is a typical residence within the community;

 

(B) the residence, neighborhood, and community meet the needs and choices of the individual and provide an environment that ensures the health, safety, comfort, and welfare of the individual;

 

  (C) there is a sufficient supply of hot water at sinks and in bathing facilities to meet the needs of individuals;

 

    (D) the temperature of the hot water at sinks and bathing facilities does not exceed 120 degrees Fahrenheit unless the program provider, in accordance with subsection (i) of this section, conducts a competency-based skills assessment evidencing that all individuals in the residence can independently regulate the temperature of the hot water from the sinks and bathing facilities;  (see hot water assessment form from HHSC)

 

(E) unless contraindications are documented with justification by the service planning team, the individual lives near family and friends and needed or desired community resources consistent with the individual’s choice, if possible;

 

(F) the individual or LAR is involved in planning the individual’s residential relocation, except in the case of an emergency;

 

(G) unless contraindications are documented with justification by the service planning team, the individual has a door lock on the inside of the individual’s bedroom door, if requested by the individual or LAR; and

 

(H) the door lock installed in accordance with subparagraph (G) of this paragraph:

 

(i) is a single-action lock;

 

      (ii) can be unlocked with a key from the outside of the door by the program provider; and

 

      (iii) is not purchased and installed at the individual’s or LAR’s expense;

ISS Service Delivery Logs -Update

March 30th, 2023

Service Delivery Logs for Individualized Skills and Socialization

As of March 14th, 2023, information from the HHSC ISS SDL website page:

ISS SDL Logs

Form 8615, On-site and Off-site Individualized Skills and Socialization Service Delivery Log, and Form 8616, In-Home Individualized Skills and Socialization Service Delivery Log, are no longer mandatory to document a service claim of on-site, off-site, or in-home individualized skills and socialization.

A program provider may develop their own service delivery logs or use an electronic health record system to document individualized skills and socialization. All elements from Form 8615 and Form 8616 must be included in any documentation developed.

For each service event the service delivery log must include the following elements:

  • Individual’s name
  • Name of the individualized skills and socialization provider
  • Individualized skills and socialization Provider License Number
  • Date of service
  • Time in and time out for each service event
  • Location
  • Description of billable activities
  • Name and signature of service provider

For off-site service delivery logs, in addition to the information above for each service event, the elements that must be documented include:

  • Individual’s level of need (LON)
  • Ratio or approved enhanced staff rate
  • Number of individuals being served by the service provider during the service event
  • Name and address of community location(s) visited during the off-site service event
  • Name and signature of the service provider

For in-home service delivery logs, in addition to the information for each service event, the elements that must be documented include:

  • Staff ID as assigned by the program provider (meaning the HCS/TxHmL program provider)

HHSC will update Form 8615 and Form 8616 to provide Spanish-language versions. Any submission of forms containing information that is not in English will need to comply with 26 TAC §263.7.

For providers who use Form 8615 and Form 8616, HHSC has provided clarification below:

Form 8616 and Form 8615 are only required to document service events for individuals in the HCS and TxHmL Programs. (Does not include DBMD program)

In the off-site section of the form:

  • “Ratio” refers to the ratio for the individual as required by 26 TAC §263.2017 (HCS) or 26 TAC §262.917 (TxHmL).
  • “Staff” would equal one.
  • “Individuals” refers to the total number of individuals or other persons receiving services assigned to a service provider during a service event. This does not include any identifying information. *Persons outside of the HCS and TxHmL Programs, receiving a similar service, must be included in the number of individuals for the delivery of off-site individualized skills and socialization.

Form 8615 and Form 8616 were developed to document a service event for on-site, off-site, or in-home individualized skills and socialization. Program providers may request additional information or documentation from an individualized skills and socialization provider to obtain updates on the progress or lack of progress towards an individual’s goals.

The days of the week included on Form 8615 and Form 8616 may be altered if an individual receives individualized skills and socialization on a Sunday or Saturday. The program provider must ensure that an individual does not exceed the service limit of five days per calendar week (Sunday–Saturday).

Each service event must have an exact time in and time out and all documented elements. The total amount of time providing the service each day cannot be combined into one service event for that date.

If a program provider chooses to complete Form 8615 or Form 8616 electronically, it must be in compliance with 40 TAC §49.305(j) related to a contractor using electronic records.

For questions about this alert or the service delivery logs for individualized skills and socialization, email HCSPolicy@hhs.texas.gov.


March 1st, 2023

 

ISS Service Delivery Logs (SDL’s) & Electronic Health Record (EHR) systems

Do providers have to use HHSC Forms 8615 and 8616 – ISS Service Delivery Logs for On-Site and Off-Site ISS and In-Home ISS? 
Can they use their own forms or EHR systems?
HHSC Response:  HCS Policy is working to develop clarification on the service delivery logs forms. Further communication will be provided and the HCS Billing Requirements will be updated to reflect that a program provider may use the forms provided by HHSC or they may use their own forms or EHR systems that include all required elements.

February 21st, 2023

 

Service Delivery Logs Finally Available for Individualized Socialization Skills Services

**Please Note:  In viewing please know that the logs only include Monday – Friday.  According to HHSC the form will not be changed, rather one can just scratch out one of the days listed and write Saturday or Sunday on it.  Also, the form to document On- and Off-site ISS does not provide instructions on what to enter into the fields labeled “Staff’ and Ratio”.
External workgroup members commented that many providers use Electronic Health Records (EHRs), thus asking if HHSC would remove the requirement that the provider must use the ISS service log created by HHSC.  HHSC has so far stated that they will consider and get back about this issue.  For now you may have to upload completed forms to your EHR system if possible for billing purposes.  Some EHR systems are creating the same form I believe in their program.
If you are having problems with how to fill out the forms, please scroll down the same page you find the link to click on to open the original document.  Here are the instructions for the 8615 form
INSTRUCTIONS:  Updated: 2/2023
Purpose
Form 8615 is used by Texas Health and Human Services Commission (HHSC) staff, as well as Home and Community-based Services (HCS) and Texas Home Living Service (TxHmL) Waiver program providers to document a service event for on-site and off-site individualized skills and socialization.
Procedure
When to Prepare
Form 8615 must be completed within 14 calendar days after the activity being documented is provided.
Form Retention
The program provider must maintain a copy of the completed Form 8615 in the individual’s record.
General Instructions
  • Form 8615 must be used for only one individual.
  • Form 8615 may be used for multiple billable service events. Each billable service event must have a begin and end time.
  • Form 8615 is considered a Medicaid document used for Medicaid purposes. By using this form, you understand it is your responsibility to record accurate information, as this information may be subject to a court of law. Failure to record accurate information or deliberate falsification of documentation is strictly prohibited.
Detailed Instructions
Individual Name — Enter the individual’s name.
Place of Service(s) — Enter the address at which the billable activity occurred.
Level of Need — Enter the individual’s level of need.
Name of Individualized Skills and Socialization Provider — Enter the name of the entity.
Individualized Skills and Socialization Provider License Number — Enter the license number of the individualized skills and socialization provider.
Date and Days of the Week — Enter the date (month, day, year) when the billable activity occurred.
Time In — Enter the time when the billable activity started.
Time Out — Enter the time when the billable activity ended.
Name of Service Provider — The printed name of the service provider who provided the service event for on-site or off-site individualized skills and socialization.
Service Provider Signature — At least one service provider who provided the service event for on-site or off-site individualized skills and socialization must sign the form. If more than two service events occur in a calendar day, the service provider must complete a new Form 8615.
Initial all areas in which you assisted the person — Initial the box that corresponds to activities provided by the service provider. The services initialed must justify amount of time spent providing services. A minimum of one activity must be marked for a billable service claim to have occurred.
Community Locations Visited and Special Events or Occurrences — This field is required to identify the location(s) for off-site individualized skills and socialization and may be used to document special events or occurrences. If providing written documentation, enter the date on which the billable activity occurred and the staff initials.
Initials — Enter the initials of the service provider(s) providing billable activities to the individual.
Questions
To inquire about Form 8615 or instructions, email hcspolicy@hhs.texas.gov.

TMHP: Where Do HCS/TxHmL Providers Go To Find The Information To Complete Their Cost Reports For 2022?

March 30th, 2023
Update

HHSC’s Response to Some Of The Questions Concerning Cost Reports for 2022:

 The HCS/TxHmL Units of Service Look-up tool was created at the providers’ request to assist them in completing the 2022 cost report.  Providers have questioned whether it captures all that is needed for the cost report and if HHSC is responsible for ensuring there is an appropriate report page for providers to collect this information in TMHP and/or Texas Med Connect.

HHSC has stated that Providers may rely on their own billing records to complete their required reports in accordance with the Title 1 of the Texas Administrative Code (1 TAC) and cost report instructions, etc.  The provider must certify that the information included in the cost report is accurate. As a reference, 1 TAC Section 355.102(c) states:

Accurate cost reporting is the responsibility of the contracted provider. The contracted provider is responsible for including in the cost report all costs incurred, based on an accrual method of accounting, which are reasonable and necessary, in accordance with allowable and unallowable cost guidelines in this section and in §355.103 of this title, revenue reporting guidelines in §355.104 of this title (relating to Revenues), cost report instructions, and applicable program rules. Reporting all allowable costs on the cost report is the responsibility of the contracted provider. The Texas Health and Human Services Commission (HHSC) is not responsible for the contracted provider’s failure to report allowable costs; however, in an effort to collect reliable, accurate, and verifiable financial and statistical data, HHSC is responsible for providing cost report training, general and/or specific cost report instructions, and technical assistance to providers. Furthermore, if unreported and/or understated allowable costs are discovered during the course of an audit desk review or field audit, those allowable costs will be included on the cost report or brought to the attention of the provider to correct by submitting an amended cost report.

