Twogether Updates

September 1st, 2024

Texas Conservative Coalition Research Institute (TCCRI) met last spring with 3 IDD provider associations to discuss the IDD workforce shortage crisis and their efforts to secure additional funds to increase the wage rates above the $10.60/hour funded by the 88th Texas Legislature. TCCRI prepared a white paper originally on this topic in 2019 and had great interest in preparing another white paper on this topic. After many months of research, TCCRI has published the finalized white paper. It is posted on the TCCRI website. See the link below.

Link to the White Paper: https://e42ea9dd-2882-426d-95f1-f27bebf54b2c.usrfiles.com/ugd/e42ea9_fcdce33a4d2c42e6969ce3e4d99db83d.pdf

TCCRI will re-publish the paper when the 89th Texas Legislature convenes.

Time To Care Coalition (TTCC)-Update

https://www.kvue.com/article/news/health/texas-group-home-staffing-crisis-austin/269-100a1214-21e8-49cc-999b-b543cf27d541

September 1st, 2024

The day before the House Human Services Committee hearing (August 27th, 2024 was the hearing date), Time to Care Coalition held a press conference in Houston urging Texas legislators to prioritize support for IDD funding.

Avondale House,

Center for Pursuit

Volunteers of America

These 3 programs all spoke about the workforce shortage crisis and the need for additional funds to increase direct care wages. To view the press conference go to: https://timetocaretx.org/updates/

July 16th, 2024

From our friends at PPAT, see information sent out today on data collected by Time To Care Texas organization:

New Data Shows Escalating Workforce Crisis Facing Community-Based DSPs Serving Texans With IDD

AUSTIN, TX – Today, the Time To Care: Save Texas Caregivers Now coalition released a statement on new data underscoring the escalating workforce crisis facing community-based direct support professionals (DSPs) serving Texans with intellectual and developmental disabilities (IDD). The data, collected from a statewide survey of IDD service providers conducted by the Texas Council of Community Centers (Texas Council), Providers Alliance for Community Services of Texas (PACSTX) and the Private Providers Alliance of Texas (PPAT), found that community-based service providers are facing unsustainable staff vacancy rates of 33-34% due to a lack of competitive wages for the DSP workforce.

“It is abundantly clear that the 88th Texas Legislature’s wage increase for DSPs from $8.11 per hour to $10.60 per hour has failed to address the workforce crisis among community-based providers of IDD services, as the issue has only been exacerbated,” Time To Care coalition spokespeople Sandy Batton and Carole Smith said. “Instead, we’re seeing more group homes close, along with an untenable increase in staff vacancies. With thousands of Texans with IDD relying on paid staff in small residential settings—including Home and Community-based Services (HCS) and Intermediate Care Facility (ICF) group homes—it’s imperative that we act now to protect our most vulnerable. The most recent statistics should serve as a clear call to action to Texas leaders, illustrating the urgent need to ensure that Texans with IDD receive the quality care and support they deserve.”

Additionally, the survey found that:

Staff vacancy rates in HCS homes and ICF facilities rose from 30% in 2021 to 33-34% in 2024.
DSPs in group homes currently work an average of 60 hours per week, with some working 100 hours per week or more,leading to fatigue-related errors and lower tolerance for stressful situations.
- 48% of HCS homes and 57% of ICF facilities are struggling to meet federal access standards.
- 20% of HCS homes and 22% of ICF facilities are reporting an increase in medication errors.
- 30% of HCS homes and 43% of ICF facilities are experiencing an increase in behavioral issues.
- 14% of HCS homes and ICF facilities are reporting an increase in hospitalizations.
94% of HCS providers and 96% of ICF providers indicated that $10.60 per hour is not sufficient to address the workforce shortage.
A total of 179 HCS homes and 50 ICF facilities closed between January 2023 and February 2024.
From March 2024 onward, there are an additional 92 HCS homes and 34 ICF facilities anticipated to close by the end of the year.

To read the full survey report, please click here.

To learn more about the workforce crisis facing community-based DSPs, please click here.

Time To Care: Save Texas Caregivers Now is a coalition dedicated to securing competitive wages for direct support professionals (DSPs) who provide essential care to Texans with intellectual or developmental disabilities (IDD). Through collaboration and grassroots efforts, the coalition strives to enact meaningful change at both the legislative and community levels. Learn more about how to get involved at https://timetocaretx.org/.

July 11th, 2024

KVUE: Texas group home advocates urging lawmakers to raise pay for caregivers

Coordinated by the Time to Care Coalition, please see the piece below which aired on KVUE July 3rd, 2024 featuring the Mary Lee Foundation. Mary Lee Foundation allowed Ms. Sanchez to conduct the interview and the persons who agreed to tell their story: Carroll Rabalais, Christopher Botello and Judy Kegg. The full story is below, and the package itself is viewable at the following link: https://www.kvue.com/article/news/health/texas-group-home-staffing-crisis-austin/269-100a1214-21e8-49cc-999b-b543cf27d541

‘This is what we need’ | Texas group home advocates urging lawmakers to raise pay for caregivers

Kelsey Sanchez

KVUE-TV July 3, 2024

AUSTIN, Texas — Group homes for the disabled and elderly are key in securing services for those with limited income and nowhere to go.

For many – like Christopher Botello, who has lived in a group home for 50 years – these facilities play a vital part in their residents’ lives and independence.

But according to advocates and group home workers, caregiving is a job that doesn’t pay enough and leaves group homes with a revolving door of employees.

Botello lives within the Mary Lee Foundation, an Austin nonprofit that offers affordable housing within its community, along with a variety of programs for those with Intellectual or Developmental Disabilities (IDD).

Botello has cerebral palsy, but to him, it’s simply a condition he lives with. He has become what some may call the “captain of the ship” at Mary Lee.

”I train a lot of the people, a lot of the residents here, to ride with buses and staff and learn how to ride buses, so that way, they can go to where they want to go,” Botello said.

It’s an opportunity he found and was able to establish through the foundation – along with people he considers family.

“Being here as long as I have makes you feel like you’re one of the most important people here, which is good because if you get that feeling in your system, then nothing can put you down,” Botello said.

Botello is just one example why some employees haven’t left their post.

Mary Lee offers $13.50 as a starting wage. Overtime is offered, but Interim Director Carroll Rabalais said she is painfully aware that it isn’t sustainable.

“It’s really difficult to ask that of someone and say, ‘You get $10.60 an hour.’ You know, Dairy Queen is going to offer you $15, or any other any other restaurant down the street is going to offer you more,” Rabalais said.

According to an IDD group home provider report, on average, caregivers work about 60 hours per week. Others average out 100 hours or more.

In 2023, Texas lawmakers slightly increased the base wage for group home workers from $8.11 to $10.60. Earlier this year, a newly formed coalition called Save Texas Caregivers Now sent a letter to Gov. Greg Abbott and legislators, urging them to raise the minimum wage for community-based direct-support professionals from $10.60 to $15 an hour.

Rabalais said she and other advocates have taken their stance to the Legislature themselves, but they have found themselves at a crossroads when it comes to achieving a better base wage.

“It really has not been an area that [state lawmakers are] interested in supporting,” Rabalai said. “This is what we need. This is how we sustain the care and the quality of life for our clients.”

Mary Lee is short 14 full-time direct-care professionals and has five fewer employees today than it did three years ago, according to Rabalais.

Judy Kegg’s stepdaughter also lives at Mary Lee. She explained how she wouldn’t be able to fully provide the services the foundation offers.

Kegg is aware of the staffing crisis and worries about the outcome should the facility close its doors.

“We really, really rely on caretakers,” Kegg said.

According to Texas Human and Health Services (HHS), Travis County has 152 group homes open. In 2023, 15 opened and two shut down.

“Time To Care Coalition”

What is the Coalition’s purpose? To increase awareness about the current and future access to IDD community-based services — more specifically, to increase awareness about the unprecedented workforce shortage in ICFs/IID and HCS group homes and its impact on services to individuals with IDD, secure emergency funding to increase wages of direct care staff working in these group homes and lay the groundwork for the next Texas legislative session. Note: The Coalition is acutely aware of the critical need for all persons providing attendant or direct care services across the host of Medicaid programs in Texas to receive wages higher than what the 88th Texas Legislature funded. However, given the number of providers exiting these services (i.e., terminating their contracts) or just closing or reducing the number of group homes they currently operate, the Coalition is currently focused on emergency funds for the aforementioned IDD group homes.

How did the Coalition start? As past efforts in garnering attention on services to persons with IDD have not been successful, a small group of providers concerned about the future of IDD services in Texas came together to establish the Coalition. Recognizing that past efforts seemed ‘siloed’ (meaning it was primarily just IDD providers), the Coalition deemed it critical to widen the circle of support for IDD services. This is being accomplished by reaching out to organizations and persons which, heretofore, have never been tapped (or actively tapped) which may have a strong interest in not only supporting the Coalition, but, more importantly, supporting delivery of quality services to persons with IDD. Note: Given time needed to establish the Coalition, create a website and determine and plan strategies for ‘getting the word out’, outreach to other organizations, and even to Texas IDD providers, was initially minimal. Now that the Coalition has officially launched, it is actively reaching out to prospective supporters.

Why are emergency funds needed?

To increase the wages of direct care working in ICF/IID and HCS group homes. The 88th Texas Legislature only appropriated funds to increase wages of direct care working in the ICF/IID and HCS group homes to $10.60/hour. The increase does not afford IDD service providers the competitive edge needed to maintain or recruit hardworking, dedicated caregivers. These caregivers deserve to be paid a wage that is commensurate with their work and their contributions to the lives of people with IDD.
To protect individuals’ access to IDD services – in short, preserve the IDD service system. The already prevalent and growing shortage of direct care staff supporting individuals with IDD is rapidly increasing and directly contributing to group home closures, displacement of individuals and decreased stability leading to more behavioral episodes and medical events. Without emergency funding, the current network of IDD providers will continue to shrink, eroding not only individuals’ choices in where they receive and who provides their services, but also placing at risk their health and safety and desire to remain in the community.

Are there other funding sources available to increase IDD direct care wages? No! Medicaid is the sole source of funding for IDD services. The only way to increase pay for direct care staff is for the Legislature to appropriate funds.

Where can one find out more about the Coalition, its activities and current list of supporters? Though not all sections have been fully developed with a few needing some tweaks to ensure clarity in the Coalition’s message, the website may be viewed at: https://timetocaretx.org/

What does support entail? There are various options available to participate and support the Coalition. Organizations can choose all of the options or just one or two of the options.

Donating to the Coalition, though it’s important to note that a monetary donation is not required.
Consenting to have your organization’s logo on the Time to Care website. If interested in this option, complete this Release Form and send, along with your company logo, to: IDD@pluspr.com.
Sharing information about the Coalition with others both within your organization (staff, families and individuals you serve) and outside your organization (such as churches, vendors/businesses or parent groups).
Posting information and news about the Coalition on one’s website, Facebook and any other social media one uses.

***Twogether Consulting would ask that you please share this information and website.

Letter To Providers From Twogether Consulting-September 1st, 2024

September 1st, 2024

From Twogether Consulting!

I hope everyone has had a wonderful extended weekend this Labor Day! Lots of good stuff happening. Please check out our “Updates” section of the website for the latest news for IDD providers.

Twogether Consulting would like to welcome back Kevin Kirkpatrick from Guardian Pharmacy as a presenter for our “Free Resources Webinar Series” that we will be hosting on September 17th, 2024. In October, Ricardo Ortega from ICareManager will be our “Free Resources Webinar” presenter on October 17th, 2024 from noon-1pm. The information is currently posted on our website calendar and the ICareManager free session will be posted in the next few days. You may register by clicking on the calendar and then the “REGISTRATION” button. Please continue to check our website calendars at www.twogetherconsulting.com for the date of this webinar and for more information concerning Guardian Pharmacy and their upcoming webinar hosted by Twogether Consulting.

Twogether Consulting will be a vendor at the PPAT (Private Providers Association of Texas) conference this week. Come by and meet me at our booth. This year’s session is Sept. 4th-6th, 2024 in Austin, Tx. Please don’t miss all the great topics for information sessions for HCS, TxHmL, ICF and ISS providers.

In October & November of 2024 we have several other conferences for IDD Providers: PACSTX (Providers Alliance For Community Services of Texas) has their conference Oct. 1st-3rd, 2024 in San Marcos, Tx and the Texas Chapter of AAIDD (American Association of Intellectual and Developmental Disabilities) will have their conference Nov. 12th-15th, 2024 in Galveston. Information and registration for these events are posted in this newsletter.

Twogether Consulting has several webinars posted for September already and we are working on October as well. Webinars posted on the Home Page of the website now are:

HCS/TxHmL New Provider Training: “Now I Got My Contract. What Do I Do?” Part I September 11th, 2024

HCS/TxHmL New Provider Training: “Now I Got My Contract. What Do I Do?” Part II September 18th, 2024

Developing The Implementation Plan Using Person-Centered Practices (Short Version) HCS/TxHmL (Includes a review of completing the IPC (Form 3608) September 19th, 2024

Please feel free to e-mail us or contact Meghan Jones to schedule an appointment for consultation. 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 will continue to provide whatever assistance we can with questions you may have, especially concerning HCS/TxHmL Care Coordination, Nursing, or general survey requirements from LTCR department in these programs. We continue to assist those working with the ICF/IID program as well. We are currently providing on-site live training at this time and live training is open to the public as well.

FYI-We do still provide “mentoring” assistance for program managers, case managers, and especially for nurses. We continue to provide nursing trainings and we can refer you out to our partner RN consultants, Nursing Innovations, who provide IDD nursing consultation, mentoring and/or training for HCS, TxHmL and ICF. If you have new staff or nurses who need training quicker than classes posted on the calendar, please let me know and we do offer some of our previously recorded sessions for a low cost which includes the handouts. We are happy to schedule one-on-one training sessions and mentoring with one of our consultants. We can also refer you to another resource, if more appropriate.

For HCS Providers who want to purchase specific services and/or specific forms we have on our website, may go to the following link “purchase services” page. If you are having issues downloading forms, please feel free to contact us at info@twogetherconsulting.com and I will be happy to send them to you.

Thank you,

Julie Blacklock/ Owner & IDD Waiver Consultant

Neighborhood LTC Pharmacy Hosting Educational Webinar With Jazz Pharmaceuticals For IDD Providers: September 23rd, 2024

Neighborhood LTC Pharmacy

August 31st, 2024

From Our Friends At Neighborhood LTC Pharmacy

NRx Upcoming FREE Educational Webinar: Cannabinoid Science 101

“We are hosting an educational webinar with Jazz Pharmaceuticals on September 23rd – you can see the registration page here: https://us06web.zoom.us/webinar/register/WN_BsCk1c4fSreeLF4pR64uYg#/registration

This webinar is geared towards IDD Providers and care teams. Please feel free to mention/share this opportunity with the folks you work with directly and share the link if they’re interested. We will also be promoting this through email outreach campaigns and social media.

We’re hoping for a great turnout!

If you have any questions, please let me know.”

Stacy Wilson

Director of Business Development

816.654.6200

Click to Schedule a Meeting with Me!

Stacy Wilson

Director of Business Development

Neighborhood LTC Pharmacy

816.654.6200

Click to Schedule a Meeting with Me!

House Human Services Committee Meeting: August 27th, 2024 (Link To Recorded Hearing)

August 30th, 2024

Presentations from August 27th, 2024 House Human Services Committee meeting to receive information on interim charge #3 related to the HCS program and the Interest List. The committee received invited testimony from HHSC and two panels.

The first panel was comprised of representatives from the ARC, ADAPT and Disability Rights Texas; the second panel included representatives from the 3 IDD associations. Lastly, ANCOR, the national IDD provider association, presented a national perspective on direct care/attendant wages and workforce shortages, as well as managed care, specifically an overview of which states have IDD long term services and supports under managed care and related costs.

Presentations attached include the following:

~ HHSC’s presentation

~ Joint presentation of the Texas Council, PPAT and PACSTX

~ ANCOR’s presentation on managed care

~ ANCOR’s testimony on wage rates (submitted, not presented during the hearing)

You can go to the following link, click on 8/27/2024 Human Services and scroll to the 1:27:40 time stamp: https://house.texas.gov/videos/committees/88

HHSC will present its LAR and answer questions from the LBB and GOBP.

Interested persons may watch the hearing on 9/30/2024 by going to: https://house.texas.gov/videos

IDD and PI Quarterly Webinar With HHSC LTCR-July 31st, 2024: Recording Available

August 18th, 2024

The July 31 recording of the Intellectual and Developmental Disability Programs (IDD) and Provider Investigations (PI) quarterly webinar with Long-term Care Regulation (LTCR) is available.

Read the IDD and PI Quarterly Webinar (PDF).

Email LTCR Policy for the transcript.

HHSC’s Pre-Recorded Modules: TxHmL Certification Principles

Click here to access these pre-recorded modules.

August 18th, 2024

FYI- These training modules are very helpful to new HCS providers and/or HCS provider applicants

New TxHmL Certification Principles modules available for Providers

HHSC Long Term Care Regulation has posted 4 recorded modules online, covering the new TxHmL Certification Principles for TxHmL Providers. These new principles became effective June 21, 2023. Each module is approximately 40-minutes in length. All current and potential TxHmL Providers are encouraged to access each of these modules.

Certificates of Attendance will not be offered for viewing the pre-recorded webinars.

Joint Training From HHSC For Providers

Joint Training Page Available for HCS/TxHmL/ICF/ISS Providers

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

August 18th, 2024

September 2024 HCS/TxHmL Provider Training Opportunities

Long-Term Care Regulation staff and program providers are invited to attend the following webinar trainings hosted in June. If you register and can’t attend, please cancel your registration as soon as possible.

Death Notifications and Provider Investigation Reports for HCS/TxHmL Providers (course description)

Tuesday, September 3, 2024 (3:00 PM – 4:00 PM)

Writing Plans of Correction for Individualized Skills and Socialization Providers (course description)

Thursday, September 12, 20243:00 PM – 4:30 PM

July 28th, 2024

August 2024 HCS/TxHmL Provider Training Opportunities

HCS Certification Standards: An Overview of Changes
Tuesday, August 6, 2024 (1:30 PM – 2:30 PM)
Register here for the webinar.