Regarding concerns about the data provided in HHSC’s units of service look-up tool, information letter 2023-12 clarifies:

HHSC will be updating the record of paid units of service before beginning the financial examination of the 2022 cost reports. This timing will allow cost reports to be revised based on any paid claims adjudicated after the 2022 cost report was submitted. HHSC PFD’s Cost Report Review Unit (CRRU) financial examiners will work individually with the provider and cost report preparer if there are material variances between the units reported and the updated paid claims data.

Regarding concerns about the unit totals and not reflecting units that have not been paid, information letter 2023-12 clarifies:

Providers must report, on an accrual basis, paid units of service delivered during their 2022 cost reporting period in Step 5 on the cost report. Providers should report units of service for each waiver service by the level of need delivered during their cost reporting period and paid by the time the cost report is submitted. Any units of service delivered during the cost reporting period, but not paid by the time the cost report is submitted, should be reported as a non-reimbursed unit. HCS and TxHmL providers should report all allowable costs incurred during their cost reporting period for paid and non-reimbursed units of service.

Regarding concerns about additional training or a webinar:

HHSC is incorporating training related to accessing and using the units of service look-up tool in upcoming cost report trainings and is working on publishing recorded instructions to assist providers with using the tool. A Gov Delivery will be published when this information is made available.

HHSC encourages any provider who has questions about the tool to contact HHSC Provider Finance at PFD-LTSS@hhs.texas.gov for assistance.

 

Regarding requests for cost report extension:

HHSC is not granting cost report extension at this time outside of the 15-day extension established in accordance with 1 TAC Section 355.111.

 


March 21st, 2023
2022 Cost Report Units of Services for HCS and TxHmL
HCS and TxHmL providers have not had access to all the necessary information they need to complete their cost reports; i.e., information providers reported was previously available prior to the migration of CARE to TMHP. (Much of it on screen C72)  Here is a lookup tool referenced in the notice and IL 2023-12 from HHSC. If providers do not find this notice helpful or if they need additional information to assist in completing 2022 cost reports, please let your provider associations know or send us an email and I can try to pass it along.

Remember providers to submit 2022 cost reports prior to May 1st, 2023. Cost reports are due April 30, 2023.

 The lookup tool will include any units paid through the Client Assignment and Registration (CARE) and Texas Medicaid & Healthcare Partnership (TMHP) claims systems during the cost reporting period.

Please refer to Information Letter 2023-12 for more information on how to obtain the lookup tool and report units of service on the 2022 cost report.

Please refer to our Cost Reporting Training webpage for the 2022 Cost Report Unit of Service (UOS) Tool Webinar demonstration on how to obtain the lookup tool and report units of service on the 2022 cost report.

If you have questions after reviewing the Information Letter, please contact PFD-LTSS@hhs.texas.gov or  (737) 867-7817.

 Heightened Scrutiny: Process For ISS

March 29th, 2023

 Heightened Scrutiny Process For ISS (Individualized Skills and Socialization)

Individualized skills and socialization has replaced day habilitation in these programs: HCS, TxHmL & DBMD. Individualized skills and socialization will include an on-site component and an off-site component.

The heightened scrutiny process will be required if a setting in which on-site individualized skills and socialization is provided:

(1) is located in a building in which a state supported living center or a certified intermediate care facility for individuals with an intellectual disability or related conditions (ICF/IID) operated by a LIDDA is located but is distinct from the state supported living center or the certified ICF/IID operated by a LIDDA;

(2) is located in a building that is on the grounds of or immediately adjacent to a state supported living center or a certified ICF/IID operated by a LIDDA;

(3) is located in a building in which a licensed private ICF/IID, a hospital, a nursing facility, or other institution is located but is distinct from the ICF/IID, hospital, nursing facility, or other institution;

(4) is located in a building that is on the grounds of or immediately adjacent to a hospital, a nursing facility, or other institution except for a licensed private ICF/IID; or

(5) has the effect of isolating individuals from the broader community of persons not receiving Medicaid HCBS.

If heightened scrutiny is required, a provider must complete the heightened scrutiny process and receive written approval from HHSC before submitting an application to become licensed as a day activity and health services facility with a special designation for individualized skills and socialization.

Read more about the heightened scrutiny process for individualized skills and socialization in Information Letter 22-53, Requirements for Providers Seeking to Deliver New Individualized Skills and Socialization Services (PDF).

Questions

If you have questions about the heightened scrutiny process or whether it applies to you, email MCS_Heightened_Scrutiny_Review@hhs.texas.gov.

ISS Updates & New Rules (HCS/TxHmL)

March 28th, 2023

Host Home Companion Care Providers Concerning ISS & PHE Flexibilities For In-Home ISS

Clarification Concerning Information Letter No. 2023-10 (Replaces IL 2023-06) from February 2023
In-Home Individualized Skills and Socialization Information for Program Providers for COVID-19 PHE

In response to COVID-19 and to provide access to day habilitation services, the Health and Human Services Commission (HHSC) temporarily waived certain requirements in Sections 3710, 4381.3, 4381.7(6) and 4381.7(7) of the HCS Billing Requirements and the TxHmL Billing Requirements. Until the end of the COVID-19 PHE, this flexibility will continue as part of in-home individualized skills and socialization.

Effective May 12, 2023, these flexibilities will no longer be in effect:

The flexibility has allowed HCS and TxHmL program providers to provide in-home individualized skills and socialization to an individual in the individual’s residence, including those residing in their own homes or family homes, without having the required justification outlined below. Program providers and LIDDAs need to have transition plans ready for individuals who receive in-home individualized skills and socialization prior to this end date (before May 12th, 2023).

Beginning May 12th, 2023:

in order to receive in-home individualized skills and socialization, individuals must meet all requirements outlined in the HCS and TxHmL Program Rules, the HCS Billing Requirements, and the TxHmL Billing Requirements, which include:
• A physician has documented that the individual’s medical condition justifies the provision of in-home individualized skills and socialization; or
A licensed professional or behavioral support service provider has documented that the individual’s behavioral issues justify the provision of in-home individualized skills and socialization; or
• The individual is 55 years of age or older and requests to receive in-home individualized skills and socialization.
In addition, after May 11, 2023, a service provider of host home/companion care will not be permitted to provide in-home individualized skills and socialization to the individual to whom they provide host home/companion care services.

Clarification & Answer to Question From Some of Our Readers: 

This letter indicates that HHSC does not appear to prevent a host home provider from becoming an ISS provider, nor does it prevent that licensed ISS provider from providing on-site and/or off-site services to their own individuals living with them.  In other words, it would appear they can be a HH/CC provider and licensed ISS provider at the same time and they can provide ISS services to their own individuals they are serving as HH/CC providers.   They can not provide their own in-home ISS (anymore) as an HH/CC provider as of May 12th, 2023.  The only ISS they can provide after May 11th, is if they are a licensed on-site and/or off-site provider.


March 1st, 2023

Reminder Must Be Licensed As ISS Provider To Bill As Of March 1st, 2023

For HCS/TxHmL Providers, you can’t bill for On-site &/or Off-site ISS as of today March 1st, 2023, if you send someone to an ISS location or have staff providing Off-site services (previously Community DH), if they are not listed as a licensed ISS program. 

The directories may be accessed at:  https://www.hhs.texas.gov/providers/long-term-care-providers/day-activity-health-services-dahs  to find out if the ISS program is licensed.

**You can bill for In-Home ISS as persons providing In-Home ISS do not have to be licensed!  No justification is needed for In-Home through May 11th, 2023 I believe. I believe HH/CC providers can still provide In-Home (This was part of the PHE exception prior to March 1st) up through May 11th, 2023, but I am still unclear and will inquire and update everyone when I get some kind of definitive answer.

Previous DH providers & New ISS Provider applicants: If you do not have a temporary ISS license by March 1, 2023, you may not provide or bill HCS, TxHmL, or DBMD providers for on- and off-site ISS services until the temporary license is received.  HCS/TxHmL, DBMD Providers who have individuals attending an ISS program may not send persons to the program until they confirm that the operator of the program has received the license.  There are no exceptions.


February 21st, 2023

More ISS Training

In addition to the training sessions occurring in various locations across the state, HHSC will conduct a training on ISS in Austin on April 3, 2023.
Registration information should be posted on or before March 13th, 2023.

 Very Important:  Surveys of ISS Providers With Temporary Licenses

In case this information was overlooked by new ISS providers:

  • Once HHSC issues a temporary license, HHSC may conduct a survey at any time.
  • HHSC may conduct a survey of any licensed Individualized Skills and Socialization Providers prior to March 1, 2023.
    • i.e. if HHSC issues a temporary license on Feb. 21, 2023, HHSC may conduct an initial survey on Feb. 27, 2023.
  • HHSC conducts unannounced surveys of ISS Providers.
  • For on-site ISS providers, the address on the license must match the address for service provision.
  • ISS providers must allow HHSC surveyors access to the on-site location and off-site activity locations.

Please refer to Texas Administrative Code Title 26, Chapter 559 for more info on the LTCR survey process.


February 10th, 2023

How Do I Find A Licensed ISS Provider?

HHSC has now posted directories on the DAHS webpage to help people find a licensed ISS Provider.

The directories may be accessed at:  https://www.hhs.texas.gov/providers/long-term-care-providers/day-activity-health-services-dahs

 

Please note the following:

  • There are 2 directories:  DAHS with ISS and DAHS-ISS Only.
  • The DAHS with ISS Directory is intended to reflect entities licensed as just a DAHS, and entities licensed as DAHS with ISS.
    • At this time, this particular directory lists all entities as just having a DAHS license. This is because the commission has yet to approve any DAHS with ISS licenses.  The process for approving a DAHS with ISS application takes longer than that of a provider applying as an ISS-only entity.  According to HHSC, the entity must undergo an LSC and Health survey before a license is issued to a DAHS with ISS entity.  Once these have been approved, they will be listed in this directory as DAHS with ISS.
  • Entities listed in the DAHS – ISS Only Directory, currently reflect a 6-month license.  This is because these licenses are considered ‘temporary’ at this time. Once the health survey is conducted the entities will receive a one, two or three-year license

February 5th, 2023

HHSC LTCR Updates the ISS FAQ’s

HHSC Long-term Care Regulation updated the Individualized Skills and Socialization frequently asked questions document on Feb. 01, 2023.

Read the FAQ here.


January 27th, 2023

FYI- somehow I missed this alert back in November for Licensed ISS providers.  Please be sure to log in and set up your account.

PL 22-32 letter issued 11/28/22 to ISS providers that was sent out concerning Blackboard Connect Emergency System

The purpose of this letter was to inform providers of the emergency communication system called Blackboard Connect, how it will be used, and your responsibility in signing up for the system if you are an ISS provider. This system will be used to send emergency and outreach notifications through email, phone, voice and text if available.

The rules require program providers to assign a designee to enroll in and respond to requests through the system. The designee should be someone who is associated with the licensed building or someone who is responsible for communicating emergency communications. However, you may also have other designees, such as corporate headquarters staff, sign up.

Blackboard Connect sign-up process:

Go to this link and click “Sign Me Up!”

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

Rember, this also applies to HCS, TxHmL and ICF providers among other services.


January 16th, 2023

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

ISS FAQs and Upcoming Webinars:

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

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


January 12th, 2023

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

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

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

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

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

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

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

IL-2023-03


January 3rd, 2023

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

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

HHSC Bulletin:

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

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

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

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

Read PL 2023-01.


December 23rd, 2022

NEW RULES FOR ISS & ISS LICENSE

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

December 18th, 2022

HHSC Adds Individualized Skills and Socialization to Email and Text Updates

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

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

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


November 28th, 2022

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

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

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

Register for the webinar: Licensing Process Webinar


November 19th, 2022

DAHS ISS Licensing Application Available!

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

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

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

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


October 13th, 2022

Licensing Application Process For ISS:  

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

October 2nd, 2022

Register for Individualized Skills and Socialization Provider Portal Trainings

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

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

Email questions to LTCR Policy.


September 24th, 2022

HHSC Moved The Individualized Skills and Socialization Webpage

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

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


August 23rd, 2022

No Public Hearing on ISS Licensing Rules

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

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


Public Hearing on ISS Program Rules

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

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


August 13th, 2022

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

August 8th, 2022
ISS Resources page

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

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

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

Provider Communications


August 6th, 2022

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

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

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

Info Concerning Medicaid HCBS Settings Compliance Requirements Including CMS Toolkit

March 26th, 2023

HHSC published PL 2023-06 Compliance with New HCBS Settings Rules

HHSC Long-term Care Regulation published Provider Letter 2023-06 regarding Compliance with New HCBS Settings Rules on March 24, 2023. This letter explains how LTCR surveyors will assess HCS providers for compliance with the new HCBS settings requirements.


March 15th, 2023

The Center for Medicaid and CHIP Services (CMCS) is sharing this toolkit with State Medicaid Agencies, Operating Agencies, and other stakeholders a Home and Community-Based Settings Toolkit to assist states to develop Home and Community-Based 1915(c) waiver and 1915(i) SPA amendment or renewal application(s) to comply with new requirements.

Texas State Transition Plan for CMS’s HCBS Compliance Requirements (2022 update)

These requirements were noted in the recently published Home and Community-Based Settings (HCBS) regulations.  HHSC is amending TAC rules to add requirements for all settings in the HCS program, including 3-person and 4-person group homes and host home/companion care settings, to comply with HCBS settings requirements at 42 CFR §441.301(c)(4)(i)-(v).

These new HCS rules have been added as TAC Title 26, Part 1, Chapter 263.

Texas Home Living HCBS regulations for compliance requirements is the following TAC title 26 part I Chapter 262

I would pay attention, in particular to the following information in the toolkit:  Info on residential & non-residential settings, Q&A for HCBS, Transition Plan toolkit, and the info on Heightened Scrutiny and the Review process for it, as well as person-centered requirements.  

Handy Dandy List of Items In The Toolkit:

REQUEST TECHNICAL ASSISTANCE WITH HCBS SETTINGS CRITERIA

Bills Submitted During Texas’s 88th Legislative Session

March 20th, 2023

​88th Legislative Session in Texas!

Here Are A Few House Bills Submitted That May Affect Long-Term Care & Other Services For Persons With Disabilities

  • HB 54: Personal needs allowance for certain Medicaid recipients who are residents of long-term care facilities.

  • HB 144: Possible Exemption from ad valorem taxation of the total appraised value of the residence homestead of an unpaid caregiver of an individual.

  • HB 166: The appointment of an educational representative for certain students with disabilities.

  • HB 245: Community attendants under the community attendant services program.

  • HB 568: Education and training for peace officers on interacting with persons with Alzheimer’s disease and other dementias.

  • HB 653: Guardianships of the person of wards with profound intellectual disabilities who are minors or were minors when their guardianship proceedings commenced.

  • HB 1430: Establishing a minimum wage for certain personal attendants under Medicaid and other programs administered by HHSC  (One can only hope this means an increase in funding for wages!)

  • HB 1593: Infection prevention and control programs and other measures for communicable diseases at certain long-term care facilities.

 

See more info on House Bills and Senate Bills in the PDF links below.

Feb 2023 HB’s

Feb 2023 SB’s

March 2023 HB’s

March 2023 SB’s 

*Note:  Each bill provides a link to the text of the bill.  After clicking on the link, click on ‘text’.  Under ‘Text’ you will find the bill as filed and various versions of the bill as it makes its way through the committee process and moves from one chamber to the other. Bills highlighted in yellow are deemed ‘priority’ bills. 

1-Day Live Training- Austin, Tx- Introduction To ISS (Individualized Skills & Socialization) April 3rd, 2023

March 19th, 2023

Individualized Skills and Socialization Joint Training Opportunities

For:  Applicants For ISS Licensure and New ISS Providers

HHSC Joint Provider Trainings will host a 1-day live training (Austin, Tx) that will cover the licensing process for the Individualized Skills and Socialization Program, as well as an overview of the rules, survey process, and reporting requirements for allegations of abuse, neglect, and exploitation.

Introduction to Individualized Skills and Socialization Program (course description)

Monday, April 3, 2023
8:30 AM – 5:00 PM
John H. Winters Building
701 W. 51st Street
Room: Public Hearing Room
Austin, TX 78751
(150 MAX)

1915(c) Waiver Interest Lists: Find By Legislative Districts

March 5th, 2023

Thanks to our friends at ARC for posting this in one of their recent newsletters

1915(c) Waiver Interest Lists by Legislative District

Find below maps produced by The Arc of Texas showing how many Texans on Medicaid waiver interest lists live within each State House, State Senate, and Congressional district. The Medicaid waivers being tracked are all CLASS, DBMD, HVC, MDCP, STAR+ PLUS, and TXHML.

The darker the hue of the district, the more people there are on any interest list in that district.

Each district’s label indicated the current incumbent in that district.

Clicking on each district with show more detailed information.

Letter IL 2023-09: Host Home Provider’s Who Are Immediate Family Members & New CMS Rules For HCS

February 27th, 2023

Letter IL 2023-09 discusses that Sections 263.502 and 263.503 (a)(1)(A) and (b) through (m) of the new Chapter 263 CMS rules do not apply to HH/CC providers in which the HH/CC provider is an immediate family member of the person receiving HH services.  See page 1, 2nd paragraph of the IL for the definition of an immediate family member.  Sections 263.502 and 23.503 (a)(1)(A) and (b) through (m) will however, apply if a HH/CC provider does not meet the definition of an immediate family member

Under Chapter 263, Subchapter F related to Provider Owned or Controlled Residential Settings, in particular Sections 263.501, 263.510 and 263.503.  The rules under these sections address the following:  requirements related to HCBS settings (Section 263.501); requirements as to what providers must ensure in the delivery of services, such as privacy in bedrooms, an operable bedroom door lock, access to food, choice of roommates, etc. (Section 263.502); and requirements related to residential lease agreements (Section 263.503).

Providers must follow the instructions on page 2 of the letter related to obtaining written documentation of all HH/CC settings in which the HH/CC service provider is an immediate family member of persons receiving HH/CC services. Providers and LIDDAs Need to Document Immediate Family Member.   This must be done within 60 days of the date of the IL and signed by the program provider, HH/CC service provider and the individual or LARThe signed document must be sent to the LIDDA SC to be added as an addendum to the PDP.
Upon receipt of the signed document, the LIDDA SC must complete Form 8665-ID to document whether the HH/CC is an immediate family member and to specify the relationship between the HH/CC service provider and the individual.

Do You Know How Millin Billing Pro Can Help Providers With TMHP Billing & EVV? Check Out These Videos

February 23rd, 2023

millin logo animated 1x

Check Out This Info From Milling Billing Pro.

See the following Vimeo Videos.  If you need billing software or billing services for TMHP and EVV this may be a great option for Texas HCS & TxHmL providers.  They are also ready for the change over to ISS (Individualized Socialization Skills) when March 1st, 2023 comes around.  To request a demo from Millin Billing please go to  Request A Demo

Remember to tell them how you heard about Millin Billing Pro (Twogether Consulting) for a discounted rate.