Writing Acceptable Plans of Correction for HCS and TxHmL Providers (course description)
Thursday, August 22, 2024 (9:30 AM – 4:00 PM.)
Register here for the webinar

Hurricane and Flooding Readiness for Home and Community Based Services and Texas Home Living and Individualized Skills and Socialization (course description)
Wednesday, August 28, 2024 (1:00 PM – 2:00 PM).
Register here for the webinar.

Click on the following links for more training opportunities:
Joint Training
HCS & TxHmL Training
Individualized Skills and Socialization

December 13, 2023

January 2024 HCS/TxHmL Provider Training Opportunities

Administrative Penalties and Related Processes for HCS & TxHmL Providers

Wednesday, Jan. 3
11:00 a.m.–noon.
Register here for webinar.

HCS Certification Standards: An Overview of Changes

Monday, Jan. 8
3:30–4:30 p.m.
Register here for webinar.

Infection Control for HCS & TxHmL Providers

Tuesday, Jan. 9
2–3 p.m.
Register here for webinar.

ICF Dietetic Services

Tuesday, Jan. 30
10–11 a.m.
Register here for webinar.

Live Session! Writing Acceptable Plans of Correction for HCS and TxHmL Providers
Wednesday, Jan. 17
9:30 a.m.–4:00 p.m.
Waco, TX
Register here for in-person class.

November 10th, 2023

November 2023 HCS/TxHmL Provider Training Opportunities

Death Notifications for HCS/TxHmL Providers
Monday, Nov. 20
4–5 p.m.
Register here for webinar.

Writing Acceptable Plans of Correction for HCS and TxHmL Providers

Wednesday, November 15, 2023

9:30 AM – 4:00 PM

Texas Health and Human Services Commission
535 S. Loop 288, Suite 2001
Room: Conference Room 2134
Denton, TX 76205
(19 MAX) Register For Live Training here

Writing Plans of Correction for Individualized Skills and Socialization Providers
2:30 p.m.–4:30 p.m.
Tuesday, November 28, 2023

October 15th, 2023

October 2023 HCS/TxHmL Provider Training Opportunities

Writing Plans of Correction for Individualized Skills and Socialization Providers
Monday, Oct. 30
2–4 p.m.
Register here for webinar.

What Surveyors Look for in Intermediate Care Facilities – ICF
Tuesday, Oct. 31
10–11 a.m.
Register here for webinar.

Understanding the Survey Process
Tuesday, Oct. 31
1–2:30 p.m.
Register here for webinar.

August 24th, 2023

September 2023 HCS/TxHmL Provider Training Opportunities

Individualized Skills and Socialization Survey Process and ANE Overview
Friday, Sept. 1
9–10:30 a.m.
Register here for webinar.

Top 10 Citations for HCS and TxHmL Providers for FY 2022
Tuesday, Sep. 5
3:30–4:30 p.m.
Register here for webinar.

Writing Plans of Correction for Individualized Skills and Socialization Providers
Tuesday, Sept. 19
1:30–3:30 p.m.
Register here for webinar.

Administrative Penalties for HCS and TxHmL Providers
Thursday, Sept. 21
11:30 a.m.–12:30 p.m.
Register here for webinar.

HCS Certification Standards: An Overview of Changes
Thursday, Sept. 28
3–4:30 p.m.
Register here for webinar.

Coming in July 2023!

HCS Certification Standards: An Overview of Changes (course description)

Wednesday, July 5, 2023

11:30 AM – 1:30 PM

Regulatory Services Incident Reporting for Individualized Skills and Socialization Providers (.5 hours) (course description)

Thursday, July 6, 2023

3:30 PM – 4:00 PM

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

Wednesday, July 12

9:30 AM – 10:30 AM

Hurricane and Flooding Readiness for Home and Community Based Services and Texas Home Living and Individualized Skills and Socialization (course description)

Wednesday, July 19, 2023

3:00 PM – 4:00 PM

and more coming

June 13th, 2023

June 2023 HCS/TxHmL Provider Training Opportunities

Hurricane and Flooding Readiness for HCS and TxHmL Providers and Individualized Skills and Socialization Providers
Tuesday, June 13
4:30 p.m.–5:30 p.m.
Register here for webinar.

Individualized Skills and Socialization Basic Program Overview
Tuesday, June 20
1–2 p.m.
Register here for webinar.

Individualized Skills and Socialization Basic Program Overview
Thursday, June 22
10–11 a.m.
Register here for webinar.

Understanding the Health Maintenance Activity (HMA) Rules ALF
Thursday, June 22
2–3 p.m.
Register here for webinar.

Individualized Skills and Socialization Basic Program Overview
Thursday, June 22
10–11 a.m.
Register here for webinar.

Regulatory Services Incident Reporting for Individualized Skills and Socialization Providers (.5 hours) (course description)

Monday, June 26, 20232:30 PM – 3:00 PM

Hurricane and Flooding Readiness for ICFs
Tuesday, June 27
1–3 p.m.
Register here for webinar.

Regulatory Services Incident Reporting for Individualized Skills and Socialization Providers (.5 hours) (course description)

Monday, June 26, 2023

2:30 PM – 3:00 PM

Writing Acceptable Plans of Correction of HCS and TxHML (course description)

Wednesday, June 28, 2023

9:00 AM – 4:00 PM (Live Session in Conroe)

HCS & TxHmL Training

ISS Training

April 2023 HCS/TxHmL Provider Training Opportunities

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

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

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

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

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

February 2023 HCS/TxHmL Provider Training Opportunities

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

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

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

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

Dec. 2022 HCS/TxHmL Provider Training Opportunities

Emergency Preparedness 101 for HCS and TxHmL Providers

Tuesday, Dec. 1311:30 a.m.–12:30 p.m.

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

Wednesday, Dec. 211–2 p.m.

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

9 a.m.–4 p.m.Nacogdoches, Texas

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

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

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

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

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

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

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

Emergency Preparedness 101 for HCS Program Providers (course description)

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

July 2022 HCS/TxHmL Provider Training Opportunities

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

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

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.

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

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

July 5th, 2022

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

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

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

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

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

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

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

HHSC Info: Comprehensive Guide To Navigating Immunizations

August 16th, 2024

The Texas Department of State Health Services (DSHS) hosts a website that offers immunization information and tools for the general public, health care providers, and local health departments.

General public: Provides a user-friendly system for accessing services such as requesting immunization records, finding a vaccine provider, and staying updated on the immunization schedule.

Health Care Providers: Provides an overview of DSHS programs, webinar access, and a learning portal that offers training for providers in the Texas Vaccines for Children (TVFC) and Adult Safety Net (ASN) programs.

Health Departments: Provides effective support for department initiatives through access to contracts, grants, specialized training, and educational materials.

Monthly Provider Demonstration Webinars For CIMS

August 16th, 2024

Note: All Critical Incidents are entered into the CIMS system for HCS/TxHmL providers. FYI-ISS providers please report all critical incidents to CIIS in Tulip, not CIMS.

Monthly provider demonstration webinars are offered to providers with access to CIMS. HHSC encourages providers to take advantage of these live training opportunities.

This applies to:

Community Living Assistance and Support Services providers (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).

Register for the webinars by logging into CIMS and navigating to Help (top right of dashboard). Click on Help, followed by Training. Choose Register for Provider Demonstrations from the available courses.

Email MCS_CIMS@hhs.texas.gov with any questions or concerns.

LIDDA Handbook Has Been Revised

August 15th, 2024

LIDDA Handbook Revision

The Local Intellectual and Developmental Disability Authority Handbook (LIDDA) revision 24-2 updates Sections 13000, 15000, 19000, 21000 and 24000, and adds Appendix VI and Appendix VII.

This revision is effective Aug. 15, 2024. Click this link to see the updates.

PPAT Fall Conference For September 4th-6th, 2024: Update

August 14th, 2024

27^th ANNUAL PPAT CONFERENCE

Doubletree Hotel Austin

6505 IH-35 North, Austin, TX 78752

*Twogether Consulting will have an exhibitor booth at this event. Please come by and meet us.

Join PPAT for Their Annual PPAT Conference, September 4th-6th, 2024!

Online Registration available at: 2024_PPAT_Conf_Registration

Keynote Speaker: Robert Canino, JD, Regional Attorney, Dallas District Office, U.S. EEOC. Mr. Canino who prosecuted the case of EEOC v. Hill Country Farms, Inc., dba Henry’s Turkey Services will discuss how the EEOC used the American with Disabilities Act (ADA) to win compensatory and punitive damages for intentional discrimination of the 32 Texas men with intellectual and developmental disabilities who lived the majority of their adult lives in deplorable and abusive conditions for over 30 years working, unnoticed, in a turkey processing plant in Iowa. If you are not familiar with the case and the history of its origins, this is a ‘must hear’ presentation. Even if you have previously heard Mr. Canino speak on this topic or even if you’ve read the book – The Boys in the Bunkhouse – you need to hear the story again!

Preview of Sessions (The list is not inclusive and is subject to change)

Re-establishing Medicaid Eligibility: Help is on the Way!

Billing for Nursing Services: Helpful Tips from the Experts

Updates on HHSC Office of Disability & Coordinating Services Activities

EVV: New billing codes, extension of PCS grace period & more

Fair Housing Act: Impact of city ordinances on group homes

Building Collaborative Relationship with Your LIDDA

89th Legislative Session: What to Expect, How to Prepare (All Hands on Deck Needed)

Abuse, Neglect & Exploitation Investigative Processes for ICF/IID & HCS

Regulatory Year in Review & More: Joanalys B. Smith, Attorney at Law

Employment Services: Contracting with TWC/Helping persons obtain employment

Medicaid Revalidation Process/PEMS: ICF/IID & HCS

Change of Ownership (CHOW): Step-by-step review of process

Best Practices: Caring for persons with IDD with dementia

Individualized Skills & Socialization (ISS):

PPAT Conference: A session on ISS has been added to the PPAT Conference program. Kaliope Schmidt, HHSC, will review billable and non-billable services, frequently cited billing errors and touch on ISS-related HCBS Settings rules requirements.

ISS Proposed Licensing Rule Amendments: Last spring HHSC requested ‘informal’ comment on proposed amendments to the ISS Licensing rules under Chapter 559. According to HHSC, the proposed amendments will be presented at the November HHSC Executive Council meeting. It’s not known whether the proposed amendments will be published in the Texas Register for formal comment before or after the November meeting.

Implementation Status of HB 4696 (Nobel) & HB 1009 (Turner) in ICF/IID and HCS: In confirming HHSC’s presentation on these two bills at PPAT’s conference, HHSC stated it will only be able to review newly implemented ANE reporting and investigating processes in the ICF/IID program, but will provide an update on implementation plans related to HCS/TxHmL.

Registration Information & Marketing Opportunities:

Call the PPAT Office at 512-452-8188 or email Jaim Kaysonphet, Administrative Assistant at jaimppat@aol.com.

Online Registration available at: 2024_PPAT_Conf_Registration

Hotel Information & Reservation Link:

DoubleTree Hotel: 6505 IH 35 North ~ Austin, TX 78752 ~ 512.454.3737

Make room reservations NOW at: 2024PPATConf-HotelReservationLink

You can also make reservations with the DoubleTree Hotel toll-free national reservation center line at 1.800.866.3126, by the August 16, 2024 designated cut-off date to receive the special rate of $169.00 Single/Double. Identify yourself with the Private Providers Association of Texas (promotional code PPA). Reservations are subject to space and availability. All reservations must be guaranteed by credit card or advance deposit. Reservations must be canceled by 1:00 PM (noon) local time, 48 hours before the day of arrival or the first night of the stay will be charged.

Parking:

Covered self-parking for conference attendees is $10/day. Parking based on availability.

ICF/IID Updates

IL 2023-45 Personal Needs Allowance (PNA) Adjustment (Replaces IL 2022-16) (texas.gov).

August 12th, 2024

PL 24-04 -Changes & Guidance To ICF/IID Provider Reporting Processes and HHSC Investigating Processes- Effective March 1, 2024.

ICF/IID: The ICF/IID rules to implement HB 4696 were circulated for informal comment in December 2023.

As the ICF/IID rules to implement HB 4696 applies to the 6-13 bed facilities and is not yet adopted, yet the provisions in the bills became effective 9/1/2023. We are unclear if or how HHSC is monitoring for compliance as the only guidance released to date is PL 24-04 . And, this PL only addresses the provider reporting processes and HHSC investigating processes which became effective March 1, 2024. The PL does not provide guidance or address compliance related to the directives in the bill which, as of September 1, 2023, is now law.

In response to inquiries from providers and provider associations, HHSC has now stated that “at this time ICF/IID surveyors are surveying for compliance with the current regulations located in 26 TAC 551 and guidance issued in PL 2024-04.“

NOTE: HCS/TxHmL: It’s anticipated the rules to implement HB 1009 in HCS/TxHmL will be posted for ‘informal’ comment this fall. Rules to implement HB 4696 are postponed until after the 89th Session.

March 10th, 2024

ICF/IID ANE Webinar- Very Important!

Reporting Abuse, Neglect, Exploitation Changes and Self Reporting Incidents for Intermediate Care Facilities
Thursday, March 21
2–3:30 p.m.
Register here for webinar.

HHSC Long-term Care Regulation has published Provider Letter 2024-04 Revised (Replaces PL 17-02 and 17-03) Revised Process for Reporting and HHSC Investigations of Abuse, Neglect, and Exploitation for Intermediate Care Facilities for Individuals with an Intellectual Disability (ICF/IID). Don’t forget, as of March 1st, 2024, this replaces the previous ANE Reporting & Investigations process. Reporting is now done to (CII) Complaint & Incident Intake.

February 25th, 2024

New Reporting Process for ANE Reporting & Investigations for ICF/IID Program

HHSC 2/23/2024 Notice:

HHSC has released a new letter of guidance regarding the revised ANE reporting process to CII and the ANE investigation process for ICF/IID. Here is the published provider letter (PL) 2024-04

Beginning March 1, 2024, reporting of investigations for allegations of abuse, neglect, and exploitation (ANE) for Medicaid consumers served by an Intermediate Care Facility for Intellectual and Developmental Disabilities (ICF/IDD) will transition from the Department of Family and Protective Services Statewide Intake (DFPS SWI) to HHSC Regulatory Services Complaint and Incident Intake (CII). 

Additionally, processes related to investigations of ANE of ICF/IDD will change as of March 1, 2024.

For questions contact LTCRPolicy@hhs.texas.gov.

January 20th, 2024

Surrogate Decision-Making Program (SDMP)

Randy Rowley, Manager, SDMP, HHSC, provided an overview of the surrogate decision-making program to the workgroup. Click here for link to ppt

HHSC December 27, 2023 Bulletin:

The legislatively mandated Surrogate Decision-making Program (SDMP) authorizes Surrogate Consent Committees (SCCs), comprised of trained volunteers, to provide written informed consent for individuals residing in community-based ICFs/IID who have been assessed to lack the capacity to make certain treatment decisions for themselves and have no legal guardian or actively involved family members serving as Surrogate Decision Makers (SDMs) or the treatment decisions are beyond the scope of the SDMs.

The SDMP facilitates compliance with Code of Federal Regulations (CFR) Title 42 and state ICF/IID rules regarding protection of individuals rights.

For the list of treatment decisions that a SCC can make see the HHS SDMP webpage.

Watch for upcoming training event announcements.

For questions about SCCs, or if you want to volunteer to serve on a SCC, email SDMP Manager Randy Rowley or call 512-438-4306.

ICF Rules-TAC Code Draft Title 26 Part I Ch 551

Draft Rules

Personal Needs Allowance Information Letter

Personal Needs Allowance (PNA): PNA of individuals residing in a nursing home or ICF/IID from $60/month to $75/month, and for couples from $120/month to $150/month effective January 1, 2024. HHSC posted an information letter regarding this change:

June 15th, 2023

Personal Needs Allowance Increase Bill passed during 88th legislature session

~ HB 54 (Thompson) relating to increasing the personal needs allowance of persons in a nursing home or ICF/IID from $60/month to $75/month.

Access to HB 54: https://capitol.texas.gov/tlodocs/88R/billtext/pdf/HB00054F.pdf#navpanes=0

HB 54 Analysis: https://capitol.texas.gov/tlodocs/88R/analysis/pdf/HB00054S.pdf#navpanes=0

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

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 updated ICF COVID-19 Response Plan (PDF).

Email LTCR Policy for the transcript.

February. 20th, 2022

Mar. 07 ICF COVID-19 Webinar with HHSC LTCR

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

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

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

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

February 13th, 2022

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

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

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

The rule requires ICF/IIDs to:

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

January 7th, 2022

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

Document Version Date Change Comments

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

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

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

Update your Infection Control Policies and other related policies accordingly.

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

November 21st, 2021

HHSC Publishes PL 2021-38 Medicaid Bed Reallocation

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

November 4th, 2021

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

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

October 24th, 2021

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

Super important!!!!

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

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

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

September 15th, 2021

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

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

September 5th, 2021

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

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

September 5th, 2021

ICF/IID Leave During COVID-19 Rule Reinstated

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

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

August 1st, 2021

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

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

Read the updated ICF 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.

Listen to the COVID-19 Q&A recording.

March 11th, 2021

Recording of ICF COVID-19 March 8 Provider Webinar Available

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

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

February 8th, 2021

Draft ICF/IID Rule Changes

Attached please find the following:

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

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

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

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

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

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

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

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

January 19th, 2021

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

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

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

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

Read the updated ICF 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.

View the COVID-19 Q&A recording.

January 10th, 2021

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

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

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

HHSC Publishes Revised Reporting Guidance for Long-Term Care Providers

(PL 20-37)

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

November 22nd, 2020

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

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

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

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

ICF Provider Webinar

November 30, 2020

11 a.m. – 12:30 p.m.

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 (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,

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

LTCR Form 2195

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

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

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

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

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

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

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

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

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

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

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

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

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

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

10/05/20

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

HHSC Email Update

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

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

10/03/20

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

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

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

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

Phase I Visitation Rules, no longer in effect!

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

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

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

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

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

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

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

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

FAQ’s (June 2020)

(Section) Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs)

31.Question:

How should an ICF handle the discharge summary when a client is admitted on a temporary emergency basis from the community or another ICF?

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

32.Question:

How should an ICF handle the development of a Comprehensive Functional Assessment (CFA) and an Individual Program Plan (IPP) when a client is admitted on a temporary emergency basis from the community or another ICF?