Millin Billing Pro Video

 

Management System video from Millin Billing

HCBS Settings Rules Adopted for HCS, TxHmL & TAS (Transition Assistance Services)

February 25th, 2023

Please click on links below to find the referenced rules which were published as adopted on February 24th, 2023, with an effective date of March 1, 2023.
Please be aware of the following:
  • Only the rule provisions to which changes were made are included in the links above.  I believe HHSC will post the complete set soon.
  • You are urged to read the preamble to the rules, in particular HHSC’s responses to comments received from stakeholders, before reading the rules.
  • See pages 74 through 81 in the HCS rules for the adopted rules governing Residential Settings and Residential Agreements.

PHE (Public Health Emergency) & New ISS Services

February 22nd, 2023

I know providers have really been concerned about the period of time between March 1st and May 11th while the PHE has been extended, as to whether or not this will include ISS services for In-Home ISS.

HHSC stated it would release a notice soon stating that beginning March 1, 2023 in-home ISS can be done without the justification (medical or behavioral justification or anyone 55 years of age and older should they request such) for such that will be required in the rules, through May 11th.  After May 11th, however, this will not be permitted anymore and the justifications for in-home ISS must be in place.

***Remember medical and behavioral justifications will require medical recommendations or orders from physician and/or behavioral support professional recommendations (i.e. psychologist, bcba)

 In-Home ISS in Host Home Companion Care (HH/CC) Settings: Update

February 22nd, 2023

 In-Home ISS in HH/CC Settings:  If persons receiving HH/CC services receive in-home ISS only, the provider does not have to be licensed.  If the person receiving HH/CC services engages in community activities (known as off-site ISS), then the provider of the off-site ISS must be a licensed ISS provider.

 Note:  EVV is NOT required for in-home DH or in-home ISS in a HH Setting – EVV is only required in own home/family home settings.  Also, the requirement for EVV matching has been pushed to May 1st, 2023.

Modifications to CMS Regs HCBS Settings Rules: Access To Food, Locks On Individual’s Doors & More

February 21st, 2023

Update on Who Qualifies To Assess The Need For A Modification

According to HHSC (and the proposed rules that will now be under Chapter 263) modifications to the door lock requirement must be based on a documented, assessed need and brought to the SPT for review and documentation in one’s PDP

As to whom determines the assessed need, HHSC stated at recent training sessions in Lake Jackson and Austin I believe, that a licensed professional, defining such as a doctor, RN, behavioral health provider, or other therapist providing such determination is within the scope of their practice.


February 14, 2023

Protocol For Modifications to AccessTo Food, Locks on Individual’s Doors & Other CMS Regs HCBS Settings Rules

Please see the alert letter below for complete information discussed in this post:

IL-2023-05

“In 2014, CMS issued federal regulations for settings where Medicaid home and community-based services (HCBS) are provided. All settings where Medicaid HCBS are delivered must meet federal requirements by March 17, 2023.

HHSC is finalizing updates to the HCS Program rules at 26 TAC §263.502. The rules are expected to be adopted in early 2023 and will include the detailed requirements outlined below.
The federal regulations require that all individuals residing in a provider-owned or controlled setting must ensure certain requirements are met. These requirements include:

● Individual privacy in the bedroom;
● Choice not to share a bedroom;
● Choice of roommate if sharing a bedroom;
● A lock is installed on the bedroom door;
● Individual can furnish and decorate their bedroom;
● Individual has control over their schedule and activities that are not part of an implementation plan;
● Individual has access to food at any time;
● Individual has the ability to have visitors of their choosing at any time;

If a program provider becomes aware that a modification to one of these requirements must be implemented due to a specific assessed need of an individual, the program provider must notify the service coordinator as soon as possible. The program provider must provide the service coordinator with the following information:

● A description of the specific and individualized assessed need that justifies the modification;
● A description of the positive interventions and supports that were tried but did not work;
● A description of the less intrusive methods of meeting the need that were tried but did not work;
● A description of the condition that is directly proportionate to the specific assessed need;
● A description of how data will be routinely collected and reviewed to measure the ongoing effectiveness of the modification;
● The established time limits for periodic reviews to determine if the modification is still necessary or can be terminated;
● The individual’s or legally authorized representative’s (LAR’s) signature evidencing informed consent to the modification; and
● The program provider’s assurance that the modification will cause no harm to the individual.

If the service coordinator receives a notification from the program provider of a required modification(s), the service coordinator must convene a service planning team (SPT) meeting to update the person-directed plan (PDP) with the information above.

If the SPT agrees to the modification(s) and updates the PDP, then the program provider may implement the modification(s).

**Note that a family member/LAR’s request or preference to not comply with one of the requirements is not considered an individualized assessed need that justifies a modification to the federal requirement.”

Link to PowerPoint Handout From Austin Training on February 10th, 2023 for information discussed on this subject and other current issues (residential agreements, ISS, etc…)

Repeal of HCS Rules under Title 40, Chapter 9 / Movement to Title 26, Chapter 565

February 14th, 2023

 

Repeal of HCS Rules under Title 40, Chapter 9 / Movement to Title 26, Chapter 565

Attached please find the proposed changes to the HCS certification principles. The proposed changes repeal rules under Chapter 9, Subchapter D and move to Chapter 565.  Remember that in addition to moving the rules to Chapter 565, several new rules are mentioned to be put in place as well as changes to existing rules for purposes of either updating, streamlining or providing clarity in intent are proposed.
One new proposed rule would require conducting quarterly visits in HH settings.
Also discussed are new requirements for emergency preparedness, fire drills and evacuation drills are also proposed.
The attached proposed rules will be presented to the HHSC Executive Council on February 16, 2023 beginning at 10:00 a.m.  According to the agenda, no public comment will be taken on these rules, which have already been submitted to the Texas Register for publication as proposed.  To listen to the meeting and to see the complete agenda, go to:  https://www.hhs.texas.gov/about/communications-events/meetings-events/2023/02/16/health-human-services-commission-executive-council-agenda
Here are some highlights of the agenda for February 16th, 2023
“Quoted from HHSC Agenda for February 16th”
“The purpose of the proposal is to draft new rules that describe the regulatory certification standards for Home and Community-based Services (HCS) Medicaid waiver program providers and repeal duplicative sections of the Texas Administrative Code (TAC) Title 40, Part 1, Chapter 9, Subchapter D, relating to the Home and Community-based Services (HCS) Program and Community First Choice (CFC).
The proposed rules describe certification standards regarding service delivery, rights of individuals, requirements related to abuse, neglect, and exploitation, staff members and service providers’ requirements, and quality assurance. The proposed rules also include new requirements for emergency preparedness, fire drills, and evacuation drills in all residential types in the HCS program.
Current requirements listed on the waiver survey and certification checklist that are not currently in ruleare included in the proposed rules. The proposed rules set forth recommendations for increased oversight of HCS host home/companion care homes, clarify restraint and seclusion requirements and add language for obtaining and using enclosed beds.The proposed rules also modify HHSC surveyor requirements to allow for survey flexibility as the HCS waiver program evolves.
Stakeholders expressed concern with retaining certification principle §565.11(a)(1), which requires HCS program providers to serve any individual who chooses them regardless of whether providers have a residence in the individual’s preferred area or can accommodate their specific needs. However, advocates are strongly in favor of this regulation because it prevents program providers from potentially picking and choosing the individuals they want to serve and possibly leaving some individuals without services.
An additional concern from HCS program providers involves their ability to comply with the regulations without financial support from HHSC. Program providers expressed that both existing requirements that will transfer to new Title 26 and new requirements added to improve health and safety create an undue financial burden given the current reimbursement rate structure within the Medicaid HCS waiver program. Program providers and advocates also expressed a desire for interpretive guidance to ensure accurate implementation from both a provider and surveyor perspective.
HHSC worked closely with HCS program providers and advocacy groups while creating these rules to attempt to mitigate their concerns regarding cost of implementation and clarity of rules language. HHSC also agreed to develop interpretive guidance once rules are adopted to ensure consistent application from providers and surveyors. During the year-long workgroup process, HCS program providers, advocacy groups, and HHSC staff crafted health and safety language that all parties agreed would meet the needs of the individuals who receive HCS waiver program services.
STAKEHOLDER INVOLVEMENT:
In March 2021 through February 2022, HHSC met with HCS providers associations, including PPAT, PACTX, and Texas Council for Community Centers; advocacy groups, including Disability Rights Texas and Every Child; and HHSC program staff. This workgroup focused on creating clear and concise rule language dedicated to the health and safety of the individuals who receive HCS waiver program services. HHSC held monthly workgroup meetings to review existing HCS regulations and create revised HCS regulations, with the focus on health and safety. Workgroup participants provided feedback both during and between meetings by providing feedback on proposed language. The workgroup received the complete draft regulatory language in February 2022 and provided input prior to beginning the formal rulemaking process.”
“The main objective of this rule project is to ensure the health and safety of the individuals who receive HCS waiver program services. HHSC accomplished this by creating a residential requirements section in the proposed rule. This ensures the HCS program providers have policies and procedures in place to determine whether the environment an individual resides in is safe. HHSC crafted a protective devices and enclosed bed section in the new rule language which provides explicit guidance about the use of enclosed beds. This project also adds requirements for infection control, medication administration, fire drills, and emergency plans to ensure the continued health and safety of those individuals who live in HCS residences.”
Please note the following while reading the proposed new rules in the agenda:
  • Target date for publication in the Texas Register:  February, 2023.
  • Target date for adoption:  May 2023.
  • See pages 1-3 for Background Information.
  • See pages 4 – 8 for Preamble to repeal of rules under Chapter 9.
  • See page 9 for Preamble to the proposed new rules which provides a high-level summary of changes.
  • See pages 16 – 106 for proposed new rules.
  • See pages 73 – 74 for Residential Requirements, including provisions related to locks on bedroom doors. These proposed rules contradict the proposed HCBS settings rules under Chapter 263 regarding locks.  [Though confirmation is being sought, it was reported that at the ISS and HCBS training HHSC conducted in Austin last Friday, HHSC stated the rules under Chapter 263 (which are still not adopted) will take precedence.
  • See page 78 for provisions related to the new requirement for conducting quarterly on-site visits in HHs.
  • See bottom of page 81 for requirements related to Finances and Rent.