Answer: Clients who are admitted on a temporary emergency basis to an ICF during the PHE will nonetheless continue to need to have a Comprehensive Functional Assessment (CFA) and an Individual Program Plan (IPP) in accordance with 42 CFR 483.440(c). Completion of these documents will provide an opportunity for the IDT and staff to meet the basic and critical care needs of the client. CMS is aware that staffing shortages and/or client surges due to the PHEmay create a high demand on available staff time that makes it difficult to complete a full CFA and IPP. Each ICF will need to evaluate what amount and detail of documentation is necessary to ensure that critical health and treatment information is identified to allow active treatment during the PHE. This health and treatment information will support successful adjustment for the client to the new temporary living environment. When available and if appropriate, the IDT should maximize the use of telehealth for the development of a client’s IPP for temporary emergency admissions during the PHE.

33.Question:

During the PHE are ICFs still required to have and use a specially constituted committee or committees?

Answer: Yes. CMS believes that the use of this committee may be of value during the time of the COVID-19 PHE. The committee can provide an opportunity to support and make suggestions to facilities as they may need to adapt policies and procedures as well as why and how services are being provided to clients, which clients may find difficult to understand and potentially lead to inappropriate adaptive behavior. When available and if appropriate, the specially constituted committee should maximize the use of telecommunications to convene this committee as a resource to support the challenges faced by staff and clients during the PHE.

34.Question:

When a client has tested positive for COVID-19 and the ICF/IID implements quarantine procedures, client rights are immediately abridged and severe behaviors are likely to occur. What is the guidance from CMS on balancing the CDC expectations with the rights of the individual?

Answer: The health and safety of the clients, visitors, and staff at an ICF/IID are of the utmost importance for CMS. Based on the ICF Emergency Preparedness plan, and in accordance with the requirement at 42 CFR 483.440(c)(3)(v) that the IPP assess the client’s health status in the context of a COVID-19 diagnosis, the ICF/IID must revise the client’s IPP to reflect specific procedures and steps that will be taken to quarantine the client while also taking every step reasonable to protect the rights, safety, and health of the infected client, as well as those of the staff and other clients. ICF/IIDs are encouraged to use telehealth and assistive technology to minimize social isolation to the extent possible.

35.Question:

Are intermediate Care Facilities required to participate in the COVID-19 CDC National Healthcare Safety Network (NHSN) reporting requirements?

Answer: ICF/IIDs do not have a regulatory requirement for the reporting of communicable diseases, healthcare-associated infections, and potential outbreaks to Federal (such as the CDC), State and/or local health departments. ICF/IIDs do have a requirement under 42 CFR 483.420(c)(6), which addresses communication to family and/or guardian when a client’s condition changes, including the onset of serious illness (such as COVID-19). Although reporting to CDC is not required, ICF/IIDs may voluntarily report COVID-19 cases to the CDC, and CMS encourages them to do so to facilitate public health tracking of the pandemic. You may find the following CDC resource links helpful:

https://www.cdc.gov/nhsn/pdfs/covid19/ltcf/covid19-enrollment-508.pdf and

https://www.cdc.gov/nhsn/pdfs/covid19/ltcf/cms-covid19-req-508.pdf.

Rural Health Clinics (RHC)/Federally Qualified Health Centers (FQHCs)

36.Question:

Has CMS implemented any flexibilities to help RHCs and FQHCs respond to the PHE posed by COVID-19?

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

37.Question:

When do these flexibilities go into effect?

Answer: The flexibilities for staffing requirements, physician supervision of nurse practitioners, and temporary expansion sites are retroactively effective beginning March 1, 2020, through the end of the emergency declaration and CMS issues an end of outbreak notification.

38.Question:

Do these flexibilities apply to all RHCs and FQHCs?

Answer: The flexibilities for physician supervision of NPs apply to all RHCs and FQHCs, to the extent permitted by state law. Flexibilities to the 50% mid-level staffing requirement apply to RHCs only as the mid-level requirement is RHC specific. Lastly, flexibilities to the location requirement apply to existing RHCs and FQHCs.

39.Question:

How does the mid-level practitioner 50% flexibility benefit an RHC? Are RHCs required to submit any documentation to CMS for this waiver?

Answer: This waiver provides RHCs with flexibilities with regards to the percentage of operating hours the facility has a mid-level practitioner available to furnish patient care services. While the waiver offers flexibilities with staffing mixes, a physician, NP, physician assistant, certified nurse midwife, clinical social worker, or clinical psychologist must be available on site to furnish patient care services whenever the RHC is open and operating. CMS does not require any submission of documentation for this waiver.

40.Question:

How does the waiver affect the physician supervision of NPs?

Answer: During the PHE, NPs may function to the fullest extent possible without physician supervision, and to the extent of applicable state law. However, the physician continues to be responsible for providing the overall medical direction for the RHC/FQHC’s health care activities, consultation for, and medical supervision of all other health care staff, either in person or through telehealth and other remote communications.

41.Question: Can an RHC/FQHC provide patient care services at temporary locations?

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

42.Question:

Do these flexibilities apply to temporary locations established in a parking lot?

Answer: Yes. During the COVID-19 PHE, CMS is allowing RHC/FQHCs to establish temporary expansion sites in a parking lot; either on or off its premises. As with other temporary expansion locations, the parking lot site must meet the same RHC/FQHC regulations as the main site, unless otherwise waived. Therefore, the RHC/FQHC may provide for those services via the existing CCN of its approved permanent location. RHC/FQHC is expected to be operating in a manner not inconsistent with its state’s emergency preparedness plan.

43.Question:

Can an RHC/FQHC provide patient care services to a patient in the patient’s vehicle?

Response:During the COVID-19 PHE, to help minimize transmission, an RHC/FQHC visit can take place if the patient is in a vehicle on the premises of the RHC/FQHC and all requirements for a billable visit are met (e.g. medically-necessary, face-to-face visits with an RHC/FQHC practitioner). The RHC/FQHC would provide the services using its existing CCN. All services provided are held to all RHC/FQHC regulations, unless otherwise waived. This includes, but is not limited to, the provisions of services as per 42 CFR 491.9(c). RHCs/FQHCs must consider the clinical appropriateness of services before conducting a visit and/or treating a patient in their vehicle.

44.Question:

Will a RHC or FQHC seeking approval of its temporary location as being consistent with the emergency response and pandemic plan be provided with evidence of approval or denial from the state?

Answer: State emergency plans and processes will vary. RHCs/FQHCs should retain any communications with the State emergency preparedness representatives to demonstrate that its temporary location(s) are not inconsistent with the state emergency preparedness and pandemic plan for the COVID-19 PHE. Once the state has approved the addition of temporary location(s), there are no additional CMS enrollment or reporting requirements. The RHC/FQHC may begin utilizing the temporary expansion location throughout the duration of the COVID-19 PHE.

45.Question:

May an RHC or FQHC continue providing RHC/FQHC services at the temporary location once the COVID-19 PHE ends?

Answer: No. All waived CoPs, CfCs, requirements, and most temporarily revised regulations will terminate at the end of the PHE. If the RHC/FQHC wishes to continue services at the temporary expansion location after the PHE has ended, the facility must submit form 855A to begin the process of enrollment and initial certification as a RHC or FQHC under the regular process and meet all applicable requirements, including 42 CFR 491.5.

46.Question:

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

Answer: The flexibilities apply to both accredited and non-accredited RHCs. Notifying your AO of the temporary location is recommended.

47.Question:

Where can I find answers to COVID-19 flexibilities regarding Medicare Fee-for-Service (FFS) billing for RHCs and FQHCs?

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

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

See the following pdf link from HHSC

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

March 13th ICF FAQ’s See link below:

https://hhs.texas.gov/sites/default/files/documents/services/health/coronavirus-covid-19/covid-icf-iid-faq.pdf

Survey Operations Resume as of June 15th, 2020

From HHSC

As of June 15, 2020, Survey Operations has begun to resume some normal survey activity, and Enforcement is also resuming enforcement processes and activities. This means we will be issuing various due process notice letters to individuals, agencies, and facilities that have been on hold due to COVID.

Please contact Enforcement Director Derek Jakovich by email at derek.jakovich@hhsc.state.tx.us if you have questions.

In response to questions regarding what normal survey and enforcement activities are resuming as of June 15 and what programs are affected, HHSC replied as follows:

As of June 15, 2020 Survey Operations is resuming some survey activity such as complaints with lower priorities, and possibly some licensure and certification surveys. For Enforcement, due process notice letters such as denials, revocations, and imposition of administrative penalties will be issued and the opportunity to appeal will be provided. Of course, the COVID circumstances may affect these activities.

The notice applies to NF, ALF, DAHS, PPECC, HCSSA, and ICF/IID.

Providers Must Log Residents’ Leave

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

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

Contact Information

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

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

Provider Joint Training Opportunities

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

Survey Process for ICF Has Changed: Please Be Aware

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

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

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

Appendix Q of SOMA (Immediate Jeopardy) Changes

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

CMS clarifications letter

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

Online basic training for Core Appendix Q is available on the Integrated Surveyor Training

Website at the following link:https://surveyortraining.cms.hhs.gov/

This basic training is intended to provide Regional Office and State Survey Agency surveyors, management staff, and

training coordinators, as well as providers, suppliers, and laboratories, and other stakeholders with

the ability to identify immediate jeopardy

NOTE: This is a required training for RO and SA staff involved in immediate jeopardy

determinations. All RO and SA surveyors, members of management, and training coordinators

are expected to take this training as soon as practicable, but not later than March 22, 2019.

Point of Contact:

For questions related to this information, please add in subject line

“Immediate Jeopardy Inquiry” and send your email to:

QSOG_GeneralInquiries@cms.hhs.gov

Effective Date:

Immediately-This policy should be communicated to all survey and certification staff, their managers and the State

and Regional Office training coordinators within 30 days of this memorandum.

SOMA appendix Q Section Immediate Jeopardy

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

II. Proposed ICF/IID Rates: Below please find the link to information about the August 2, 2019 HHSC public hearing on the proposed ICF/IID rates. The hearing will be at 3:00 p.m. and held in the HHSC public hearing room (first floor of HHSC). Additional information about the hearing (specifically, needed member action) will be forthcoming.

https://hhs.texas.gov/about-hhs/communications-events/meetings-events/2019/08/02/proposed-medicaid-payment-rates-non-state-operated-intermediate-care-facilities-individuals

Though the above link provides the proposed rates, below is a chart which reflects both the current and proposed ICF/IID rates. Note that with the exception of LON 9, all LON categories and facility settings/sizes are proposed to receive an increase. Also, at this time, the specifics regarding the impact of the increases on the rate categories (residential direct and indirect & day habilitation direct and indirect) are not yet available. According to HHSC the ‘specifics’ should be available on or after this Friday (July 19, 2019).

LON & Facility Size	Current Rates	Proposed Rates
SMALL
LON 1	$144.25	$150.31
LON 5	$160.74	$167.90
LON 8	$182.82	$191.85
LON 6	$223.88	$236.59
LON 9	$406.11	N/C
MEDIUM
LON 1	$118.04	$123.14
LON 5	$134.06	$140.24
LON 8	$158.90	$166.92
LON 6	$190.24	$200.79
LON 9	$385.84	N/C
LARGE
LON 1	$112.09	$116.30
LON 5	$119.64	$124.64
LON 8	$133.22	$139.44
LON 6	$179.40	$188.96
LON 9	$387.25	N/C

Pre-Vocational Services: Proposed Rule Amendments to Implement HB 4169

https://www.sos.texas.gov/texreg/archive/August22024/Proposed%20Rules/26.HEALTH%20AND%20HUMAN%20SERVICES.html#53

August 6th, 2024

House Bill (H.B.) 4169 (Price) which was passed by the 88th Legislature directs HHSC to add pre-vocational services as a new benefit to HCS, TxHmL and DBMD.

HHSC activities related to Implementation:

Following the bill’s passage and Governor’s signature, HHSC consulted with the IDD SRAC Meaningful Skills Development & Employment Services subcommittee on several occasions to not only obtain feedback on implementation of the service, but also to share conversations HHSC had with CMS regarding the bill including that CMS told HHSC the service must be separate from ISS.

Earlier this year, (February 15, 2024), HHSC held a public hearing to receive comment on the proposed new service. Links to the recording of the public hearing and HHSC handout are provided below.

Last month HHSC sought public comment on the waiver amendments it intends to submit to CMS later this month requesting approval to add the new service to the HCS, TxHmL and DBMD waiver programs.

Last Friday, August 2, 2024, HHSC published as proposed in the Texas Register rules to implement the new service in the HCS,TxHmL & DBMD programs. See attached or the link provided below.

Effective date targeted for January 1, 2025.

Proposed Rules: There are two options for reading the proposed rules. You may click on the first link under ‘Resources’ below, or you may download the attached documents. If choosing the latter option, know that PPAT highlighted the following items in yellow: the proposed provisions, the summary of proposed amendments (see Section-by-Section Summary, pages 1-2), and the Public Comment instructions (page 3).

Resources:

Link to access the DBMD, TxHmL & HCS HB 4169 rules as proposed in the August 2, 2024 Texas Register:

February 15, 2024 HHSC Public Hearing: https://texashhsc.v3.swagit.com/videos/297572

Link to handout provided at February 15, 2024 Public Hearing:

https://www.hhs.texas.gov/sites/default/files/documents/feb-2024-hcs-txhml-dbmd-public-hearing-agenda-item-2a.pdf

PACSTX CONFERENCE: “LAUNCHING FORWARD”-OCT. 1st-3rd, 2024-SAN MARCOS, TX

From our friends at PACSTX!

2024 Annual PACSTX Conference October 1st-3rd

Embassy Suites Conference Center

San Marcos, Tx

Members: $350 | Non-Members: $375 Early bird pricing ends September 1. Group pricing is available.

2024-PACSTX-Topics-Flyer

FOR MORE INFORMATION CLICK HERE

FOR REGISTRATION

HOTEL REGISTRATION

This Year’s Topics

-New regulations & regulatory enforcement

-Strategies for addressing personnel issues unique to our industry

-Tech solutions & related strategies for providing outstanding management

-Legal challenges & proactive strategies to manage risk

-Health, welfare, & safety

-Enhancing our understanding of our services into the future

-Partnering with other community resources to improve our ability to meet the needs of those we serve

-Partnering with HHSC & the LIDDAs to improve outcomes

-Grass roots advocacy initiatives to achieve legislative outcomes

Medicaid Renewal Due Date: Notice of Extension

July 29th, 2024

A waiver was received from CMS to extend renewals for individuals who receive Medical Assistance Only for Medicaid for the Elderly and People with Disabilities due for renewal in October through December 2024 for 12 months.

To clarify this would apply to the individuals who are receiving Medicaid due to a disability (SSDI) or being over 65 years of age, and would include individuals receiving a waiver program or residing in a facility. Their Medicaid will continue unless there is a change in circumstance.

NOTE: The extension does not apply to individuals receiving Medicaid due to receipt of Supplemental Security Income or SSI.

SEE NOTICE BELOW:

HHSC Contact List Update: Provider Claims Services (PCS)-Claims Management Division

July 26th, 2024

New PCS Contact

In December, Marie Redman, Provider Claims Services, HHSC, retired. Many providers relied on Ms. Redman for assistance with billing and claims issues. Please update your HHSC contact list to change the contact person to Leah Gann (at least for now).

Ms. Gann started in February of this year, as the Manager V with PCS in the Claims Management Division. She now holds the position that Marie Redman held prior. She has requested that providers please send emails that would have gone to Marie Redman to her and she or her team will get you a response as quick as possible.

Contact Information:

Leah Gann (Manager V with PCS)

HHSC MCS/Operations LTC Claims Management

Office: 512-438-2268

Mobile: 737-308-1175

Email: Leah.Gann1@hhs.texas.gov

City of Austin: Register For Extra Help During A Power Outage If You Have Medical Needs Requiring Electricity

July 25th, 2024

Register Now For Extra Help Before a Power Outage

Austin Energy logo: Customer Driven. Community Focused

Great resource I just saw from the city of Austin that providers may need for some of their more medically fragile individuals during a power outage with medical equipment requiring power.

“Does someone in your household have a critical medical condition that could become life-threatening during a power outage?

You may qualify for the City of Austin’s Medically Vulnerable Registry.

Customers on the Medically Vulnerable Registry work with a designated case manager to establish an emergency backup plan for power outages. If a customer is having trouble paying their utility bill, their case manager can help with flexible payment plans and other options.

The Medically Vulnerable Registry is just one part of the Customer Assistance Program, a City of Austin program which helps residents in need.

To learn more about the Medically Vulnerable Registry, visit coautilities.com/go/mvr or call 512-494-9400 to get started.”

Correction to “LTC Dashboard Data Export Report Column Names (HCS/TxHmL Providers)

July 24th, 2024

Correction to “LTC Dashboard Data Export Report Column Names”

Regarding the Excel Export Reports on the Long-Term Care (LTC) Dashboard:

On June 21, 2024, two mislabeled column names were corrected on several LTC Dashboard Data Export Reports:

Column O – Previously mislabeled as ‘Medicaid Eligibility End Date’ is now correctly labeled as ‘Last Billed Date;’ and
Column P – Previously mislabeled as ‘Last Billed Date’ is now correctly labeled as ‘Medicaid Eligibility End Date.’

The corrected column names are reflected on the following LTC Dashboard Data Export Reports:

Past Due

Medicaid Eligibility
LOC/LON Assignment
Individual Plan of Care

Due

Medicaid Eligibility due in 90 days
LOC/LON Assignment due in 60 days
Individual Plan of Care due in 60 days

Exceptions

Suspension Over 30 days
Pending Termination Over 60 days
NO Billed Svcs. Over 60 days

Other Dashboard Data

Individual by Program
Individual by LA
Individual by WCA
Individual by Status

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

EVV Guidance For Providers During Severe Weather

Contact EVV with questions.

July 23rd, 2024

SEVERE WEATHER POLICY REMINDER

In response to the recent severe weather, HHSC is issuing the following guidance for EVV program providers, financial management services agencies (FMSAs) and Consumer Directed Services (CDS) employers.

All service delivery for an EVV-required service must be documented in the EVV system. If an EVV clock in and clock out method (home phone landline, mobile, or alternative device) was not available due to the severe weather, service providers and CDS employees must make best efforts to document service delivery visits according to program policies.

For visits which were not recorded using an EVV clock in and clock out method, program providers, CDS employers and FMSAs must:

Create manual visits in the EVV system based on the program requirements , and ensure the visit is accepted into the EVV Aggregator/Portal within 95 calendar days from the date of the visit.
Keep all supporting service delivery documentation available as required by program policy.