PAT: Provider Applicant Test-Update 2023

February 10th, 2023

From HHSC’s PAT  FAQ’s as of Jan. 1st, 2023

“Frequently Asked Questions for Providers Applicant Training (PAT) for HCS/TXHML”

-When is the Provider Applicant Training (PAT) Online available?
This training is now available online. The PAT training is the first step for applicants to obtain a contract with HHSC. Please do not submit your application without the PAT certificate that reflects a passing score of 85% or above.

-Who can take the training?
Applicants listed on Form 3681, Section 8.a and 8.b must complete the online PAT training. The Program Manager listed must complete the training and pass the test with an 85% or above.
See Texas Administrative Code Title 40, Chapter 49, Rule §49.204.

-How can I access the HHS Learning Portal?
• HHS Learning Portal (texas.gov).
• Set up your new account. You will need to confirm your new account through the email address used.
• Find and select the Medicaid Long Term Services and Support Training under “Course Categories.”
• Select the Provider Applicant Training (PAT) link. Select “Enroll me” to access the Training and get access to the “Welcome” page.

The training is compiled in four different steps.

Step 1. Important to know Before you Get Started
 Fill out the Provider Applicant Training (PAT) Information form. This form must be completed to access the introduction and the training modules.

Step 2. Training Modules
 Complete each module must be completed to advance to the next module.

Step 3. Evaluation and Certificates
 Complete the mandatory survey

Step 4. Provider Competency Exam
 Download, and save your exam certificate upon completion. Submit the certificate along with your completed application

PAT FAQ’s read more

IMPORTANT:  You must take the PAT before you can apply to be an HCS Provider!!!.  You must pass the Test by 85 %  If you fail the test, you can’t retake the test for a period of 6 months, so please study the TAC before and pay careful attention to the PAT modules before answering test questions.

Note: If you do not pass on your first attempt, please DO NOT apply.

Important: Re-evaluation of Medicaid Eligibility!!

March 2nd, 2023

Unwinding of Continuous Medicaid Coverage:  HHSC will stagger Medicaid Eligibility Determinations, separating into 3 groups.  IDD will be in the last group, meaning that packets will be sent in June with persons having 30 days to reply.  More information can be found at:  https://www.hhs.texas.gov/services/health/coronavirus-covid-19/coronavirus-covid-19-provider-information/end-continuous-medicaid-coverage-ambassador-toolkit


February 9th, 2023

The Biden administration plans to end the state of Public Health Emergency (PHE), due to the pandemic.  Many are warning that the shift will have major implications for people with disabilities that go far beyond COVID-19.

Under the public health emergency, which has been in place since 2020, states have been eligible for extra federal funding for Medicaid in exchange for agreeing not to drop most beneficiaries from the program. The federal government has also given HCS providers added flexibilities during this time.

Currently, it appears that President Biden plans to extend the public health emergency to May 11, at which point it will end.

Once the PHE is over, it will trigger a widespread effort by Medicaid programs across the country to re-evaluate each beneficiary (in this case, meaning individuals in our IDD programs) to determine whether or not they remain eligible. Many are worried that quite a few persons with developmental disabilities could inadvertently or accidently be dropped from the program, even if they still qualify.  In addition, if they lose Medicaid eligibility even temporarily due to this issue, it will make it much harder to reverse the decision in a timely fashion.  This would affect providers in receiving funds for their services provided to individuals.  It would also mean that these individuals would not be able to obtain HCS services possibly anymore as they would not qualify for the waiver and they would not be able to receive their medical care and medications through Medicaid.

I can’t stress enough, that people with disabilities and their families (or specific Medicaid contact person) make sure they respond to any mail or email from their Medicaid office, that their address is up to date at HHSC & Medicaid as well as being in compliance with the financial eligibility rules under Medicaid as well.  Be sure to fill out any annual Medicaid Status Reports on time as well.

If an IDD provider (HCS, TxHmL, etc..) is the contact person for Medicaid please have all available persons that are appropriate assist with this process to ensure your individuals do not lose their Medicaid. ( i.e. case managers/care coordinators, program managers, financial dept. staff, etc.) 

States can start the redetermination process as soon as this month and can terminate Medicaid coverage for individuals as early as April 1. Across the country, the process is expected to be complete no later than May 2024.

 

TMHP’s 1915(c) Waiver YouTube Training Videos Website: PEMS (Program Enrollment Management Systems) & More

February 9th, 2023

Where can you find helpful Training Videos on the PEMS process? Check out the TMHP page with their Youtube videos for PEMS.

In addition, you will find information on removing TPI’s and a Video series on running and utilizing your R&S Reports

1915 (c) waiver page at TMHP For YouTube Training Videos

Specific link to R&S Report Video Series

Specific link to Removal of TPI From Forms Video

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


February 5th, 2023

IDD and PI Quarterly Webinar with HHSC LTCR Recording Available

The January 26 recording of the Intellectual and Developmental Disability (IDD) Programs and Provider Investigations (PI) Quarterly Webinar with Long-term Care Regulation (LTCR) is available.

Listen to the webinar recording.

Read the IDD and PI Webinar (PDF).

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

 


November 1st, 2022

HCS & TxHmL Updates Provider Webinar from Oct. 13

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

This webinar will provide information on the following:

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

HCS and TxHmL Program Updates Provider Webinar

Oct. 13

1–3 p.m.

Register for the Pre-Recorded Oct. 13 webinar.

 


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

Proposed HCS and TxHmL Billing Requirements

February 5th, 2023

Proposed HCS and TxHmL Billing Requirements

Home and Community-based Services and Texas Home Living stakeholders can now comment on the proposed revisions to the HCS and TxHmL Billing Requirements by Feb. 14.

The proposed billing requirement revisions and a summary of changes are located on the Long-term Care Providers webpage and are outlined below:

HCS

HCS Billing Requirements Draft Revision 23-2 (MS Word)

HCS Billing Requirements Draft Revision 23-2 Summary of Changes (PDF)

TxHmL

TxHmL Billing Requirements Draft Revision 23-2 (MS Word)

TxHmL Billing Requirements Draft Revision 23-2 Summary of Changes (PDF)

Email stakeholder comments to TxHmL Policy.

IMT and IPC Form Enhancements Pertaining To Location Code Issues in TMHP Now Available!

January 5th, 2023

IMT and IPC Form Enhancements and IBI Guide Updates Now Available

Last updated on 1/27/2023

From HHSC:

“On January 13, 2023, a text box replaced the location code drop-down box on the following Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Individual Movement (IMT) and Individual Plan of Care (IPC) form fields:

  • IPC transfers (3608/8582) field 39a: Receiving Program Provider Location Code
  • IMT (all-purpose codes) field 18: Location Code
  • IMT Individual Update fields 122: Current Location Code and 123: New Individual Location Code
  • IMT LA Reassignment field 111: New Location Code

The information that is entered manually will be validated upon submission to ensure that the location code is valid for the provider. This enhancement will improve overall system performance.”

***Should be a huge help to getting those transfers through that many have had pending at the LIDDA’s!

The following item-by-item (IBI) guides have been updated to reflect enhancements:

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

Twogether Consulting Webinars

Please go to www.twogetherconsulting.com for more information and registration. Click on  “the calendar” of the Webinar you want to attend. 
********We also have pre-recorded webinars you can purchase for use at your facility.  Please contact Meghan Jones at: meghanjones.tx@gmail.com for more information, registration, and payment.

 

 

February 2023

 

Common Nursing Violations:  Prevention & Correction 

February 23rd, 2023 10 AM-12:00 PM

(ICF/IID)

 

 

The HCS/TxHmL Interpretive Guidance Booklet: Nursing Focus

February 27th, 2023 11AM-12:30 PM

(HCS/TxHmL)

 

 

March 2023

Abuse, Neglect & Exploitation: Definitions, Signs & Symptoms, Reporting  

March 2nd, 2023  11 AM-12:30 PM

(HCS/TxHmL)

(This session is for employees, contractors, volunteers, and more)

 

 

The CRA (Client’s Responsible Adult) & Their Responsibilities To The Nurse

March 8th, 2023 10 AM-11:30 AM

(HCS/TxHmL & ICF)

RN Delegation: Important Things To Remember

(This session does not cover SB1857/HRC 161 or HH/CC Exemptions)

March 9th, 2023 10 AM-11:30 AM

(HCS/TxHmL & ICF)

 

Billing Requirement Changes In HCS-2023 Update 

March 29th, 2023  10AM-12:30PM

 


To Be Determined At A Later Date

Abuse, Neglect & Exploitation Allegation Follow-Up Requirements: (HCS/TxHmL Providers)

(This session is for:  Administrative Staff, Program Managers, Case Managers/Care Coordinators, Nurses, and Quality Assurance Staff)

 

Abuse, Neglect & Exploitation Allegation Follow-Up Requirements: (ICF/IID Providers)

(This session is for: Administrators, QIDPs, House Managers, Nurses, and Quality Assurance Staff)

 

Please Continue To Check The Website For More Trainings


Pre-recorded sessions are available for purchase!

To Purchase these Pre-Recorded Trainings:

Go to www.twogetherconsulting.com

Or

Contact us at Javasbja@gmail.com at Meghanjones.tx@gmail.com


Currently, we have the following pre-recorded sessions:

 

ICF/IID Pre-Recorded Webinar Sessions

QIDP In The ICF Program (3 Part Series)

Nurse In The ICF Program (3 Part Series)


HCSTxHmL Pre-Recorded Webinar Sessions

Expectations of The Nurse: HCS/TxHmL

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

Care Coordination (5 Part Series)

 

CARE COORDINATION  (5 Part Series)

Part I  

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

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

 

Part II   Pre-recorded sessions available for purchase!

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

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

Part III   Pre-recorded sessions available for purchase!

For HCS & TxHML Providers

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

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

 

Part IV   Pre-recorded sessions are available for purchase!

HCS/TxHML/ICF Providers

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

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

 

Part V  Pre-recorded sessions are available for purchase!

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

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

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


Migration of In-Home DH to In-Home ISS Update

January 27th, 2023

As of 1/27/23, there have been no new alert letters concerning the extension of temporarily waiving certain requirements for In-Home DH  due to the Public Health Emergency, past  January 31st, 2023. This was the date we were given in Letter No. 2022-55.

My understanding is providers would receive notice at least 30 days prior to ending the PHE.  I am assuming at this time that the PHE will extend through Feb. 28th, 2023.  In-Home DH billing will discontinue in TMHP as of March 1st, 2023, so the last day to bill In-Home DH will be Feb. 28th, 2023.  At this point, we move to In-Home ISS services. However, if the PHE does not end, I am unclear yet if In-Home ISS will allow for continuing to waive certain requirements temporarily due to the PHE.  I believe that due to the fact the allowance for anyone to qualify for In-Home DH during the PHE is not part of the In-Home ISS rules/ISS rules, that an addendum would have to be put in place to cover In-Home ISS due to PHE.  Not sure that will happen, so I would plan to be ready by March 1st.

Otherwise, come March 1st, 2023 all individuals wishing to receive In-Home ISS services will have to qualify in the following way:

In-home ISS must be provided in the individual’s residence.

Billing Requirements Section 49102.3

Requirement for Justification by a Licensed Professional or to be 55 Years or Age or Older
Revision 23-1; Effective January 1, 2023

An individual may receive in-home individualized skills and socialization only if:

(a) a physician has documented that the individual’s medical condition justifies the provision of in-home individualized skills and socialization; or

(b) a licensed professional or behavioral supports service provider listed in Section 4240(2), Qualified Service Provider, has documented that the individual’s behavioral issues justify the provision of in-home individualized skills and socialization; or

(c) the individual is 55 years of age or older and requests to receive in-home individualized skills and socialization.


In addition, EVV will need to occur for In-Home ISS services.

Qualifications for Service providers of In-Home ISS are as follows (they don’t need to be licensed)

49102.8 Qualified Service Provider

Revision 23-1; Effective January 1, 2023

In addition to meeting the requirements in Section 3400, Qualified Service Provider, a qualified service provider of the in-home individualized skills and socialization service component;

  • (a) must have: (1) one of the following:
  • (A) a high school diploma or a certificate recognized by a state as the equivalent of a high school diploma; or
  • (B) documentation of a proficiency evaluation of experience and competence to perform the job tasks that includes:
    • (i) a written competency-based assessment of the ability to document service delivery and observations of the individuals to be served; and
    • (ii) at least three written personal references from persons not related by blood that indicate the ability to provide a safe, healthy environment for the individuals being served; and

    (b) must not be the individual’s host home/companion care service provider


November 21, 2022

Letter No. 2022-55 (Replaces IL 2022-54)

This information letter (IL) replacesd IL 2022-54 In-Home Day Habilitation Information for Program Providers for COVID-19, previously released on October 31, 2022, to extend the temporary guidance through January 31, 2023, unless the COVID public health emergency ends sooner. HHSC will provide guidance if anything changes.
In response to COVID-19 and to provide access to needed day habilitation services, the Health and Human Services Commission (HHSC) is temporarily waiving certain requirements in Sections 4381.3, 3710, 4381.7(6) and 4381.7(7) of the HCS Billing Guidelines and the TxHmL Billing Guidelines.

Effective March 13, 2020, through January 31, 2023 unless the COVID PHE ends sooner:
● 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 4381.3. This includes individuals residing in their own homes or family homes.

For more info, please click on the information letter.

HHSC Form 4719 Required for Fire Drills for ISS Providers

January 27th, 2023

HHSC Form Required for Fire Drills for ISS Providers

Click on link below

Form 4719

* Some providers have noted that this form seems a bit inappropriate for ISS providers as the form has locations that seem more appropriate for a “home” setting, as opposed to maybe a “building” used by a licensed ISS provider, but it does have a box for “other” locations.

Blackboard Connect Emergency System (HCS, TxHmL, ICF, & DAHS-ISS Providers)

January 26th, 2023

FYI- somehow I missed this alert back in November for Licensed ISS providers.  Please be sure to log in and set up your account.

PL 22-32 letter issued 11/28/22 to ISS providers that was sent out concerning Blackboard Connect Emergency System

(This applies to HCS, TxHmL, ICF, & DAHS-ISS Providers among other services)

The purpose of this letter was to inform providers of the emergency communication system called Blackboard Connect, how it will be used, and your responsibility in signing up for the system if you are an ISS provider. This system will be used to send emergency and outreach notifications through email, phone, voice and text if available.

The rules require program providers to assign a designee to enroll in and respond to requests through the system. The designee should be someone who is associated with the licensed building or someone who is responsible for communicating emergency communications. However, you may also have other designees, such as corporate headquarters staff, sign up.

Blackboard Connect sign-up process:

Go to this link and click “Sign Me Up!”

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

STATEWIDE TRANSITION PLAN: HCBS

January 16th, 2023

Statewide Transition Plan

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

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

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

HHSC invites members of the public, including HCBS recipients and their families, providers and other stakeholders, to submit comments on the STP.  Comments will be accepted until 11:59 pm on Feb. 13, 2023. 

Access the STP and instructions for submitting public comments here.


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

Email: Medicaid_HCBS@hhs.texas.gov  

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

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

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

 

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

January 16th, 2023

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

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

It is unclear when the HCS rules will be adopted.

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

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

 

 

HCS/TxHML: /TMHP Recoupment, Due To Overpayment

January 15th, 2023

TMHP Recoupment Letters

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

December 12th, 2022

Avoiding HCS and TxHmL Overpayment of Services

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

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

Read the full alert.

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

January 15th, 2023

Help With The New Residential Agreements

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

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

Initial Critical Incident Management Services (CIMS) User Account Email

January 14th, 2023

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

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

August 31st, 2022

Initial CIMS User Account Email

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

This applies to:

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

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

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

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

January 12th, 2022

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

See actual TAAIDD link  

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

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

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

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

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

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

Employment Assistance & Supported Employment Training Options From HHSC

Employment Assistance & Supported Employment Training Options From HHSC

 

January 12th, 2022

Please see notice below from Monty Chamberlain, HHSC.

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

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

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

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

Houston 02/07/23 Registration

Houston 02/08/23 Registration

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


August 1st, 2021

Live HHSC Training Workshop!

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

Training includes:

·         Overview of Texas Employment First Policy

·         Employment services in Medicaid waivers

·         Basic facts on Social Security Administration disability benefits

·         Basic facts on developing an employment profile and vocational assessment

·         Building connections and working with families

·         Development of soft skills and job-readiness skills

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

·         Building and maintaining strong employer relationships

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

 

Registration Links for each event as follows:

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

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

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

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

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

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

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

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

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

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

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

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

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


 

June 28th, 2021

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

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

Each training has a corresponding quiz.

 

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

Public Health Emergency (PHE) Renewed

January 11th, 2023

 

RENEWAL OF DETERMINATION THAT A PUBLIC HEALTH EMERGENCY EXISTS

 

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

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

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

ISS Rates

January 11th, 2023

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

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

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

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

HCS Rates Jan. 1st, 2023 including ISS services


December 06, 2022

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

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

September 27th, 2022

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

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

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

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

Trainings Initiatives: From HHSC

January 10th, 2023

Below are just some of the trainings offered by HHSC on their “Trainings Initiative” page. Some live and some via webinar.

For more information, please go to: https://www.hhs.texas.gov/providers/provider-training/training-initiatives

SSI/SSDI Benefits Overview

The SSI/SSDI Benefits Overview web-based training provides a basic foundation for understanding Supplemental Security Income and Supplemental Security Disability Insurance and provides contact information for people who can help you further understand these programs. The training has a corresponding quiz.

Employment First

The Employment First web-based training covers Texas’ new Employment First policy. The training has a corresponding quiz.

Visit the HHS Employment First website.

HCS and TxHmL

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

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

Each training has a corresponding quiz.

Direct Service Workers

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

STATUS OF HCS RATES!

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

HCS Rates Jan. 1st, 2023 including ISS services


Status of HCS Rates as of June 3rd  2022

Provider Rate Updates for HCS and TxHmL Providers

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

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

Read the full alert.

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

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


Status of HCS Rates as of January 17th, 2022

HCS and TxHmL Day Habilitation Rates, Respite Rates and Other Concerns

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

 

Please contact the Rate Analysis Department’s Customer Information Center at (512) 424-6637 or by email at RAD-LTSS@hhsc.state.tx.us should you have any questions regarding the information in this document.

Free Provider Resource Webinar Series

Free Webinars!!