As a reminder, claims matching for all EVV required services began April 1, 2024. If a claim is submitted for an EVV required service, a valid EVV visit must be on file.

EVV Reason Code

See the following EVV reason code example when performing visit maintenance on visits affected by the hurricane (including creating manual visits):

Reason Code: Disaster

Number: 130

Description: B – Hurricane

EVV Compliance Impacts

Program providers, CDS employers and FMSAs are currently in a grace period for EVV usage and landline reviews. This means that anytime a manual visit is entered into the EVV system, it will affect your EVV Usage Score. Per the HHSC EVV Policy Handbook, Payers must perform due diligence before taking any enforcement action. Manual entries with a reason code for natural disaster lowering a stakeholder’s overall EVV Usage Score would be considered before taking any enforcement action during a non-grace period.

Don’t Forget About ACRES Open Enrollment July 1st-31st, 2024

July 15th, 2024

HHSC announces State Fiscal Year (SFY) 2025 Open Enrollment for the following programs:

Attendant Compensation Rate Enhancement Program for:
Community Living Assistance and Support Services (CLASS) – Direct Service Agency (DSA)
Home and Community-based Services (HCS)
Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID)
Texas Home Living (TxHmL)
And other appropriate programs

For SFY 2025, enrollment for the Attendant Compensation Rate Enhancement and Direct Care Rate Enhancement programs (Rate Enhancement) will be open from July 1, 2024, until July 31, 2024, at 5:00 p.m. CDT, in accordance with Title 1, Texas Administrative Code Sections 355.112 and 355.308.

For more information, including access to the HHSC Open Enrollment Portal, instructions, worksheets, notices, and additional information, please visit the 2025 Rate Enhancement Attendant Compensation Information webpage.

Fee Review for Medicaid & Non-Medicaid Reimbursement Rates and Methodologies

July 12th, 2024

Biennial Fee Review for Medicaid & Non-Medicaid Reimbursement Rates and Methodologies

Please register for the sessions of importance to you. See below or go to: https://www.hhs.texas.gov/about/communications-events/meetings-events/2024/08/08/biennial-fee-review-medicaid-non-medicaid-payment-rates-rate-methodologies-agenda

Online Meetings. The Texas Health and Human Services Commission (HHSC) will conduct stakeholder engagement meetings on August 8, 2024, to receive comments as part of HHSC’s biennial fee review for Medicaid and non-Medicaid payment rates and rate methodologies.

Purpose. The purpose of HHSC’s biennial fee review is to evaluate established payment rates and rate methodologies to ensure methodologies are appropriate. HHSC is seeking public comment regarding established methodologies and payment rates and any supporting documentation or information HHSC should consider in evaluating rates and rate methodologies.

These meetings will be conducted online only.

Note: HHSC will not publish proposed rates at this time, and the stakeholder engagement meetings are solely to receive commentary on the topics listed below.

The stakeholder engagement meetings will be held online only as follows:
Long-Term Services & Supports (LTSS), August 8, 2024, Central Daylight Time (CDT)
Session 1: 8:30 a.m. – 10:00 a.m.
Session 2: 10:30 a.m. – 12:00 p.m.
Session 3: 1:00 p.m. – 2:30 p.m.

HHSC may limit speakers’ time to ensure that all attendees wishing to present public comment are given an opportunity to do so. HHSC reserves the right to end an engagement meeting if no participants have registered to present public comments within the first 30 minutes of the meeting.

Visit the following GoToWebinar links to register to attend one or all of the online meetings.

Session 1 (8:30 a.m. – 10:00 a.m.):
https://attendee.gotowebinar.com/register/8798170439730100058
Webinar ID: 448-958-003

Session 2 (10:30 a.m. – 12:00 p.m.):
https://attendee.gotowebinar.com/register/7142162991788014940
Webinar ID: 153-524-275

Session 3 (1:00 p.m. – 2:30 p.m.):
https://attendee.gotowebinar.com/register/4657758194711912791
Webinar ID: 519-135-819

After registering, you will receive a confirmation email containing information about joining the webinar.

If you are new to GoToMeeting, download the GoToMeeting app at https://global.gotomeeting.com/install/626873213 before the hearing starts.

HHSC will record the meetings. The recordings will be archived and can be accessed on-demand at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings.

Topics. The topics for the Stakeholder Engagement Meetings are below.

Long-term Services & Supports (LTSS):

Session 1 (8:30 a.m. – 10:00 a.m.):

Assisted Living Facility Services
Day Activity and Health Services
Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions
Nursing Aide Training
Residential Care

Session 2 (10:30 am – 12:00 pm):

Community Attendant Services, Family Care, Primary Home Care
Community Living and Support Services Waiver
Deaf-Blind with Multiple Disabilities Waiver
Home and Community-Based Services Waiver
STAR+PLUS Home and Community-Based Services
STAR+PLUS State Plan Services
Texas Home Living Waiver

Session 3 (1:00 p.m. – 2:30 p.m.):

Home and Community-Based Services: Adult Mental Health Program
STAR Kids Medically Dependent Children’s Program
STAR Kids State Plan Services
Texas Health Steps Personal Care Services

Written Comments. Written comments regarding the proposed topics may be submitted in lieu of, or in addition to, oral comments until 5:00 p.m. on August 9, 2024. Written comments may be sent by U.S. mail, overnight mail, fax, or email.

U.S. Mail
Texas Health and Human Services Commission
Attention: Provider Finance Department
Mail Code H-400
P.O. Box 149030
Austin, Texas 78714-9030

Overnight mail or special delivery mail
Texas Health and Human Services Commission
Attn: Provider Finance Department
North Austin Complex
Mail Code H-400
4601 Guadalupe St
Austin, Texas 78751

Fax
Attention: Provider Finance at (737) 867-7817

Email
PFD-LTSS@hhs.texas.gov

Preferred Communication. Email or telephone communication is preferred.

Note. Persons with disabilities who wish to participate in the hearing and require auxiliary aids or services should contact Provider Finance at (737) 867-7817 at least 72 hours before the hearing so appropriate arrangements can be made.

“Beyond The Basic Certified Public Accounting Firm”-Presented by LaShonda Dennis of Pegue-Dennis, CPA PC

“Beyond The Basic Certified Public Accounting Firm” Hosted by Twogether Consulting- Presented by LaShonda Dennis of Pegue-Dennis, CPA PC

July 9th, 2024

Thank you so much for those of you who could attend today’s session hosted by Twogether Consulting.

I know many of you who registered were unable to attend today. Our thoughts and prayers go out to those of you in Houston and other areas affected by the hurricane and flooding. We have recorded today’s session and will also post it on our “gotostage” channel as well as LinkedIn and FB pages.

Click on the link below to the recording of today’s session. Register name and email and begin watching.

Thank you so much to our presenter today, LaShonda Dennis from Pegue-Dennis CPA, PC

La Shonda M. Dennis, CPA

ldennis@peguedenniscpa.com

Ph: 469-708-4272

Address: 1320 Prudential Dr, Dallas, TX 75235

La Shonda M. Dennis, CPA is the founder and Chief Executive Officer (CEO) of Pegue-Dennis, CPA PC a DFW-based boutique certified public accounting firm whose passion is the success and prosperity of our clients.

La Shonda brings 28 years in diverse tax, financial, and business consulting experience to her role as a Certified Public Accountant and currently serves as a Fractional CFO for service organizations in need of executive financial leadership on an interim or contracted long-term basis.

For small to medium-sized businesses, La Shonda has expertise in providing comprehensive accounting services, including individual, corporate, partnership, and exempt organization income tax returns, tax planning, IRS representation, startup business consulting, personal finance coaching, TX Medicaid/Medicare cost report preparation & advisory, TMHP Analytics Reporting as well as overall client advisory services.

Feel free to contact LaShonda if you would like her to reach out to you or scan her QR code below for initial services.

Dallas, TX CPA Firm | Home Page | Pegue-Dennis, CPA P.C.

SPECIAL OFFER: SCAN QR CODE BELOW TO SCHEDULE AN INITIAL DISCOVERY CONSULTATION!

HB 4169 Implementation: Proposed Amendments to HCS, TxHmL & DBMD Waivers

July 1st, 2024

HB 4169 directed HHSC to add pre-vocational services as a service through ISS or add it as a new service/benefit to HCS, TxHmL & DBMD. In conversations with CMS last fall, HHSC was informed that the service had to be a separate service from ISS, hence HHSC is proposing the service as a new benefit.

Discussions with CMS, the Meaningful Skills Development and Employment Services subcommittee of the IDD System Redesign Advisory Committee and stakeholder feedback received in a public hearing earlier this year, the new service will be called “employment readiness”.

You can view a description of the service in the handout used during the February, 2024 Public Hearing to learn more: https://www.hhs.texas.gov/sites/default/files/documents/feb-2024-hcs-txhml-dbmd-public-hearing-agenda-item-2a.pdf

Remaining Actions related to Implementation:

-Publish rules as proposed in the Texas Register in July for formal comment.

– Seek a waiver amendment from CMS in August.

-Adopt the rules

-Implement the service in January, 2025.

Link to HB 4169: https://www.capitol.state.tx.us/tlodocs/88R/billtext/pdf/HB04169F.pdf#navpanes=0

Town Hall about HCS enrollment requirements in PEMS: Practice Locations

https://www.hhs.texas.gov/sites/default/files/documents/hcs-revalidation-notice.pdf

June 30th, 2024

Town Hall about HCS enrollment requirements in PEMS

Home and Community-based Services (HCS) providers must list their practice locations and billing offices in the Provider Enrollment and Management System (PEMS). Please review the following article which HHSC published on 5/2/2024 for more information:

To help you add or maintain your practice locations in PEMS, the Texas Medicaid & Healthcare Partnership (TMHP) is hosting a town hall webinar to discuss how to access PEMS, the requirements for revalidation requests, and adding, completing, or disenrolling practice locations from your enrollment record.

Add Practice Locations

In addition to all HCS group homes being included on the revalidation application, all Host Homes (regardless of the relationship of the HH service provider to the individual) MUST also be included. The only locations NOT considered practice locations are those with a residential location of Own Home/Family Home (aka, CFC PAS/HAB).

Sign Up for the Town Hall

To register, to attend, and fill out the required fields:

Tuesday, July 2, 2024, 10 a.m. to 11:30 a.m. Central time

The sessions will also be recorded and available on the TMHP website.

Use These Resources

You can also view the following resources to learn more information about PEMS:

Adding or Completing Practice Locations YouTube video
Maintaining or Adding Practice Locations Job Aid

Information Letter No. 2024-06: Practice Locations in the Home and Community-based Services Program was sent from HHSC to HCS providers on June 18^th, 2024.
- Per this Information Letter, a practice location is defined as follows: “The definition of a practice location refers to a physical location where Medicaid-covered services are provided to beneficiaries. A practice location has a specific physical address where health care services are delivered. This address is used for enrollment and verification purposes. Based on how services are delivered in the HCS program, a host home/companion care (HH/CC) residence, a 3-person residence, or a 4-person residence are each considered a physical location where health care services are provided by a provider or entity that is not a person’s own home or family home.”
- Click the following link to access the complete Information Letter: IL 2024-06 Practice Locations in the HCS Program (texas.gov)
Whether the location is family-owned or not, you must add the practice location in the Provider Enrollment and Management System (PEMS) if it is classified as a host home/companion care residence within the Long-Term Care – Online Portal.

If you require any assistance adding Practice Locations within PEMS or have questions about the webinars, please send an email indicating such to provider.relations@tmhp.com. Provider Relations will contact you to schedule time with a representative who can guide you through adding Practice Locations to your enrollment record.

HCS/TxHmL Providers & FMSAs: Technical Assistance Session For TMHP on July 8th, 2024

Register for the session.

June 25th, 2024

This is a very good opportunity for providers who need help, to receive assistance with issues they encounter when attempting to submit forms or claims in the LTC portal.

HHSC Bulletin: Medicaid and CHIP Services (MCS) will be hosting monthly sessions for Program Providers and Financial Management Services Agencies (FMSAs), who use the Long-term Care (LTC) online portal for the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver programs.

TMHP and HHSC staff will be available to troubleshoot and potentially resolve issues with forms and claim submissions in the LTC online portal.
All attendees should be prepared to discuss and show, if needed, the issues they encounter when attempting to submit forms or claims in the LTC online portal.

The technical assistance session will be held on:

Monday, July 8, from 1–3 p.m.

How Technical Assistance sessions will be conducted:

You’ll be placed in a queue in the Technical Assistance session’s main meeting room when you log into the session.
The host will troubleshoot your equipment (microphones, computer connection, speakers, etc.) to ensure it’s working properly and briefly review the forms and claims submission issue you’re experiencing to ensure the right specialists are available to assist with resolution.
You’ll be transferred to a breakout room where TMHP and HHSC staff will troubleshoot the issues with you.
Click the red “leave” button to leave the TA session when you’re finished with the troubleshooting session. If you have more questions, log in again to get into the queue.

This Technical Assistance session will only address questions about forms and claim submissions in the LTC online portal. Any other questions should be sent via email to the appropriate HHSC area.

PEMS: Update On HCS Revalidations For Current Providers

https://www.hhs.texas.gov/sites/default/files/documents/hcs-revalidation-notice.pdf

June 28th, 2024

Town Hall about HCS enrollment requirements in PEMS

Home and Community-based Services (HCS) providers must list their practice locations and billing offices in the Provider Enrollment and Management System (PEMS). Please review the following article which HHSC published on 5/2/2024 for more information:

Sign Up for the Town Hall

To register, select one of the following sessions to attend, and fill out the required fields:

The sessions will also be recorded and available on the TMHP website.

Use These Resources

You can also view the following resources to learn more information about PEMS:

Adding or Completing Practice Locations YouTube video
Maintaining or Adding Practice Locations Job Aid

If you have any questions about the webinar, please contact provider.relations@tmhp.com.

June 20th, 2024

Information Letter 2024-06

HHSC has published the following information letter IL 2024-06, Practice Locations in the Home and Community-based Services Program

Information Letter 2024-06, Practice Locations in the Home and Community-based Services Program.

The letter informs providers of requirements related to HCS practice locations.

Questions about the state and federal requirements for practice locations may be sent to providerenrollmentmanagementsystem@hhs.texas.gov.

Questions about this Information Letter may be sent to HCSPolicy@hhs.texas.gov.

June 10th, 2024

Update: Issues Concerning Challenges With The Revalidation Process at PEMS

Access the May 2, 2024 PEMS Guidance at: https://www.hhs.texas.gov/sites/default/files/documents/hcs-revalidation-notice.pdf

**If you experience challenges with your revalidation or have questions, please send them to the following email box: Oversight@hhsc.state.tx.us

3. According to the above-referenced May 2, 2024 PEMS Guidance, if one’s revalidation falls within Group 1, meaning the revalidation was due BEFORE January 1, 2024 but was never submitted, providers had until June 1, 2024 to submit a completed revalidation application. Providers in Group 1,now have until June 17, 2024 to complete their applications. A provider in this group who fails to submit a re-enrollment application by this new date may be subject to additional sanctions including, recoupment, vendor hold, and contract termination. HHSC is contacting all HCS providers included in Group 1 who failed to meet the June 1, 2024 deadline to not only inform them of the new due date, but also to remind them that TMHP has yet to receive their application.

**Kaliope Schmidt, HHSC, is calling these providers and sending a follow-up email if a provider has not yet returned her call. Please start the process now, if you have not done so already and fall into group 1 category.

Remember-ALL Host Home (HH) locations are considered practice locations and MUST be entered on the application. Note: There may have been a miscommunication earlier that 3rd party HH locations did not have to be entered, but ALL must be entered.

Job Aid Manual that explains how to add Practice Locations. According to HHSC and TMHP, the number of locations in PEMS need to match the number of locations in LTC-OP. The FAQ at the following link provides information on how to add or close locations in the LTC-OP (see page 47, FAQs 4.60 and 4.61): HCS and TxHmL Waiver Programs Frequently Asked Questions (tmhp.com)

When possible, we have been informed, that TMHP will leverage previous HCBS Settings reviews, meaning that any practice locations which underwent an HCBS Settings review within the last 2 years, will not be subject to an on-site revalidation visit. See bottom of page 1 in the above-referenced May 2, 2024 PEMS Guidance for further details.

** Important Note:

HHSC and TMHP will conduct a webinar later this month to review the May guidance regarding practice locations and address other issues HCS providers are experiencing with the revalidation process. The 1.5 hour webinar will include 45 minutes for Q&A. Once a date and time are posted, we will gladly share registration information.

March 11th, 2024

The notice below provides an email address/box for providers to use in obtaining assistance with the revalidation process, please remember to contact HHSC’s oversight email box to report any inconsistencies you receive from TMHP representatives regarding practice locations, site visits and payment holds. That email address is: oversight@hhsc.state.tx.us

(HCS) Providers May Continue Submitting Service Claims While Completing Medicaid Enrollment Revalidation

“The Texas Health and Human Services Commission (HHSC) is aware that 1915(c) HCS providers are experiencing delays in completing Medicaid enrollment revalidation through the Texas Medicaid & Healthcare Partnership (TMHP), due to the need for additional clarification and guidance for submitting practice location information. HHSC and TMHP are working to address this and will provide further clarifications and instructions to HCS providers in the near future.

In the meantime, HCS providers that intend to stay enrolled in Medicaid must continue to work with TMHP to complete all aspects of Medicaid enrollment revalidation not related to practice locations. HCS providers that intend to stay enrolled in Medicaid may continue to submit electronic service claims for services rendered even if their Medicaid enrollment revalidation date has passed because of process delays related to practice location issues. Further, HCS providers will not be placed on vendor hold if their Medicaid enrollment revalidation has been submitted in the Provider Enrollment Management System but has not been completed because of issues related to practice locations and site visits.

HCS providers that need assistance with completing the steps for revalidation can contact the TMHP Provider Relations department at provider.relations@tmhp.com.”

**A TMHP representative can schedule an enrollment walkthrough to assist with questions and completing the revalidation steps.

EVV (Electronic Visit Verification) Updates

EVV Home Health Care Services Bill Codes Table (texas.gov)

June 19th, 2024

FYI- there are also additional modifiers for EVV-required services (such as TG for Specialized Nursing and UC for CDS Nursing).

Useful EVV tool:

April 1, 2024, provides additional HCPCS and modifier combinations.

June 7th, 2024

Reminder:

Please Use Appropriate Modifiers To Be Reimbursed Properly For Nursing & Other Specific Therapies That Occur In (OFH) In-Home Services!

Updates LTC HCS and TxHmL Bill Code Crosswalks for EVV Home Health Care Services

See Information From HHSC on November 13, 2023, below:

Please Note The In-Home Billable Activities for Nursing & Specific Therapies in Own Family Home (OFH) EVV Crosswalk Changes

Electronic Visit Verification (EVV) claims matching for home health care services (HHCS) began Jan. 1, 2024.

EVV claims with dates of service of Jan. 1, 2024, and after that do not have an EVV visit match will be denied.

HHSC created new Long-Term Care billing combinations to submit claims for EVV and non-EVV service delivery locations.

Existing HHCS billing combinations have new descriptions for EVV services in the member’s own home/family home (OHFH).
New out-of-home services use the existing billing combinations with the KX modifier.
New in-home or other residential-type settings use the existing billing combinations with the HQ modifier.

Services that begin or end in a member’s OHFH setting will require an EVV visit match. Services provided out-of-home in the community or in other residential-type settings will not require an EVV visit match.

Home and Community-based Services (HCS) and Texas Home Living (TxHmL) EVV claims require the Texas EVV Attendant ID for in-home EVV services. Reference the document, HCS and TxHmL Best Practices to Avoid EVV Claim Mismatches (PDF) for information related to the Texas EVV Attendant ID.

Agency Services Affected

• Nursing Services provided in the member’s own home/family home (RN; LVN; Specialized RN; Specialized LVN)

• Occupational Therapy provided in the home

• Physical Therapy provided in the home

“Own home/family home” does not include Host Home/Companion Care or Supervised Living/Residential Support Services (3/4-bed home).

CDS (Only Nursing Affected)

Crosswalk changes

Place of Service: 12 (the group home or host home)

HCPCS:

~ T1002 (RN)

~ T1003 (LVN)

Modifier: HQ

Place of Service: 11, ,49, 99, etc. (applies to ALL persons regardless of their place of residence)

HCPCS:

~ T1002 (RN)

~ T1003 (LVN)

Modifier: KX

Place of Service: 12 (OHFH). REQUIRES EVV

HCPCS:

~ T1002 (RN)

~ T1003 (LVN)

Modifier: no modifier

Resources:

See the new billing combinations in the Long-term Care Bill Code Crosswalks.
For more information about EVV, visit the HHS EVV webpage.
For news and updates, visit the Texas Medicaid and Healthcare Partnership website.
Review FAQs about the EVV HHCS Implementation (PDF), located on the EVV 21st Century Cures Act webpage.
People who deliver EVV-required services must be registered for EVV GovDelivery to receive EVV updates by email.

For questions about the EVV HHCS bill codes, modifiers or HHCS required to use EVV (PDF), email HHSC EVV Operations.

May 25th, 2024

EVV Proprietary Systems

Last updated on 4/18/2024

Short Recap below, for more info go to: EVV Proprietary Systems (HHSC page)

An Electronic Visit Verification (EVV) proprietary system is an HHSC-approved system that a program provider or financial management services agency (FMSA) may decide to use instead of the state-provided EVV vendor system and:

Is purchased or developed by a program provider or an FMSA.
Is used to exchange EVV data with the EVV Aggregator.
Complies with HHSC EVV Policy as it relates to EVV proprietary systems.
Complies with HHSC EVV Business Rules for proprietary systems.
Complies with the requirements of Texas Government Code Section 531.024172 or its successors.

An EVV Proprietary System Operator (PSO) is a program provider or FMSA that is approved to operate an EVV proprietary system.

Refer to the EVV Policy Handbook, including Section 5000 , for more information.

EVV PSO Onboarding Process

Step 1: Submit a Request Form

Program providers and FMSAs must complete, sign, and submit the EVV Proprietary System Request Form located in the EVV Portal to start the PSO onboarding process.

Note: EVV Portal access is required to submit a request form. Refer to the Accessing the EVV Portal for Program Providers and FMSAs job aid for more information. Request forms that are emailed to HHSC or TMHP will not be accepted.

When the request form is successfully submitted, program providers and FMSAs will receive a confirmation number (Request Form ID) and a confirmation date and time (Request Form Submission Date and Time).

Note: The submission of a request form does not guarantee an assignment to a PSO Operational Readiness Review (ORR) session. TMHP will review the submitted request forms and PSO ORR session requirements and notify program providers and FMSAs of their assignment status.

EVV ORR Sessions

The following PSO Onboarding Process Overview and Timeline documents outline the steps and required timeframes for a program provider or FMSA to onboard their proprietary system in the Texas EVV operating environment managed by HHSC and TMHP.

PSO Onboarding Standard Process Overview and Timeline

PSO Onboarding Expedited Process Overview and Timeline

Here is the high-level schedule for the 2024 PSO Onboarding:

Session	Planning Meeting Date	ORR Start Date	Session Approval Date
2024-1: Expedited	Feb. 5, 2024	Feb. 19, 2024	Mar. 8, 2024
2024-2: Expedited	Apr. 29, 2024	May 6, 2024	Jun. 3, 2024
2024-3: Standard	May 20, 2024	Jun. 3, 2024	Jul. 18, 2024
2024-4: Expedited	Aug. 12, 2024	Aug. 19, 2024	Sept. 24, 2024
2024-5: Standard	Sept. 2, 2024	Sept. 16, 2024	Oct. 30, 2024

Note: Please note that TMHP has a limited number of slots based on the available capacity and the schedule is subject to change.

A program provider or FMSA must have a developed and compliant proprietary system that meets all HHSC requirements by the ORR begin date.

Visit the PSO Business Rules to learn more about the compliance standards for proprietary systems in the Texas Medicaid EVV Program.

TMHP Contacts

LTC Help Desk:
800-626-4117
(Option 4)

TMHP Contact Center:

800-925-9126
(Option 6)

EVV_PSO@tmhp.com

EVV Contact Information Guide for Program Providers and FMSAs

EVV Contact Information Guide for CDS Employers

May 2nd, 2024

Alternative Devices Notice

Please see links to handouts below:

EVV Alternative Devices Notice

EVV Updates on Claims Matching Handout

One provides an update on EVV focusing on the claims matching bypass, compliance review grace periods and geo-perimeter expansion. The other handout pertains to the phasing out of alternative devices for service providers and CDS employees to clock in and clock out. The phase out schedule begins January 1, 2025 and ends January 1, 2028.

In late April, HHSC issued a notice explaining its plan to phase out alternative devices and is asking for stakeholder feedback. Comments are due by 5:00 p.m.on May 15, 2024 and are to be sent to: evv@hhs.texas.gov

January 7th, 2024

Clarification Landline Vs. Mobile

EVV Program providers and financial management services agencies (FMSAs) must enter and maintain correct information in the EVV system for their service providers or Consumer Directed Services (CDS) employees.

Program providers and FMSAs must not enter an unallowable landline phone type into the EVV system as the member’s home phone landline.

An unallowable landline phone type is a cellular phone or cellular-enabled device, such as a tablet or a smart watch. A phone used to clock in or clock out through the landline method must be a landline phone, and not a cellular phone or device. Cellular phones, tablets, smart watches, and laptops come under “mobile devices” and should be entered as such..

TMHP Published EVV Known Issues and Resolutions, Vol. 2

December 19, 2023

Texas Medicaid & Healthcare Partnership (TMHP) published a table that highlights the most frequently occurring issues Electronic Visit Verification (EVV) users have experienced with the HHAeXchange system. The table also features a resolution for the issues that were identified.

For more information, refer to EVV Known Issues and Resolutions, Volume 2, on TMHP’s EVV webpage.

Resources

EVV Known Issues and Resolutions, Vol. 1

Email questions to TMHP.

January 1st, 2024

HHSC has revised the Electronic Visit Verification (EVV) rules in Texas Administrative Code (TAC), Title 1, Chapter 354, Subchapter O. The new TAC rules are effective Jan. 1, 2024.

The new EVV TAC rules:

Add the home health care services required by the 21st Century Cures Act, 1903(l) of the Social Security Act (42 U.S.C. §1396b(l)).
Add the current policies regarding training, visit maintenance, and requests by program providers and FMSAs to become Proprietary System Operators (PSOs).
Add definitions related to the addition of the new TAC rules.
Reorganize the structure of the existing EVV-required personal care services list for clarity.

Email questions to HHSC EVV.

December 31st, 2023

HHSC NOTICE:

HHSC Electronic Visit Verification (EVV) is reaching out to you with time-sensitive information. Also noted in the TMHP news webpage:

Program Providers and FMSAs Should Have Download Visit Data by Dec. 22, 2023.
EVV Known Issues and Resolutions, Vol. 2.
HHSC will require EVV for Medicaid Home Health Care Services (HHCS) beginning Jan. 1, 2024.
- Effective January 1, 2024, and after, when an HHCS EVV claim is submitted without a matching EVV visit transaction, the EVV claim will be denied.
- A list of HHCS services that fall under this requirement is found in the 21^st Century Cures Act webpage.

December 6th, 2023

Discontinuation of EVV Free Text Reviews

Effective Aug. 1, 2023, the Texas Health and Human Services Commission (HHSC) and managed care organizations (MCO) will no longer conduct EVV compliance reviews for required free text.

HHSC no longer requires the documentation of any missing clock in and clock out in the free text field for dates of service on and after Aug. 1. The EVV system now requires missing time not electronically captured to be entered in the Bill Time In and Bill Time Out fields.

New reason codes effective Oct. 1, 2023 (PDF), require program providers, financial management services agencies (FMSAs) and Consumer Directed Services (CDS) employers to enter free text only when using the following two reason codes:

Reason Code 210I — Emergency
Reason Code 600 — Other

Email questions to HHSC EVV Operations.

November 11th, 2023

Prepare for EVV Cures Act Home Health Care Services Implementation

HHSC will require Electronic Visit Verification (EVV) for Medicaid home health care services (HHCS) beginning Jan. 1, 2024, as listed in the Home Health Care Services required to use EVV (PDF). The 21st Century Cures Act is the federal law that requires states to implement EVV.

HHCS Claims for EVV Required Services Must be Submitted to TMHP Starting Dec. 1

Program providers and financial management services agencies (FMSAs) must submit all HHCS EVV claims to Texas Medicaid & Healthcare Partnership (TMHP) using TexMedConnect, or through Electronic Data Interchange (EDI) using a Compass 21 (C21) Submitter ID starting with dates of service on or after Dec. 1, 2023.
Managed care organizations (MCOs) will reject any HHCS managed care claims with EVV services and dates of service on or after Dec. 1, 2023, back to the program provider and FMSA, directing them to submit the claim to TMHP for EVV claims matching.

Register for TexMedConnect

To access TexMedConnect through the TMHP website you must already have an account. If you don’t have an account, set one up using the information provided in the TMHP Website Security Provider Training Manual.
Program providers and FMSAs that need help setting up C21 or CMS Submitter IDs should contact the EDI Help Desk at 888-863-3638, Option 4, or visit the TexMedConnect webpage for additional information.

Request EVV Portal Access

To access the EVV Portal, program providers and FMSAs must have a TMHP User Account.
Program providers and FMSA staff must contact their TMHP Provider Administrator to request EVV Portal access.
For full instructions, review the EVV Portal job aids on the EVV Learning Management System (LMS).

Complete Onboarding and EVV Portal Training by Dec. 31

Program providers and FMSAs must complete the following before Dec. 31, to avoid impacts to EVV claims payment:

Onboard with the state-funded EVV vendor system, HHAeXchange by submitting the HHAeXchange Provider Onboarding Form.
Complete the TMHP Learning Management System (LMS) to complete annual EVV Portal training requirements.

Visit the TMHP EVV Training webpage for more information.

EVV Home Health Care Services Practice Period: Oct. 1 – Dec. 31

The practice period allows program providers and FMSAs, to practice using the EVV system, using the EVV Portal and submitting EVV claims before the Jan. 1, 2024, implementation date. EVV claims will be paid by the payers (HHSC or MCO) even if the EVV visit transactions do not match the EVV claims.

Consumer Directed Services (CDS) employers can practice using the EVV system selected by their FMSA.
Service providers and CDS employees can practice clocking in and clocking out using their program provider’s or FMSA’s selected EVV system, and the visit data will be transmitted to the EVV Aggregator.

EVV Claims Matching with Denials

Effective Jan. 1, 2024, and after, when an HHCS EVV claim is submitted without a matching EVV visit transaction, the EVV claim will be denied. This applies to all program providers and FMSAs required to use an EVV system. Program providers and FMSAs will be able to view EVV claim match results in the EVV Portal.

Resources:

For questions about HHAeXchange onboarding, technical help with using the HHAeXchange Portal or issues related to data, contact HHAeXchange:
Email: TXsupport@hhaexchange.com
Phone: 833-430-1307
Review FAQs about the EVV HHCS Implementation (PDF), found on the EVV 21st Century Cures Act webpage.
For specific HHCS billing codes combinations, that require the use of EVV, refer to the EVV HHCS Service Bill Codes table in Excel or PDF formats.
For more information about EVV, visit the HHS EVV webpage.

October 16th, 2023

IMPORTANT NOTICE: EVV Data Access & Conversion

For program providers transitioning to the new state-funded EVV vendor, HHAeXchange:

All visits in the EVV Aggregator will continue to be available and accessible for program providers. One year of historically accepted visits will be available in HHAeXchange as part of data conversion. This will be based on the data available in the EVV Aggregator.

For visit dates within the 95-day visit maintenance window, program providers should refer to the EVV Portal and perform visit maintenance in their legacy vendor system.

*If you rely on specific fields from EVV systems, DataLogic/Vesta and FirstData/AuthentiCare, this data may not be available after they are migrated to HHAeXchange.

Data Conversion

The following data will be transferred from your current EVV systems (AuthentiCare or Vesta) and uploaded to the new HHAeXchange system:

Five years of profile data
- Direct service provider information
- Member information
- CDS employer information
- Service authorization information
One year of accepted visit information (from the EVV Aggregator)

Data Availability

EVV visit data for dates of service Sept. 1, 2019, to present is available in the EVV Portal. Program providers or FMSAs needing access to data prior to Sept. 1, 2019, can email HHSC EVV Operations.

Program providers and FMSAs are encouraged to download and archive data in your current EVV systems that is not being converted as outlined above. For program providers and FMSAs that use the EVV systems or the paid for versions of AuthentiCare or Vesta to store or maintain non-EVV visit data, you should take steps now to maintain your non-EVV visit data. Access to the state provided AuthentiCare and Vesta systems will end on Dec. 22, 2023.

Once the data has been reviewed, users should contact HHAeXchange for any issues or concerns with their data.

Email HHAeXchange or call 833-430-1307.

August 20th, 2023

EVV Alternative Device Policy For New State EVV Vendor

HHSC has updated the alternative device policy notice posted on July 17.

In addition to allocating free alternative devices to 7.5% of the program providers or Financial Management Services Agencies (FMSAs) census (rounded to the nearest whole number), HHSC is allowing the purchase of additional alternative devices for qualifying members.

This policy applies to program providers and FMSAs who will use the new State EVV vendor, HHAeXchange.

Additional information will be forthcoming about the processes for providers and FMSAs to order alternative devices.

August 19th, 2023

Hurry Before It’s Too Late! EVV Onboard with HHAeXchange by Aug. 31

Begin the onboarding process with the new Electronic Visit Verification (EVV) vendor HHAeXchange.

Current Users

Program providers and financial management services agencies (FMSAs) who are transitioning to HHAeXchange, and are not in the proprietary system onboarding process, must submit the HHAeXchange Provider Onboarding Form by Aug. 31.

Application programming interfaces (APIs) can be used to exchange data between third-party software systems, such as payroll systems, electronic health records systems, and the HHAeXchange Portal (the new EVV vendor system).

Program provider and financial management services agencies, who want to integrate their third-party software systems with HHAeXchange, can refer to the specifications listed in the HHAeXchange Web Service API Guide (PDF).

APIs available to integrate with HHAeXchange include:

Service Provider (Create, Update, Search, Get)
Member (Create, Update, Search, Get)
Schedule (Create, Update, Search, Get)
Visit (Search, Get)
Authorization (Create, Update)

To begin the integration process, submit a ticket through the HHAeXchange Client Support Portal.

Contact HHAeXchange for provider onboarding form questions.

June 13, 2023

Next Steps and Timeline for Transition to New Electronic Visit Verification State Vendor System

HHSC has posted the next steps and timeline to transition to the new, single and state-funded Electronic Visit Verification vendor system, the HHAeXchange Portal.

As stated in the EVV notice posted on May 5, users of the current EVV vendor systems (DataLogic/Vesta or First Data/AuthentiCare) must transition to HHAeXchange or receive approval as an EVV Proprietary System Operator by Oct. 1, 2023.

The following topics are listed in the notice, “Next Steps and Timeline for Transition to HHAeXchange” (PDF):

EVV requirement
Transition to HHAeXchange by Oct. 1, 2023
Proprietary systems
HHAeXchange Information Sessions
HHAeXchange Provider Onboarding Form
EVV Policy updates
HHAeXchange System Training
Access to the HHAeXchange Portal
Contact information and other resources

*Training begins in August and access to the portal begins in September of 2023 for HHAeXchange.

HHSC has created a brief version of the notice that was posted on May 5 about the transition and changes related to the new, single and state-funded Electronic Visit Verification vendor system, HHAeXchange.

Program providers and financial management services agencies may provide the brief notice to their members, services providers and Consumer Directed Services employers. The brief notice is available in English (PDF) and Spanish (PDF).

HHSC will continue to post communications and resources throughout the transition.

https://www.hhs.texas.gov/provider-news/2023/06/01/registration-available-hhsc-evv-policy-training-webinars-program-providers-fmsas-cds-employers

June 10th, 2023

Registration Available for HHSC EVV Policy Training Webinars for Program Providers, FMSAs and CDS Employers

June 1, 2023

HHSC is hosting Electronic Visit Verification policy training webinars for program providers, financial management services agencies and Consumer Directed Services employers to complete the EVV policy training requirement. EVV policy training provides training on the EVV Policy Handbook.

Webinar agendas are included in the registration links below.