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

January 2023 Webinars

 

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

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

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

 

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

REGISTRATION

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

 

 

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

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

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

core va post card

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

 

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

 

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

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

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

REGISTRATION

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

 

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

 

 


Some Of Our Previously Recorded Free Webinars of Interest


Here is a link to a short, introductory video about the HRST: https://hrstonline.com/video/index.php?id=410335893

Topic:  Health Risk Screening Tool

HRST  (Health Risk Screening Tool) is an assessment tool that can identify & detect health risks in vulnerable populations. This tool and other services offered by HRS are based on person-centered practices. Here is a little more information about HRS from their website. The Health Risk Screening Tool (HRST) identifies and tracks health risks in vulnerable populations, making it possible to design a plan tailored to meet the unique health and safety needs of each individual in the least restrictive setting. The instrument can objectively justify resources allocated both financially and in service intensity. Used by Case Managers, supervisors, and direct support professionals. HRS also helps the provider to comply with CMS Rules and assist with Person-Centered planning and continuity of care.  It is field-tested, reliable, and user-friendly

“Health Risk Screening, Inc.’s roots began in 1992. Along with training courses, webinars, and materials, HRS is the sole developer, producer, and distributor of the web-based Health Risk Screening Tool (HRST). The HRST is the most widely used and validated health risk screening instrument for people with intellectual and developmental disabilities.

HRS was established on the principles of person-centered practices. Our founder, Karen Green McGowan was a pioneer in the early formative days of the person-centered movement..  Our focus is on developing tools and training for the person-centered support of vulnerable populations. Through the education of government agencies and service providers, we have helped improve people’s lives. Along with training courses, webinars and materials, HRS is the sole developer and distributor of the web-based Health Risk Screening Tool (HRST). The HRST is the most widely used and validated health risk screening instrument for people with disabilities.”

For more information, please contact  Hillary Gaytan at:  Phone: 727.754.9539  Emailhilary@hrstonline.com
You can also go to their website:  www.hrstonline.com 

Check out this great page they have devoted to COVID-19 Resourceshttps://hrstonline.com/covid-19-resources/

 


HRS Inc

Guest presenter:

Patrick Lane  (PCT Mentor & Trainer)

From:  HRS

Date: Thursday -November 12th, 2020  (Session ended)

Time:  11am-12pm (Central Time)

Cost:  Free!!!

Where:  See recorded link below:

https://attendee.gotowebinar.com/recording/1049673375643527182

Topic:  Person-Centered Services 

Patrick will be talking about some of the Person-Centered Services offered at HRS including software that helps the provider develop Person-Centered Descriptions. These can be used as a resource for making annual plans Person-Centered by using these same person-centered skills practiced in PCT sessions. 

“Person-Centered Planning Training is designed to help you approach support from a more holistic angle, with person-centered practices that respect the autonomy of those with intellectual and developmental disabilities while providing them with the highest possible level of care.”

Improve The Quality of Life

  • Balancing personal choice with personal responsibility by establishing and maintaining things that are important to the person with things that are important for the person
  • Being integrated in one’s community so that the person is known and respected for her or his contributions.
  • Being respectfully communicated with as a person, using language consistent with being a typical adult as opposed to using clinical or system language
  • Receiving support that is consistent so that new staff and others know and respect the person’s values and choices, as well as how others can help the person.
  • Being matches with staff, housemates, or others that the person making life more enjoyable.
You can contact Patrick at: patrick@hrstonline.com     For more info about HRS PCT services, please see the following link: https://hrstonline.com/person-centered-services/

Guest presenter:

Steve Cardie

From:     Abundant Health

Date: Tuesday -November 17th, 2020  (Session ended)

Time:  Noon-12:45 pm (Central Time)

Cost:  Free!!!

Where:  See link to the recorded session below:

https://attendee.gotowebinar.com/recording/5931551182568587528

Topic:  Cellular Blood Pressure Monitoring System   (Free To Medicare Patients!)  

Abundant Health is the distributor of a remote blood pressure monitoring system for Medicare patients that is the best on the market. It is the only FDA approved cellular blood pressure monitor. It makes it easy to report regular blood pressure monitoring to your physician with little to no effort and proving complete HIPPA compliance.  The system is much like your standard wrist BPM cuff, but it has a SIM card in it that reports all data instantly to your physician and can supply records that can be printed out by the client or facility for the individual’s records.  This would be a great system as well for individuals living in their own family home or in a host home setting that may want to be as independent as possible or may cut down on needing as much staff assistance and/or supervision.  Abundant Health works with providers, clinics, hospitals, and physicians across the country.   Here is a quote from one of them:

“Our new Cellular Blood Pressure Monitor System connects automatically to cell towers and transmits your patient’s information directly to your practice. This device makes it simple for seniors who tend to be more technology challenged to utilize Medicare’s RPM program without the difficulty of connecting to cell phones or the internet. No passwords, no Bluetooth, no internet connections required.

The rapid advance of medical device design plus an enormous upgrade in telecommunications makes Remote Patient Monitoring (RPM) suddenly possible for virtually everyone. Anywhere.  In November 2018 CMS officially approved three new billing codes for Remote Patient Monitoring (RPM).  The telehealth industry experts agree that this is the biggest financial incentive to date in the history of digital medicine.”

Register for the webinar at    https://attendee.gotowebinar.com/register/3642654945259750160

You can contact Ayshe at:

 

 

Letter From Twogether Consulting To Providers-January 2023 Update

January 1st, 2023

Update From Twogether Consulting!

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

 

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

      2023 will also be a big year of change!   Please contact us directly for your care coordination, QIDP, and nursing needs at info@twogetherconsulting.com or you may contact our assistant Meghan Jones at meghanjones.tx@gmail.com. We are happy to say that we can still continue to provide for most of your needs at this time.  We are happy to provide whatever assistance we can with questions you may have, especially concerning HCS/TxHmL Care Coordination, IT and security, Nursing, or general survey requirements from LTCR department in these programs.  We also still provide assistance with the ICF/IID program and expect to have some webinars in the near future for ICF including nursing.  We continue to provide requested on-site live training at this time and we will resume regular live training after March of 2023.
     Many of you have asked about whether or not we will provide additional training for billing/claims in TMHP and entering IPC’s and IDRC’s.  At this time we are not providing that service, but we will continue to keep providers updated on any fixes we learn for provider issues in TMHP.  Please continue to check our “Updates” posts on the Twogether Consulting website. We do have some subcontracted persons that can help with these areas and we can recommend some other options as well, such as companies who can provide either software and/or billing services.  
FYI-We do still have “mentoring” assistance (especially great for new nurses) from our RN consultant on an as-needed basis.
     
     Twogether Consulting has a new IDD Consultant who has been with us since May of 2022, Sheila Hanson.  We are so happy to have Sheila join us.  She has been of great assistance with  POC’s (Plans of Correction)  and POR’s (Plans of Removal) for Immediate Threats/Jeopardy for HCS/TxHmL and ICF as well as Directive Inservice Training as needed. Sheila has also been helping us with survey prep and assisting providers ICAPs and ICAP scoring.  She is also an HCS provider herself in the San Antonio area, for the past 12 years or so and has been a much-needed member of the team this year.  We also want to thank Marcus Denman, who has been a member of our team for quite some time.  He continues to help us with so many needs of our providers.  Marcus has many years of experience in the HCS, TxHmL and ICF programs which is invaluable to Twogether Consulting. For many of you just starting out, he has been a  super resource for HR and New Hire practices, billing, budgeting, ppening a group home and staff training, etc…We would also like to give special thanks to our administrative assistant, Meghan Jones, without which I couldn’t function, lol. Many of you may know Meghan from registering for our classes and webinars. Meghan also assists me with the application process for many soon-to-be HCS & TxHmL providers.  Lastly, I would like to say our goodbyes to our dear departed colleague, Kim Littlejohn.  Kim worked for Twogether Consulting on and off over the years, primarily with HCS & TxHmL applicants and she assisted me with our conferences and workshops in the past. We recently lost Kim this December to cancer very suddenly.  She will be missed.
     
      Twogether Consulting will be posting more of our upcoming webinar classes for the rest of January and February very soon, so feel free to check the website: www.twogetherconsulting.com or our next newsletter.
   
   We have recently updated a few items on our website:
1. The page on our website previously called “Shop” on the dropdown menu under “Services”, is now called “Service Pricing” I hope this makes it much easier for providers we currently serve and new providers to find some of our services with regular pricing posted.  We do not post all of our rates and fees as most of the services providers need our help with must be tailored to the client for their specific needs.
Before mid 2023, we hope to add a few packages with set prices for new providers.  Some examples are:
 “On-site Assistance With Opening A Group Home” for brand new HCS providers and  “On-site Assistance With a New Admission”  (GH or HH/CC clients in HCS only)
2. We have changed the look of our “Satisfied Customers” page a bit. Please submit any quotes you have by clicking on “Contact Us” and sending us a small statement of how you feel Twogether Consulting has helped your agency, the company name and your name, and contact information.  We could really use some new quotes.
3.  We do accept payments via Venmo, as well as Paypal now:  Our Venmo address is @Twogether2004
4.  We also gladly accept Zelle.  You may just use our phone # for payment:  512-294-8032.  Please inform us before you do so, thanks.
5. Once again, please don’t forget our “Updates” page on the Twogether Consulting website. This is where we post anything new from HHSC and anything going on with Twogether Consulting. It is fairly easy to navigate from one “post” to the other. If you want to read more on each section, just click on “read more”.
5.  I would like to remind everyone again, that if you need “Off-site Consultation” and you would like to purchase a block of time (1, 3 or 6 hrs at a time), please go to our  “Services” page to pay directly from the site.  There is a tab called “Service Pricing” in the drop-down menu where you pay your payment. Remember there is a discount for blocks of time larger than 3 hours, purchased on the site.  This discount is only available online on this page on the dropdown menu under “Service Pricing”.
6.There are also some additional services at a flat rate, for purchase on this page.  This includes “Off-site” ICAP Scoring, General or Nurse Consultation, and the initial consultation for HCS Provider Applicants.  