Webinar Registration

Annual EVV Policy Training Webinars: For program providers, FMSAs and CDS employers using EVV for personal care services (PDF).
- Register for the Annual EVV Policy Training for Program Providers and FMSAs webinar scheduled for June 29, 2–3:30 p.m.
- Register for the Annual EVV Policy Training for CDS Employers scheduled for July 13, 2–3:30 p.m.
Initial EVV Policy Training Webinars: For program providers, FMSAs and CDS employers new to EVV due to the EVV Cures Act Home Health Care Services implementation (PDF).
- Register for the Initial EVV Policy Training for Program Providers and FMSAs webinar scheduled for July 27, 2–3:30 p.m.
- Register for the Initial EVV Policy Training for CDS Employers webinar scheduled for Aug. 10, 2–3:30 p.m.

Program providers, FMSAs and CDS employers can also complete the EVV policy training requirement on the HHS Learning Portal.

The EVV Required Training Checklists (PDF) will help track completed EVV trainings.

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 the TMHP EVV PSO inbox 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.

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.

Email HHSC 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.

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.

Click here for more information

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

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

Email questions to EVV Operations.

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..

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 TMHP with questions about these updates.

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…

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 TMHP with questions.

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.

April 17th, 2021

EVV Policy Training for CDS Employers Now Available in Spanish

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

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

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

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

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

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

March 16th, 2021

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

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

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

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

For questions, email HCS Policy or CDS.

March 10th, 2021

Temporary EVV Policies for the Feb. 2021 Severe Winter Weather

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

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

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

Email questions to the HHSC EVV Mailbox.

February 7th, 2021

EVV Refresher Training on Feb. 19

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

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

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

Certificates of completion will not be issued.

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

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

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

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

Email HHSC EVV for questions.

Reminder: Entering Schedules for EVV-Required Services

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

EVV is only required for the following services:

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

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

January 24th, 2021

EVV Portal and Training Updates for January

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

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

Email TMHP with questions about these updates.

January 24th, 2021

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

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

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

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

Email questions about EVV policy to HHSC EVV.

January 18th, 2021

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

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

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

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

Next Steps

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

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

January 10th, 2021

EVV Notification Requirement for HCS/TxHmL Program Providers

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

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

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

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

January 4th, 2021

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

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

HHSC EVV Operations and TMHP have developed two Contact Guides:
- Contact Guide for Program Providers and FMSAs
- Contact Guide for CDS employers
To assist program providers and FMSAs identify and correct EVV visit transaction rejections, TMHP created the EVV Visit Transaction Rejection Guide (PDF).

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 TMHP, EVV@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:

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

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

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

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

Visit the HHS EVV website for more information.

November 28, 2020

HCS and TxHmL CARE Service Authorization instructions for EVV

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

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

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

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

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

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

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

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

Best Practices for Temporary EVV Policies for COVID-19

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

Contact your payer for questions or email HHSC EVV.

Visit the HHS EVV webpage.

HCS and TxHmL Program Providers Required to Select an EVV Vendor

11/18/2020

HCS and TxHmL Program Providers Required to Select an EVV Vendor

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

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

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

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

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

Deadline Approaching Soon!!

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:

Register for Session 1.
Register for Session 2.
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.

- EVV Proprietary System page
  
  http://www.tmhp.com/Pages/EVV/EVV-Proprietary.aspx
  
  Providers currently required to use EVV must continue to use EVV under state law and HHSC policy. See the Programs and Services Currently Required to Use Electronic Visit Verification (PDF)
  
  For questions about EVV vendors, email evv@TMHP.com

New EVV Proprietary System Onboarding Documents Available

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

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

Resources

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

Trainings Available:

HHSC EVV Training webpage

EVV Policy Training (Provided by your payer)

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

EVV Aggregator and EVV Portal Training (Provided by TMHP)

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

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

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

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

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

Assistance With Medicaid Renewal & Eligibility Issues

June 7th, 2024

Reposted From February 22, 2024

What Can Providers Do When They Need Assistance With Medicaid Renewal & Eligibility Issues?

HHSC is constantly evaluating ways to be more efficient and improve the quality of the application review process, it was suggested that in addition to referring cases to Ms. Perez’s office (Gracie Perez, Access & Eligibility Services) at HHSC, providers needing emergency assistance are urged to contact the Regional Director in their area.

See list of the Regional Directors.

In addition to the list of Regional Directors, HHSC provided the information on a PowerPoint on the end of continuous Medicaid coverage or Medicaid Unwinding.

Actions You Can Take Now
-Download Ambassador Toolkit from https://www.hhs.texas.gov/services/health/coronavirus-covid-19/end-continuous-medicaid-coverage-ambassador-toolkit

-Visit www.hhs.texas.gov/update

-Email: update@hhs.texas.gov – Stakeholder Engagement Email

Join the Ambassador Program email list- Ambassador Program Contact List

Medicaid Eligibility Issue: Individual Assigned Wrong Medicaid Type Code (HCS/TxHmL)

June 7th, 2024

Individual Assigned Wrong Medicaid Type Code During The Renewal/Reinstatement Process

it has been brought to my attention that some of Individuals in our IDD waiver programs have sometimes been renewed/reinstated with the wrong type code for Medicaid, which then takes them out of the HCS or TxHmL waiver. This also means the provider can’t bill.

For many of our individuals, R14 or 14 is the appropriate code for “waiver”.

Some providers have mentioned that their individuals have been assigned the wrong codes beginning with “Q” or “W” for example. I am not sure what those stand for. I believe “Q” is related to Medicare, not persons in Medicaid. Some of our individuals do have both Medicaid & Medicare, but they must have Medicaid to be eligible for the HCS/TxHmL waiver programs.

There is a form that the local authority can fill out to correct this issue.

The form that the LIDDA completes for Medicaid reinstatement is the MEPD form H1746-A
https://www.hhs.texas.gov/regulations/forms/1000-1999/form-h1746-a-mepd-referral-cover-sheet The form is called the Medicaid for the Elderly and People with Disabilities (MEPD)
Referral Cover Sheet

Contact information:

Email for Medicaid Eligibility Issues: OESMEPDIC@hhsc.state.tx.us

Helpful Tips:

**If you would like to check if your individual has the appropriate Medicaid code, you can go to their Medicaid Hx (history) which you can find on your TMHP dashboard.

**Call the IDD Ombudsman (800-252-8154) if you are having issues with Medicaid responding at all or if they are not helping or responding in a timely fashion. The IDD Ombudsman can cite them for this. Some providers have reported that Medicaid contacted them and resolved their issues immediately.

** Contact your local representative or legislator for help

** Also, be aware that If the client changed Social Security types (SSDI to SSI for example) this may have caused the issue. Or if the individual changed the type of SS during COVID-19, then it may have kicked them off of the right Medicaid or Medicaid period.

**For all other issues in general for not getting renewed /reinstated to Medicaid Eligibility for your individuals with IDD in our provider programs:

Individuals may lose coverage because the state incorrectly denied for many reasons. To get these cases corrected, please escalate them through the Office of the Ombudsman. as I stated before, If the case still can’t get corrected, families have the right to a fair hearing.
If you are denied Medicaid because they didn’t submit their renewal or needed information, you have a 90-day window to send the renewal or missing information after losing coverage. Unfortunately, the renewal link on YourTexasBenefits.com is currently not active during the 90-day reconsideration period. To submit information to complete a renewal after a denial, you can submit during this time period by calling 2-1-1 Option 2 or completing a paper application and either faxing, mailing, or bringing it into a local HHSC office.

Reminder Providers Must Sign Up For Blackboard Connect Emergency System (HCS, TxHmL, ICF, & DAHS-ISS Providers)

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

June 4th, 2024

BLACKBOARD CONNECT EMERGENCY SYSTEM

Just as a reminder, this is not a voluntary process!

All providers must appoint a designee to enroll in the system. That designee is responsible for communication and responses to requests through this system. Be sure to also note any other designees or back-up designee for the Blackboard Connect Emergency System! This system will be used to send emergency and outreach notifications through email, phone, voice and text if available.

June 26th, 2023

FYI- Reminder, if you missed this alert back in November of 2022 for HCS, TxHmL, ICF and Licensed ISS providers as well, please be sure to log in and set up your account.

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

(This also applies to DAHS-ISS Providers)

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

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

Blackboard Connect sign-up process:

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

Don’t forget, this also noted in the Rules under 565 for HCS ( §565.1 Emergency Response System) and 566 for TxHmL

HHSC Transitioning STAR+PLUS Program Contracts: Please Register For Very Important Webinar

May 30th, 2024

HHSC is transitioning contracts for the STAR+PLUS program as of September 1st, 2024

Providers be aware that members may need to select new health plans.

· Providers may need to contract with new MCOs.

The STAR+PLUS Project Team invites providers to attend an upcoming webinar to learn about changes to the STAR+PLUS program. This information will be helpful to providers in communicating with STAR+PLUS members and engaging with managed care organizations.

Each webinar will cover the same information, so providers only need to attend one session. Registration is required.

Session Date	Session Time	Registration Link
Friday, 5/31/24	3:00pm-4:00pm	Register for 5/31
Tuesday, 6/11/24	6:00pm-7:00pm	Register for 6/11
Saturday, 6/22/24	9:00am-10:00am	Register for 6/22
Monday, 6/24/24	1:00pm-2:00pm	Register for 6/24

Email HHSC at Managed_Care_Initiatives@hhs.texas.gov with any questions.

Don’t Forget To Update Emergency Preparedness Plans Before Hurricane Season

May 22, 2024

Planning For Flooding & Hurricane Season

** Please remember to address tornadoes in your emergency and evacuation planning, if they apply to your area, as they often occur during or in conjunction with Hurricane Season. In addition, Texas has already been hit by severe storms, large hail, and tornadoes during the month of May. Some of these severe storms and tornadoes have already left many people in Texas without electricity in incredibly hot temperatures.

See HHSC Recommendations Below:

“HHSC reminds long-term care facilities and agencies to review and update safety procedures and emergency plans for extreme weather in the 2024 hurricane season. 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. This will ensure the equipment functions in case of power loss.

It is important to review building integrity and identify any areas that may need repair, reinforcement or weatherproofing. Facilities in multi-story buildings should review any other needed measures as well. They should also have a plan in place for how to move residents around or out of the building if there is a loss of power or other identified need to move to a safer location.

Facilities should contact their local HHSC Regulatory Services regional office (RO) if they are impacted by an adverse event caused by severe weather — such as flooding, power loss, etc.

This communication is especially critical if a facility is projected to exceed its licensed capacity due to accepting residents that have been evacuated from another facility. All requests to exceed licensed capacity must be made through the RO and approved by the Deputy Associate Commissioner of Survey and Compliance.

Program rules require specific staff or a designee of each program to register with the emergency communication system and respond to requests through the emergency communication system. Please refer to PL 2022-32 (PDF) for instructions and more information regarding the emergency communication system requirements.”

Presentation Hosted By AAIDD: Autism CARES Act

May 28th, 2024

Presentation On The Extension of The Autism CARES Act

Hosted by AAIDD

Presenters:
– Cindy Smith, Director of Public Policy, AUCD
– Kim Musheno, Executive Vice President of Public Policy, ASA

The Autism CARES Act provides research, education, training, and services for individuals with autism and other developmental disabilities. It must be reauthorized before it expires in September 2024. In this webinar, you will learn more about this critical law and how to advocate for its extension.

Add to:

For more information go to: https://www.aaidd.org/education/event-details/2024/06/06/default-calendar/the-autism-cares-act

Direct Care Careers Online Portal From HHSC: New Enhancements

May 28th, 2024

Direct Care Careers Enhancements

HHSC launched Direct Care Careers August 2023, an optional, online portal that will connect potential employees with employers delivering home and community-based services through the state plan and HCBS authorities (1915(c), 1915(i), 1915(j), and 1115). To provide the best user experience possible, HHSC is excited to announce the following enhancements and improvements to the platform.

All Users (Employers and Candidates)

New options added to filter jobs.

New drop-down menu options for easier site navigation.

Candidates

Direct message employers to express interest in a job post.
Save prospective job posts and view later.

Employers

Select and download multiple resumes to view or print.
Resumes can be viewed in selected language.
Direct message candidates to express interest or invite to interview.
Create a screened candidate list for job posts.
View all candidates and refer prospects to job posts.

CDS Employers

Create and use job templates.

Email questions to HHSCOfficeofDisabilityServicesCoordination@hhs.texas.gov.

Branding Guidelines and Waiver Program Handbook and Form Updates

May 22nd, 2024

Home and Community-based Services (HCS), Texas Home Living (TxHmL), Community Living Assistance and Support Services (CLASS), and Deaf Blind with Multiple Disabilities (DBMD) waiver programs will be replacing the form and handbook term “individual” with “person” in accordance with HHS branding guidelines.

HHS follows federal plain language guidance to help ensure all programs use language that makes communications easier for the public to read, understand and use the first time they see or hear it. The language needs to be standardized across all HHS handbooks.

To learn more about plain language and find more plain language word and phrase replacements, visit the HHS Brand Guide Plain Language Terms and Phrases webpage.

**Twogether Consulting encourages providers to begin switching to this terminology as well, on forms created by the provider for their facility. So when you update any forms, try to use the term “person”, if you are currently using “individual”, or an even older term “consumer”. Of course that may take some time, but now is the time to start!

Notice: HHSC Hearing June 4th, 2024

May 20th, 2024

HEARING NOTICE:

Tuesday, June 4th at 9:00 a.m. in Room E2.030, Capitol Complex.

Evaluate the appropriate role of the state in overseeing Medicaid managed care.

Electronic public comment will be available for:

-Health and Human Services Commission Medicaid and CHIP procurements

-Medicaid managed care quality metrics

-Models for state Medicaid and CHIP contracting

The intention of this hearing is for the the committee to be educated on the current Medicaid managed care contracting practices and models. The committee will not participate in conversation specific to any outstanding protests, appeals, or litigation relating to the STAR/CHIP, STAR+PLUS, or STAR Kids procurements.

For those persons who will be testifying, information for in-person witness registration, can be found here: https://mytxlegis.capitol.texas.gov/HWRSPublic/About.aspx

A live video broadcast of this hearing will be available here: https://house.texas.gov/video-audio/

Instructions related to public access to the meeting location are available here: https://house.texas.gov/committees/public-access-house-committee-meetings/

Texas residents who wish to electronically submit comments related to agenda items on this notice without testifying in person can do so until the hearing is adjourned by visiting: https://comments.house.texas.gov/home?c=c310

REMINDER: Committee’s Assigned Interim Charges:

1. Monitoring: Monitor the agencies and programs under the Committee’s jurisdiction and oversee the implementation of relevant legislation passed by the 88th Legislature. Conduct active oversight of all associated rulemaking and other governmental actions taken to ensure the intended legislative outcome of all legislation, including the following:
• HB 1575, relating to improving health outcomes for pregnant women; and
• SB 24, relating to the powers and duties of the Health and Human Services Commission and the transfer to the commission of certain powers and duties from the Department of Family and Protective Services.

2. Medicaid Contracting: Evaluate the appropriate role of the state in overseeing Medicaid managed care.

3. Support for Texans with Intellectual Disabilities: Evaluate access to Home and Community-based Services (HCS) waivers, including the interest list, effects of inflation on the cost of services, and availability of services and service providers. Consider the long-term stability of long-term services and supports in waiver programs and consider alternative delivery models.

TMHP Communication Request: Confirm Your E-mail Address With PEMS!

May 18th, 2024

TMHP is currently in the process of reaching out to providers and informing them of the need to confirm their email address in the Provider Enrollment and Management System (PEMS).

Please help by sharing this information with other HCS/TxHmL/ICF providers. Having a valid email on file with TMHP will ensure any communications sent out will go to the appropriate person or entity that would need to be made aware.

Providers lacking a valid email address on file will encounter the following ramifications:

Will not receive email communication from TMHP for their Provider Type or Program.
Will not receive reminder emails regarding their upcoming revalidation due dates.
Will not be able to start a revalidation request until an email address is verified in PEMS. Providers who fail to complete their respective revalidations, by their given due date(s), will be disenrolled from the Medicaid program, which could result in gaps in enrollment. This can cause delay in reimbursement, and/or denial of claims, from both TMHP and MCOs.
Will not receive email communications regarding corrections to any PEMS request currently in-flight. Providers who do not respond to application deficiencies within a 45-day period will have their applications auto-close.

TMHP is providing the Verifying an Email in PEMS handout, which contains step-by-step instructions on how to complete this task within PEMS.

Additionally, providers should ensure the TMHP.com email domain is added to their Safe Senders list in their email system and avoid “unsubscribing” to emails received from the TMHP.com.

If providers require any direct assistance with completing this action, they can reach out to TMHP by using the Contact Us link on the TMHP website or by calling 1-800-925-9126.

AAIDD: Annual Texas Chapter Conference 2024

May 14th, 2024

48th Annual Texas Chapter Convention
Save the Date!

November 12 – 15, 2024

Location: Grand Galvez | Galveston, TX

Information For: Registration for Attendees and Vendors as well as Hotel Room Reservation Blocks coming later this summer, so stay tuned!

Grand Galvez has pleased guests worldwide for more than 100 years. Elegantly restored and tastefully modernized to welcome guests with the utmost in Gulf Coast luxury, Grand Galvez marries history with prime resort conveniences. The Spa at Grand Galvez offers a variety of body treatments, massage, and facials along with a full-service salon. You’re close to the city’s top attractions, the historic Strand District and breathtaking views of the Gulf of Mexico. Play at the คาสิโนชั้นนำของไทย – ยูฟ่าเบท and enjoy unparalleled gaming.

2023 Convention Recap

Direct Care Professional Study: You Can Help By Encouraging Your DCP Staff To Take This Survey!

https://ollusa.co1.qualtrics.com/jfe/form/SV_3Ud7Sob5JL2JaqW

May 13th, 2024

Twogether Consulting would really appreciate if providers could share this with their direct staff. Our good friend and colleague, Sergio Castillo from Life Choices Unlimited, needs your help with his doctoral project concerning Direct Care Professionals in our industry. Please read below and the link for the survey is also included.

“Dear Provider of Services to People with IDD, Direct Care Professional/Staff or IDD Service Provider:

My name is Sergio Castillo, and I am a current Our Lady of the Lake University doctoral student. I am conducting a Study of the Relationship Between of Leader’s Authentic Leadership Behaviors and Followers’ Self-Rated Organizational Citizenship Behavior Among Direct Care Professional (DCS) working with People with Intellectual and Developmental Disabilities (IDD). I am looking for participants who will complete an anonymous electronic survey that takes no longer than 10 minutes to complete.

Therefore, I am requesting for program providers to help me distribute it among your direct care staff/professionals or service providers.

Participation is voluntary, and there are no consequences for not participating or withdrawing from the study. There are (4) sections: Consent Information and selection for consent, Demographics Questionnaire, Authentic Leadership Inventory (ALQ), and the Organizational Citizenship Behavior Checklist.

To participate, direct care staff will need to click on the following link to complete the survey:

If you have any questions, or need additional information, please contact me at 956-279-9653 or scastillo16fl@ollusa.edu

You also may contact my OLLU Dissertation Chair, Dr. Yu Sun at ysun@ollusa.edu, or you may also contact Dr. Mark Green, Ph.D. at mtgreen@ollusa.edu Leadership Studies Department Chair.

Thank you for your consideration and time to complete my survey. You are truly making an impact in helping me reach my educational goals.”

Sincerely,

Sergio Castillo

Our Lady of the Lake University

Doctoral Candidate

Cohort 10 -RGV Campus

scastillo16fl@ollusa.edu

(956) 279-9653 cell

January 31st IDD and PI Webinar with HHSC LTCR

May 13th, 2024

IDD & PI Webinar April 30th , 2024

The April 30 recording of the Intellectual and Developmental Disability Programs (IDD) and Provider Investigations (PI) Quarterly Webinar with Long-term Care Regulation (LTCR) is available.

Read the IDD and PI Quarterly Webinar (PDF).

Email LTCR Policy for the transcript.

January 5, 2024

IDD & PI Webinar January 31st, 2024

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

See Recording below

IDD and PI Webinar
Jan. 31, 2024
10–11 a.m.

STAR+PLUS Transition Member Information: Change In MCO Providers Coming Soon!

Star Plus Transition Member Information

May 12th, 2024

STAR+PLUS Transition Member Information: HHSC recently awarded contracts to health plans (MCOs) for the STAR+PLUS Service Areas. As detailed below, the newly awarded contracts impact many of the service areas. The contract effective date is September 1, 2024.

Nine (9) of the 13 service areas were affected by the procurement and award processes:

~ Bexar, Dallas and El Paso, Harris, Hidalgo, Jefferson, Nueces, Tarrant and Travis service areas. With the exception of Jefferson service area, each of these areas has at least one new MCO in their area. Jefferson service area, which currently has 3 MCOs will only have 2 MCOs beginning September 1, 2024.

See slides 9 – 11 of the attached handout.

~ Lubbock, MRSA Central, MRSA East and MRSA West service areas were not affected, meaning that the current MCOs covering these areas will remain.

See slides 7 and 12 of the attached handout.

Letters from HHSC have been sent to current members in the nine (9) areas in which a change in MCOs is occurring. The letters were sent In March.
Members in the 9 affected service areas have until July 20, 2024 to pick a new health plan (MCO) and will be sent a reminder before the deadline. Note: Persons satisfied with their current MCO are not required to respond to the letter, but, if they want, may switch to the new MCO or any other MCO in their area. Of course, persons currently enrolled in a MCO which was not awarded a ‘new’ contract will need to select a health plan from the MCOs in their service area.
- Example: If a person resides in the Jefferson STAR+PLUS Service Area, and is currently enrolled with United Healthcare, the person will need to choose either Wellpoint or Molina since , effective September 1, 2024, United Healthcare will no longer serve that area. On the other hand, if a person residing in Jefferson STAR+PLUS service area is currently enrolled with Molina, the person can either stay with Molina, or change to the other MCO (Wellpoint) in that area.
HHSC is planning to conduct information sessions about the changes, but no dates were provided.

As the transition will impact the individuals providers serve and as it is not known when the information sessions/webinars will be held, we urge providers to review this information with the individuals they serve and/or their families.

Updates For Medicaid Interest Waiver List

Medicaid Enrollment Revalidation Process for HCS Program Providers: Update

May 2nd, 2024

On Feb. 13, the Health and Human Services Commission (HHSC) posted a notice for HCS program providers about completing Medicaid enrollment revalidation. HHSC is providing an update to this previous notification.

Effective for all Medicaid enrollment revalidations due on or after June 1, HCS program providers must disclose and maintain all practice locations in the Provider Enrollment Management System (PEMS).

The Update on Medicaid Enrollment Revalidation Process for HCS Program Providers (PDF), is available on the HHS HCS webpage.

ISS Updates & New Rules (HCS/TxHmL)

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

May 5th, 2024

UPDATED ISS FAQ’S

FAQs for Individualized Skills and Socialization services. In reviewing, know that all changes are reflected in red. To ensure compliance, you are urged to carefully read all changes/updates.

The following are the pages on which changes/updates are reflected:

Pages 18, 21 & 24
Pages 32, 33, and 36 thru 39
Pages 41, 57 & 58,
Pages 63, 68, 71, 73 and 75 thru 80.

Note: Please review the change on page 68 under the section titled Rates. Members may recall that the HCS rules used to be under 40 TAC, Chapter 9. Some of those rules are now under 26 TAC, Chapter 565. When the rules under Chapter 565 were adopted, the text of the provision under 9.177 (b) – now under 565.9 (e) – was slightly revised. Those revisions are reflected in the May 2, 2024 update to the ISS FAQs. Interested persons may contact the PPAT Office for the former language/requirement.

HHSC Long-term Care Regulation updated the Individualized Skills and Socialization frequently asked questions document on May 2, 2024.

Read the FAQ here (PDF).

April 1st, 2024

ISS Administrative Penalties Scope and Severity Grid

Figure: 26 TAC §559.253(b)

SCOPE AND SEVERITY GRID FOR ADMINISTRATIVE PENALTIES
	ISOLATED	PATTERN	WIDESPREAD
Immediate threat	Substantial=NRTC	Substantial=NRTC	Substantial=NRTC
Immediate threat	J	K	L
Initial	$400–$600	$450–$650	$500–$700
Repeat	$500–$700	$550–$750	$600–$800

Actual harm	Substantial=NRTC	Substantial=NRTC	Substantial=NRTC
Actual harm	G	H	I
Initial	$250–$450	$300–$500	$350–$550
Repeat	$350–$550	$400–$600	$450–$650

No actual harm with a potential for more than minimal harm	Non-Substantial=RTC	Non-Substantial=RTC	Substantial=NRTC
	D	E	F
Initial	$100–$300	$150–$350	$200–$400
Repeat	$200–$400	$250–$450	$300–$500

No actual harm	Non-Substantial=RTC	Non-Substantial=RTC	Non-Substantial=RTC
No actual harm	A	B	C
Initial	$0–$0	$0–$0	$0–$0
Repeat	$0–$0	$0–$0	$0–$0

March 7th, 2024

HHSC Hold Harmless Period Ending

This “hold harmless” period is ending for ISS providers on March 17, 2024.

Beginning March 18, 2024, HHSC will survey for compliance with all regulatory requirements, including off-site provision of services, and move forward with applicable enforcement actions as outlined in Title 26 Chapter 559, Subchapter H, Division 4 (Survey, Investigations & Enforcement)

Draft Amendments to ISS Licensing Rules

HHSC has posted draft licensing rule amendments to Chapter 559 governing the Individualized Skills and Socialization program. Comments are due to HHSC March 21, 2024. See details for commenting and for access to the draft rules at: https://www.hhs.texas.gov/regulations/policies-rules/health-human-services-rulemaking/comment-proposed-draft-rules

These draft rule amendments include some of the following changes:

Clarification of ANE requirements

Clarification of medication administration and related requirements

Clarification of staff training requirements

Movement of all rights-related requirements into one subsection

Expansion and clarification of all environmental provisions

Application of administrative penalties and any other sanctions for failure to adhere to the rules.

February 14th, 2024

Delays In Receiving ISS Licenses

Some ISS providers have been experiencing delays in receiving their license before the expiration date and concerned of the impact to their program. HHSC acknowledged they are experiencing delays and has noted the following: For renewals, as long as the provider has submitted a renewal application, their license is considered active even if processing that application takes HHSC beyond the expiration on their printed license. Provider Letter PL 2021-14 discusses this issue.

Reminders:

~ HHSC created a process to allow for an initial temporary license to be issued, which included a health survey be conducted. To effectively manage the workload, HHSC also created a staggered process so that not all licenses expired at the same time. This meant that all applications received before September 1, 2023 were assigned either a one year, two year or three year license, which upon renewal would be issued for three years.

~ The license renewal process does not require a survey, however, surveys will be scheduled every two years at the discretion of the region.

~ At the time of renewal a fee must be paid. See 559.219 for details: https://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=26&pt=1&ch=559&rl=219

~ HHSC created an ISS webpage which includes access to the rules, training information and other ISS-related information: https://www.hhs.texas.gov/providers/long-term-care-providers/individualized-skills-socialization

December 15th, 2023

Clarification on Licensure Renewals

All licensed long-term care providers must submit a renewal application in the Texas Unified Licensure Information Portal (TULIP) before their current license expires. While a re-licensure/recertification survey is part of the renewal process, it doesn’t take the place of submitting a renewal application in TULIP.

HHSC encourages providers to submit the application as soon as possible within the 120 days prior to the expiration of their license, so that if there are issues with TULIP — such as the renewal application not being in the TULIP account — the provider has time to work with TULIP Support prior to their license expiring.

If the provider is waiting on pending documentation — such as a current fire marshal report — it’s better to go ahead and submit the renewal application with the deficiency and upload a letter explaining why they don’t have the required documentation.

***If the application isn’t submitted before the license expires, the provider risks providing services without a license. This is only for licensed LTC providers. Does not include HCS/TxHmL providers as they are contracted, not licensed.

August 18th, 2023

Transition to Individualized Skills and Socialization Survey Deadline Extended

HHSC implemented individualized skills and socialization services in the Home and Community-Based Services (HCS) and Texas Home Living (TxHmL) Medicaid 1915(c) waiver programs, effective Jan. 1, 2023.

HHSC is requesting feedback from HCS and TxHmL program providers only on the impact this change has had on individuals receiving services in the form of a short survey.

Take the survey to provide your feedback.

We thank you for your input. HHSC is extending the deadline to submit responses until Aug. 31, 2023.

All HCS and TxHmL program providers who have not submitted a response must complete the survey by this deadline. Providers who have already completed the survey do not need to submit an additional response.

July 17th, 2023

HHSC Updated the Individualized Skills and Socialization Hold Harmless Period through March 17th, 2024

On Jan. 1, 2023, HHSC implemented the DAHS Individualized Skills and Socialization program and offered an initial hold harmless period from Jan. 1, 2023, through June 30, 2023.

HHSC agreed to extend part of the hold harmless period related to the provision of off-site services.

HHSC will survey for compliance with off-site service delivery but will not move forward with enforcement action.

For all other regulatory requirements, beginning July 1, 2023, HHSC will survey for compliance and move forward with applicable enforcement actions as outlined in Title 26 Chapter 559, Subchapter H, Division 4.

The new hold harmless period related to the provision of off-site Individualized Skills and Socialization services begins July 1, 2023, and ends March 17, 2024.

March 28th, 2023

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

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

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

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

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

Beginning May 12th, 2023:

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

Clarification & Answer to Question From Some of Our Readers:

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

March 1st, 2023

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

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

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

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

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

February 21st, 2023

More ISS Training

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

Blackboard Connect sign-up process:

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.

If the above link does not work, the FAQs may be accessed at: https://www.hhs.texas.gov/sites/default/files/documents/individualized-skills-and-socialization-faq.pdf

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

Use of EVV for In-Home ISS in OHFM: Please see the notice at: https://www.tmhp.com/news/2022-12-29-evv-vendor-systems-will-display-individualized-skills-and-socialization-services

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.

https://www.sos.texas.gov/texreg/pdf/backview/1223/1223adop.pdf

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.

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:

HHSCLTCRRules@hhs.texas.gov

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.

Draft licensing rules

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

https://www.hhs.texas.gov/providers/long-term-care-providers/long-term-care-provider-resources/individualized-skills-socialization

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

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

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

Provider Communications

PL 2021-42 – This Provider Letter offers a brief introduction to the new individualized skills and socialization service and what providers can expect as HHSC implements the service.
Individualized Skills and Socialization Services webinar – This helpful webinar provides an introduction and overview to Individualized Skills and Socialization
Individualized Skills and Socialization FAQs – revised April 26, 2022
July 2022 – Individualized Skills and Socialization Provider Webinar – This webinar covers the service description, ratio requirements, and licensing information based on HHSC’s draft individualized skills and socialization rules.
- July 2022 – Individualized Skills and Socialization Webinar (PDF)

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

Dyslexia Handbook 2024: Procedures for Education

https://tea.texas.gov/academics/special-student-populations/special-education/2nd-reading-2024-texas-dyslexia-handbook-2024.pdf

April 29th, 2024

Dyslexia Handbook 2024 For Special Education

Discusses procedures for educating individuals with Dyslexia and related conditions

Click on the link below for a copy of the handbook.

TED (Transition & Employment Designee) Guidelines For Students With Disabilities In Special Education Programs

April 29th, 2024

Overview of the Transition & Employment Designee (TED) What is a TED?

The TED is an employee in a district or charter school who is designated as the primary contact for transition and employment services for students with disabilities in special education programs. This role is required by Texas Education Code (TEC) §29.011(b). This employee must be able to provide information and resources about effective transition planning and employment services to school staff, students, parents/guardians, and agency providers. Local education agencies (LEAs), including districts and open-enrollment charter schools, can change this designation, as needed, to make sure that the employee serving in this role has the appropriate knowledge and skills necessary for providing information about effective transition services. Throughout this guide when the term “parent or parents” is used, the term includes the definition aligned to 34 Code of Federal Regulations (CFR) § 300.30. That definition includes biological or adoptive parent, foster parent, guardian, an individual acting in the place of a biological parent with whom the child lives or is legally responsible for the child’s welfare, or a surrogate parent as defined in 34 CFR § 300.519.

Click on the link below to see the guidelines

TED Guidelines

AAIDD Annual Conference – Hotel and Registration Reminders!

April 30th, 2024

Book Hotel Room Today

Register For AAIDD National Conference in Louisville, Kentucky (June 10th-12th, 2024)

Earlybird Registration Ends May 2nd, 2024

Registration

Parents Guide To The ARD (Admission, Review, Dismissal) Process Video: Now Available in ASL

https://www.spedtex.org/parents-guide-ard-process-asl-video-series

April 30th, 2024

Click the link below to download this resource.

DOWNLOAD PDF

2024 IDD Group Home Provider Report: Direct Support Workforce Crisis

2024 IDD Group Home Provider Report

April 24th, 2024

Above you will find the updated provider survey report conducted by the 3 IDD associations to encompass system experience subsequent to the implementation of rate increases for direct care workers that became effective September 1, 2023. This report was sent to the HHSC Executive Commissioner on April 23rd, 2024, and covers providers’ experiences and challenges in delivering quality services amid the workforce crisis during the first 5 months of FY 2024. Where possible the report compares the most recent data to data the 3 associations previously collected.

In the communication to the HHSC Executive Commissioner the 3 associations requested to meet with her and other agency leadership to discuss the report in greater detail. Know that the report will be posted on the Time to Care Coalition website and will be shared with the Texas Conservative Coalition Research Institute (TCCRI).

All of these efforts have been made to assist with hopefully getting an increase in direct support worker wages.

“Lookup Tool” Unnecessary For HCS/TxHmL Cost Reporting Accountability Report

Reminder: April 14th, 2024- in case you missed this in March

March 11th, 2024

According to HHSC, “the process outlined below and implemented by TMHP should make the lookup tool unnecessary for cost reporting.”

TMHP created a claims data export process to allow HCS/TxHmL providers to access units of service information to support cost reporting. This hopefully will make the UOS lookup tool unnecessary.

Texas Med Connect (TMC) users can request the Claims Data Export through TMC and will be available the next day to download. For those who would like more information, they should contact the LTC Help Desk at 800-626-4117 (option 1).

TMHP also created a short video detailing this process: Claims Data Export – YouTube

***PFD will be adding this information to the cost report training.

January 1st, 2023

HHSC will be producing a lookup tool for the 2023 accountability report and it will be posted to STAIRS like they did for the 2022 cost report. It should be available as of February 2023, when the reports normally are released in STAIRS. A Gov Delivery will be sent out once the tool is posted to STAIRS.

West Texas Summit Highlights Funding Challenges For IDD Community

April 14th, 2024

Permiacare and Spectrum of Solutions hosted the West Texas IDD Summit. See comments from Spectrum of Solutions and Permiacare representatives discussing the dire state of funding for individuals with IDD in current Medicaid programs, specifically funding to pay our direct support workers. Thank you for all you do Spectrum of Solutions and Permiacare for individuals with IDD in the community!

Please click on this video from local ABC News Channel 2

Watch Free IDD Webinar From TMP: “Mastering Inflation- How leveraging IDD-specific tools can save your provider agency.

https://www.taskmasterpro.com/idd-webinar-mastering-inflation/

April 14th, 2024

“Mastering Inflation”

How leveraging IDD-specific tools can save your provider agency.

Please check on this wonderful free webinar with this presentation by TMP (TaskMaster Pro) at the recent ANCOR conference and how their technology can help you.

IDD Webinar – Mastering Inflation

Provider Job Openings & Employment Opportunities: HCS/ICF/ISS

April 13th, 2024

Based on the many phone calls, emails, and contacts through our social media pages concerning employment needs and job openings in the HCS/ICF/ISS programs, we will continue to use our “Updates” page as a platform to assist providers in posting these openings and opportunities.

If you contact Meghan Jones at meghanjones.tx@gmail.com and let her know where you are posting a position and who to contact, we can also just put a link and the contact person’s name, # and/or email for free at no cost. For example, you are posting on Indeed, Linkedin, BenefitMall, Facebook, PACSTX job postings, an online newspaper, etc… If you would like to post an opening with a complete job description (or longer than a few paragraphs), the cost is $15 for a one-time fee. We will continue to run this post until you notify us otherwise. All current updates are also noted in our bi-weekly newsletter.