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

 

   

 Please see below for specific information for 2023 Services:

  • In-person group trainings/conferencesAvailable as requested. Most of these classes have already been moved to online webinars or training, but we can come on-site if you need us to do so.  We also have pre-recorded sessions of some of these trainings as well if you prefer.
  • Online training (Webinars): We will be posting upcoming webinars to the website regularly on the homepage: www.twogetherconsulting.com 
    • Webinar Registration:  Click on calendars on our website at www.twogetherconsulting.com or https://events.time.ly/anatx6f
    • Recordings of Free Webinar Series:  https://www.gotostage.com/channel/3b0bd3b1a47c4e80be974f4bcfa54d7b
    • “Updates Page”  https://twogetherconsulting.com/updates/
    • We will continue to provide 1 on 1 webinar training and any general trainings done for a specific facility/ provider for Care Coordination, QIDP’s, Nursing Services, Direct Support Staff, etc.…
    • We have pre-recorded sessions with handouts for those of you who can’t attend live sessions or can’t wait for a live session. They range from $45-$175 per session.  These range from 1 hr- 3.5 hrs per session.
    • “Pop-Up Webinars”:  We will occasionally send out invitations to some webinars to those of you who are already clients of Twogether Consulting or who are on our mailing listThese won’t be posted for the general public.  These will be fairly short notice and based on topics that we receive a large number of requests to provide.  They will also be limited registration.  (15-30 persons max).
    • Direct Support Staff Training Webinars:  We continue to offer DIT’s (Directive Inservice Trainings) for ICF as well as General Direct Support Training for HCS/TxHmL/ICF providers.  Here are just some of our training webinars currently available live and/or via pre-recorded sessions:  Abuse/Neglect/Exploitation, Direct Support Documentation (Service Delivery Logs/Residential Notes, Incident Reports, Behavioral Support Documentation and Data Collection, and Training Data Collection),  Elements of the Behavior Support Plan & The Importance of Your Documentation, Expectations From the Nurse of The DSP (Includes discussion of Medical Documentation as well-MARS, Medication Errors, Treatment Sheets, Significant Observations),  When and What to Report To The Nurse, SAM’s Training (Self-Administration of Medications Training To Staff-General Routes, Tasks, documenting), Preparing For Survey in the Group Home/Surveyor Expectations in the Group Home, Host Home/Companion Care Service Provider Responsibilities, What The Nurse Expects from the HH/CC Provider and/or CRA, and many other training webinars.
  • Consultant Support: Twogether Consultants continue to be available to assist with your HCS/TxHmL and ICF needs as usual.  We will provide anything you request of us, that we can off-site but also on-site now if requested..
  • Off-site Consultation:
    •  You may purchase a block of time for as-needed consultation:  Our current pricing will remain at $85/hr and we can offer blocks of time for more than 3 hrs at a slight discount if you pay online at: https://twogetherconsulting.com/services/off-site-services/
    • if there is an extensive project (anything over 6 hrs, we will discuss flat rate options or daily rates.)  This will involve a formal contract
    • We continue to provide as-needed off-site consultation including, but not limited to Development or assistance with policy and procedure, Monthly/Quarterly QA via Taskmaster Pro, or any other cloud-based services, Survey and Audit Prep, and you are welcome to contact us if you need us to QA or review documents through our secure cloud storage system. We also provide off-site case management and nursing consultation and mentoring for HCS/TxHmL and ICF programs,
    • And much more!
  • On-site Consultation:  This service is available as requested, but please understand we need ample time to schedule as we are backed up right now!:  
    • General On-Site Assistance is based on a daily flat fee (ranges from $550-$1050 per day), depending on your location and additional travel expenses.
    • On-site Training for groups is a daily flat fee however due to prep time, and additional costs for materials, # of attendees, the cost is a bit more (ranges from $850-$2800 per day).
  • The request for on-site is up to you and if you feel comfortable. We will of course respect any protocol you have for us if we do come on-site, including rapid testing for COVID (additional cost).
  • Concerning our ICF providers, we will follow the same guidelines ICF has provided at this time.
  • Remember for ICF we can still provide Directive Inservice Trainings (DIT) if necessary, but we prefer to provide these off-site via webinar as usually the time to complete them is limited and we are often booked already with appts. at such short notice, and most Regional Surveyors will accept a DIT via webinar, especially in these times. So please let us know.
  • Payments:  We prefer payment via Zelle or our PayPal Invoices, with Credit Card/Debit/ or PayPal or Venmo.  You are also welcome to pay via check,  e-check, or request to pay directly to Venmo.  You may also use our online link below to pay:  https://twogetherconsulting.com/payments/
    • If you must pay by check, please let us know prior to mailing the check.  Thank you.  Send all checks to:

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

 

 

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

 

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

 

Thank you and be well,

Julie Andrews Blacklock/Owner & IDD Waiver Consultant

 

Starting Jan. 2023: New HCS& TxHmL Provider Application Process

January 2nd, 2023

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

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

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

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

PAT FAQ’sPlease read before taking the PAT! 

You must pass this test by 85% and if you fail the 1st x will have to wait 6 months to retake it!

 

 

Mail Your Application to the Waiver Program Enrollment Team

Send to this address:

HHSC

Contract Administration and Provider Monitoring

Mail Code W-359 P.O. Box 149030

Austin, TX 78714-9030

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

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

Expedited PPE Delivery for Long-Term Care Providers

January 2nd, 2023

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

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

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

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

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

HCS & ICF Emergency & Disaster Preparation Updates

January 1st, 2023

LTC Winter and Extreme Freezing Weather Preparedness

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

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

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

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

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

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

 


May 26th, 2022

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

Memorandum Summary

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

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

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

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

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

Read more……

 


September 13th, 2021

Very Important Updates on Emergency & Disaster Preparedness During the Pandemic

Resources Listed Are From CMS & HHSC 

See Info For ICF Facilities Below

 

 

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

Emergency Preparedness Participant Workbook

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

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

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

 

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

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

Dec. 1 ICF Conference Recordings Available

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

Listen to the ICF session recordings.

Email questions to LTCR Joint Training.

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

December 18th, 2022

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

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

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

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

ICF/IID Updates

December 15th, 2022

ICF Resources

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


September 25th, 2022

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

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

The letter provides guidelines to assisted living facilities,

intermediate care facilities for individuals with an intellectual

disability or related conditions, and nursing facilities about

the amelioration of administrative penalties assessed for state licensure

violations.

Read the provider letter details.


June 12th, 2022

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

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

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

The following rules expired June 6:

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

Here is a copy of the previous rule that expired:

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

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

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

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

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

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

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

Email questions to LTCR Policy.


April 29th, 2022

ICF Visitation Rules Update

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

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


April 10th, 2022

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

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

The revised rule:

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

April 10th, 2022

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

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

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

– New Requirements for Infection Prevention and Control Policies and Procedures

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

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

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

-ANE & Incident definitions

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

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


April 6th, 2022

COVID Screening in ICF’s

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

.ICFs must screen individuals:

•upon admission or readmission to the facility; and

•at least once a day.

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

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

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

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

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

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

Screening Criteria:

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

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

•other signs or symptoms of COVID-19, including

-chills,

-new or worsening cough,

-shortness of breath or difficulty breathing,

-fatigue,

-muscle or body aches,

-headache,

-new loss of taste or smell,

-sore throat,

-congestion or runny nose,

-nausea or vomiting,

-or diarrhea;

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

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

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


April 6th, 2022

Reporting Confirmed Case of  COVID-19 in ICF/IID

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

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

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


April 6th, 2022

COVID-19 Mitigation and Response Emergency Rule Updated

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

It became effective April 6, 2022.

The revised rule:

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

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

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

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


February 27th, 2022

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

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

Key changes to the rule are to:

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

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

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

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

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

Listen to the webinar recording.

Email LTCR Policy for the transcript.


February. 20th, 2022

Mar. 07 ICF COVID-19 Webinar with HHSC LTCR

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

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

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

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


February 13th, 2022

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

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

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

The rule requires ICF/IIDs to:

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

January 7th, 2022

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

Document   Version    Date    Change    Comments

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

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

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

Update your Infection Control Policies and other related policies accordingly. 

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


November 21st, 2021

HHSC Publishes PL 2021-38 Medicaid Bed Reallocation

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


November 4th, 2021

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

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

October 24th, 2021

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

Super important!!!!

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

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

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

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September 15th, 2021

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

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

September 5th, 2021

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

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


September 5th, 2021

ICF/IID Leave During COVID-19 Rule Reinstated

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

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

August 1st, 2021

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

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

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

Read the updated ICF FAQs (PDF).


March 24th, 2021

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

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

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

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


March 22nd, 2021

ICF COVID-19 March 22 Webinar Recording Available

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

Listen to the COVID-19 Q&A recording.

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


March 11th, 2021

Recording of ICF COVID-19 March 8 Provider Webinar Available

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

Listen to the COVID-19 Q&A recording.

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


February 8th, 2021

Draft ICF/IID Rule Changes

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

February 7th, 2021

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

Reminder to Provide Letter to Families

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

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

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

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

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

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

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


January 19th, 2021

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

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

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

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

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

Read the updated ICF FAQs (PDF).

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

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

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

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

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

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

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

Listen to the COVID-19 Q&A recording.

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


January 10th, 2021

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

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

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


HHSC Publishes Revised Reporting Guidance for Long-Term Care Providers

(PL 20-37)

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


November 22nd, 2020

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

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

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

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

ICF Provider Webinar

November 30, 2020

11 a.m. – 12:30 p.m.

Register for the COVID-19 webinar.


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

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

View the COVID-19 Q&A recording.

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


10/16/20

Important Information!

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

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

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

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

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

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

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

or

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


LTCR Form 2195

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

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

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

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

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

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

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

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

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

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

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

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

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

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


10/05/20

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

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

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


10/03/20

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

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

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

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

Phase I Vi