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

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

Julie Blacklock/ Owner

Job Fair: Mary Lee Foundation – Austin, Tx

April 16th & 20th, 2024

Current Job Postings (See below)

Position posted 2/09/24 POSITIONS STILL AVAILABLE

Mary Lee Foundation

Position: Direct Support Proffessionals (HCS & ICF Programs)

Contact: Marc Estrada (Human Resources)

Ph: (512) 443-5777

mestrada@maryleefoundation.org

Location: (Southpointe) 1336 Lamar Square Austin, Texas

Status: Full-time, Night Shift, Weekends, Per Diem, Overnight

Hours: 8am-5pm Mon-Fri

Pay Rate: Base Rate of $13.50/hr and up to $15.50/hr for certain shifts

Call us at 512-443-5777 and interview today!

Incentives

No experience necessary – We provide training!

$1,250 Sign-on Bonus for Full-Time hires!

Generous Paid Time Off (PTO)

403(b) Retirement Plan

Annual Retention Bonus

Career Growth Opportunities with paid training

Insurance Options (Medical, Vision) for all Full-Time employees

Paid Company Dental insurance and Life Insurance for all Full-Time employees

Referral program

Student Loan Forgiveness after 10 years of service

We promote from within!

Mary Lee Foundation is looking for Direct Support Professionals to provide person-centered care tailored to meet the needs of individuals with intellectual and developmental disabilities. You’ll make a difference in the lives of people with disabilities while receiving a great opportunity for professional growth.

Some things you will find yourself doing in this position:

Assisting clients with daily personal tasks, including bathing and dressing

Completing housekeeping tasks such as vacuuming, washing dishes and tidying

Helping plan client appointments and organize a schedule

Organizing with transportation arrangements to appointments

Shopping for groceries and preparing meals that meet specific client dietary needs

Encouraging client engagement in social networks and communities

Competitive Benefits:

Generous Paid Time Off (PTO) – 24 days per year!

Career Growth Opportunities with paid training

Insurance Options (Medical, Vision,) for all Full-Time employees

Company paid Dental Insurance for all Full-Time employees

Paid Orientation

Referral program

Student Loan Forgiveness after 10 years of service

We promote from within!

Position posted 1/14/24 NOW CLOSED

Mary Lee Foundation

Position: ICF QIDP (Qualified Intellectual Disabilities Professional)

Contact: Marc Estrada (Human Resources)

Ph: (512) 443-5777

mestrada@maryleefoundation.org

Location: (Southpointe) 1336 Lamar Square Austin, Texas

Status: Full-Time

Hours: 8am-5pm Mon-Fri

Pay Rate: $19/hr

Benefits:

On the 1^st of the month following 60 days of full-time employment, this position is eligible for Dental/Vision/Health/Life insurance. Paid Annual Leave Time can be used after the 90-day probationary period is completed.

Qualifications:

2 years experience working with people with disabilities

Supervisory experience preferred.

Bachelor’s degree in a human services related field (i.e., social work, special education, psychology, rehabilitation counseling, or sociology)

Proven working experience in case management, including as a nurse, medical, mental health care manager or a related job

Good criminal history

Valid Drivers License

Clean driving history

Knowledge, Skills and Abilities:

Excellent knowledge of case management principles, healthcare management and reimbursement

Previous experience with psychological aspects of care

Effective communication skills

Excellent organizational and time management skills

Familiarity with professional and technical emerging knowledge

Problem solving skills and ability to multi-task

Compassionate with teamwork skills

Click link below to read more:

Job Description

Position posted: 01/14/23 POSITIONS STILL AVAILABLE

Mary Lee Foundation Day Hab (Austin, Tx) Habillitation & ISS Program

Position: Direct Support Professional – Adult Day Hab

Contact: Marc Estrada (Human Resources)

Ph: (512) 443-5777

mestrada@maryleefoundation.org

Status: Full Time Non-Exempt
Hours: 8:00 am – 4:00 pm, Mon – Fri
Starting pay: $13.50/hr

Benefits:

On the 1st of the month following 60 days of full-time employment, this position is eligible for
Dental/Vision/Health/Life insurance. Paid Annual Leave Time can be used after the 90-day probationary period
is completed

Job Requirements:

1. Must assist individuals with intellectual & developmental disabilities at all times while attending day habilitation &/or receiving ISS (individualized Skills & Socialization) services..
2. Supervise and assist individuals with meal prep and/or eating, personal
hygiene, grooming and other activities including but not limited to: adult daily living skills, leisure activities & community outings as needed.
3. Complete records as designated by policies and procedures such as, but not limited to;
documentation of training classes, progress notes/service delivery logs, medication leave reports, and any behavioral
management programs.
4. Provide input to individual program planning for individuals. Train/instruct individuals in areas of
individual program plan or implementation plans under the training system established by the QIDP/CM, including
supervision of individuals in day program or ISS activities in various life, social and vocational skills
5. Be aware of the approximate location of all individuals on assigned building.
6. Supervise and assist individuals in recreational activities both on campus and off campus.
7. Assist in general upkeep and repair of facility such as, but not limited to: keeping inside and
outside of vehicles clean and ensuring sufficient gasoline level for next usage, cleaning of facility
grounds and/or buildings, and informing appropriate management staff for resolving noted
problems areas.
8. Teach independent living skills classes, supervise and assist participants with meal preparation,
prompt and assist participants with personal hygiene, grooming and other activities as needed.
9. Check attendance logs and service logs for accuracy and ensure they are turned in a timely
manner.
10. Make written reports of significant incidents that occur and inform appropriate staff if needed…

Click link below to read more:

Full Job Description

Potential Threats: New LIDDA Requirement

April 12th, 2024

Potential Threats to Health and Safety (new). (SOW, 2.6.4.). The contract includes a new provision requiring the Authority to respond and immediately take action, as identified in correspondence from HHSC, related to Notifications of Potential Threats to Health and Safety. The procedure and actions taken must ensure the individual is seen in person within 48 hours.

***Health and Human Services Commission (HHSC) Intellectual and Developmental Disability (IDD) Services Broadcast Message 2024-029***

**HHSC IDD Services and PASRR has published a memo outlining the responsibilities of the local intellectual and developmental disability authorities (LIDDAs) after HHSC Long-term Care Regulation (LTCR) identifies a potential threat involving an individual in a Home and Community-based Services (HCS) or Texas Home Living (TxHmL) program.

See memo below:

https://acrobat.adobe.com/id/urn:aaid:sc:us:16f0c68c-6687-4801-9c8f-c4b783ce594c

If you have any questions regarding this letter or the LIDDA’s responsibility after notification of a potential threat, please e-mail IDDMFPSupport@hhs.texas.gov.

KERA News Article: Making Life-Or-Death Decisions For $10.60 An Hour

https://www.keranews.org/health-wellness/2024-03-27/making-life-or-death-decisions-for-10-60-an-hour-texas-group-homes-suffer-from-staffing-crisis

April 5th, 2024

Please see the article below which was published a few days ago, regarding the impact of the $10.60/hour direct care wage funded by the 88th Texas Legislature. The article provides an excellent description of an IDD provider system under mounting stress due to inadequate funds to combat the relentless workforce shortage. Note that while the article does not mention the 3 IDD associations by name, it does reference their collective efforts to secure emergency funding to increase direct care wages to $15/hour, the results of our August 2023 survey (previously sent to all members), and the letter 51 Texas State House Representatives sent to the HHSC Executive Commissioner last fall urging her to secure additional funds (also previously sent to members). Please share!

Making life-or-death decisions for $10.60 an hour: Texas group homes suffer from staffing crisis

Miranda Suarez

KERA News

March 27, 2023

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New MCO’s & New MCO Locations

March 14th, 2024

MCOs Awarded Contracts by STAR+PLUS Service Areas:

See the end of this communication for the MCOs awarded a contract and the service areas they will cover. Please note that not only will there will be 3 new MCOs (highlighted in yellow), but also that the service areas for some of the current MCOs are changing.

Notices to Individuals regarding the Change: According to HHSC letters were sent to STAR+PLUS members (individuals who receive their acute care and/or long-term care services from STAR+PLUS) on March 1st informing them of the change.

Providers we encourage you to let your individuals you serve and their families know of the upcoming changes and to expect, if not already received, a letter from HHSC and Texas STAR+PLUS informing you of the need to select an MCO.

See the notice below:

Date Individuals Must Select an MCO: Though various external sources reported that the selection must be made by July 1, 2024, a letter one PPAT member shared indicated the selection due date is July 10, 2024.

EFFECTIVE SEPTEMBER 1, 2024

Notice of Award: In accordance with 1 T.A.C. §391.219, HHSC issued a Notice of Award to the following Respondents:

United Healthcare Community Plan of Texas, LLC. – Bexar, Central Texas, Dallas, Harris, Hidalgo, Northeast Texas, Tarrant and Travis Service Areas
Molina Healthcare of Texas, Inc. – Bexar, Dallas, El Paso, Harris, Hidalgo, Jefferson, Northeast Texas and Tarrant Service Areas
Superior HealthPlan, Inc. – Central Texas, Dallas, Hidalgo, Lubbock, Nueces, Travis and West Texas Service Areas
Amerigroup Insurance Company – Jefferson, Lubbock, Nueces and West Texas Service Areas
New Contracts:
Community First Health Plans, Inc. – Bexar Service Area
El Paso Health – El Paso Service Area
Community Health Choice Texas, Inc. – Harris Service Area

Local Authority Contract Change: Potential Threats to Health and Safety

March 12th, 2024

Local Authority Contract Change: Potential Threats to Health and Safety (new). (SOW, 2.6.4.). The contract includes a new provision requiring the Authority to respond and immediately take action, as identified in correspondence from HHSC, related to Notifications of Potential Threats to Health and Safety. The procedure and actions taken must ensure the individual is seen in person within 48 hours.

LIDDAs have requested clearer direction from HHSC as to implementation expectations including what prompts HHSC (the Money Follow the Person unit) to notify LIDDAs of the need for an on-site inspection and a change in the response time to conduct the visit from “within 48 hours” to “in 2 business days.”

In order to minimize confusion and multiple calls between the provider and their staff and the provider and the LIDDA regarding the purpose of a LIDDA’s unannounced visit and its inquiries about an event that poses potential threat to one’s health and safety, HHSC is preparing a communication for distribution to providers and to LIDDAs for their use when fulfilling this requirement.

Providers understandably do have concerns about this new provision.

Resource Sheet: Person-Centered Language From IntellectAbility

March 8th, 2024

Our friends at IntellectAbility created this wonderful tool which I think Service Coordinators, Case Managers and QIDPs will really find helpful when developing their plans for individuals in their programs. These include Person-Directed Plans, Implementation Plans, and Individual Program Plans.

Please Click this link, Person-Centered Language: Resource Sheet to learn more about this tool from Intellectability

For more about Person-Centered Training Resources from Intellectabilty, go to https://replacingrisk.com/person-centered-services

For those of you who want to learn more about IntellectAbility’s Person-Centered Training, Resources and Tools.

Have a Question? Call (727) 437-3201

New Reporting Process for ANE Reporting & Investigations for ICF/IID Program

February 28th, 2024

HHSC has begun to send out new ANE Reporting Procedure Posters to ICF providers this week. If you do not get one, please contact

Even if you have not received your ANE posters, please go ahead and make your posting of the new phone # for reporting allegations of Abuse, Neglect and Exploitation in the group homes and other appropriate places for your staff and individuals in your program. Please inform all staff, volunteers, individuals, and LARS of the new protocol.

The reporting time is still “within 1 hr of your knowledge or suspicion of Abuse, Neglect or Exploitation”.

The new phone # for reporting ANE to CII is: 1-800-458-9858.

Please do not report to DFPS anymore starting March 1st, 2024 as they will no longer be investigation ANE for the ICF/IID programs.

A few items of note:

-CII will be the only place facility or persons reporting ANE will need to make your report. This should help with redundancies.

-CII will prioritize allegations that are serious health and safety concerns for individuals in the program.

-The facility will not receive a findings report from CII.

-The facility will not receive the findings until surveyors present them to the provider at the entrance meeting during a survey that results from an ANE report and investigation by CII.

-The facility should start protective measures for their individuals and corrections as soon as they are aware of the allegation, so this may start much earlier if the allegation is self-reported (immediately after self-reporting).

-The facility will also need to begin an internal investigation right away and within 5 days of the internal investigation fill out and submit a 3613-A report form to send in to CII. Facility will no longer wait for a PIR investigation report.

-PIR will no longer be part of the process. CII will receive all ANE reports, process them and complete Investigations.

-The facility is still required to report to other legal entities as appropriate: i.e, client’s rights issue contact IDD Ombudsman, robbery or stolen items, missing person-report to law enforcement, etc…

–Resident-to-resident Aggression: Facilities only need to report resident-to-resident aggression that results in serious injury. ( See TAC Title 26 Part I Ch 551.213) What is considered a serious injury? (See TAC Ch 711.3 for the definitions.)

Things your Report To CII Including ANE (section 551.213)

A facility must report any of the following incidents to HHSC’s Complaint and Incident Intake Section at 1-800-458-9858 within one hour after suspecting or learning of the incident:

(1) alleged (Class I) physical abuse of a resident, as defined in Chapter 711 of this title, that caused or may have caused serious physical injury;

(2) alleged (Class I) sexual abuse of a resident, as defined in Chapter 711 of this title;

(3) sexual activity between residents resulting from coercion, physical force, or taking advantage of the disability of a resident;

(4) sexual activity involving a resident less than 18 years of age;

(5) the pregnancy of a resident;

(6) resident-to-resident aggression that results in serious physical injury;

(7) the death of a resident; and

(8) a resident whose location has been unknown by the facility for more than eight hours or less than eight hours if there are circumstances that place the resident’s health or safety at risk.

Ch 26 Tac 771.3

Definition of Serious Physical Injury

(34) Serious physical injury—

(A) In state-supported living centers and state hospitals only, any injury requiring medical intervention or hospitalization or any injury determined to be serious by a physician or APRN. Medical intervention is treatment by a licensed medical doctor, osteopath, podiatrist, dentist, physician assistant, or APRN. For the purposes of this subchapter, medical intervention does not include first aid, an examination, diagnostics (e.g., x-ray, blood test), or the prescribing of oral or topical medication;

(B) For all other service providers, any injury determined to be serious by the appropriate medical personnel. Examples of serious physical injury include:

(i) fracture;

(ii) dislocation of any joint;

(iii) internal injury;

(iv) contusion larger than two and one-half inches in diameter;

(v) concussion;

(vi) second or third degree burn; or

(vii) any laceration requiring sutures or wound closure.

February 25th, 2024

HHSC 2/23/2024 Notice:

HHSC has released a new letter of guidance regarding the revised ANE reporting process to CII and the ANE investigation process for ICF/IID. Here is the published provider letter (PL) 2024-04

Additionally, processes related to investigations of ANE of ICF/IDD will change as of March 1, 2024.

For questions contact LTCRPolicy@hhs.texas.gov.

Upcoming Webinars:

Reporting Abuse, Neglect, and Exploitation Changes and Self-Reporting Incidents for ICFs/IID

Tuesday, Feb. 27
10–11:30 a.m.
Register for Feb. 27 webinar.

**ICF/IID Reporting and Investigating ANE Webinar with HHSC LTC:

This session will be similar to the other 3 webinars, but will provide additional information about the ANE process as well as information regarding what providers can expect both during and after an investigation. It is recommended that you register for this webinar and one of the other 3 webinars

Wednesday, Feb. 28, 2024

11:00 a.m.–noon

Reporting Abuse, Neglect, and Exploitation Changes and Self-Reporting Incidents for Intermediate Care Facilities
Tuesday, March 5
10–11:30 a.m.
Register for March 5 webinar.

Reporting Abuse, Neglect, and Exploitation Changes and Self-Reporting Incidents for Intermediate Care Facilities
Thursday, March 21
2–3:30 p.m.
Register for March 21 webinar.

HHSC IDD Operations Portal For Providers-2024 Update

Training webinar pre-recorded video HCS/TxHmL/ICF/CFC Non-waiver programs

February 23rd, 2024

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 UR 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.

Provider Webinar Available: To access a recording of the “TMHP LTC Portal for HCS/TxHmL Providers and FMSAs” webinar, please visit the HCS and TxHmL Webinars and FAQs web page.

January 19th, 2024

Other Portal Resources: FAQ’s & Training Webinar:

In case you weren’t aware, there are FAQ’s on using the IDD portal and there is a training webinar for HCS/TxHmL/ICF/CFC Non-waiver programs

IDD Portal FAQ’s

November 12th, 2023

IDD Portal Information & Additional Training Resources

The Intellectual and Developmental Disabilities (IDD) Operations Portal is an online based application used by long-term care IDD providers and Local Intellectual Developmental Authorities (LIDDAs) to submit and receive documents to and from Texas Health and Human Services IDD Program Eligibility and Support (PES) and IDD Waivers Utilization Review (UR) sections. The portal is only meant to replace document submissions by fax and mail.

It does not replace the responsibility of providers or LIDDA’s to ensure accurate completion of documents, maintain signed paper copies of forms in individual records, and comply with HIPAA regulations when making submissions to the Health and Human Services Commission (HHSC). During initial account setup, the provider or LIDDA assigns a security authority who is responsible for managing their staff’s access to the portal. Providers and LIDDAs are responsible for ensuring procedures are in place to properly manage staff’s access to individual’s records inside and outside of the portal, just as they did prior to portal implementation.

Click on to see: IDD-operations-portal-user-guide

April 15th, 2019

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

Who Can Use the Portal?

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

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

What Are the Benefits?

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

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

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

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

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

LTC Provider Bulletin Now Available

February 20th, 2024

LTC Provider Bulletin Now Available

The February 2024 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 LTC Provider Resources Guide under Reference Material.

Links to Long-Term Care Bulletins

February 2023 LTC Provider Bulletin No. 97

See links to 2024 editions below:

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:

November 2022 Long-Term Care Bulletin No. 92 (1.2 MB)

August 2022 Long-Term Care Provider Bulletin No. 91 (1.15 MB)

May 2022 Long-Term Care Provider Bulletin No. 90 (1.12 MB)

February 2022 Long-Term Care Provider Bulletin No. 89 (1.13 MB)

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

Friendly Reminder To HCS/TxHmL Providers: Providing Full Array of Services

February 18th, 2024

IDD Services and PASRR want to remind local intellectual and developmental disability authorities (LIDDAs) that Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers are required to provide, or obtain as needed and without delay, the array of services in the respective programs in accordance with Texas Administrative Code (TAC), specifically 26 TAC §565.11(a)(3) for HCS and 26 TAC §566.7(d)(1) for TxHmL.

Program providers cannot limit the program services they offer to an individual. The requirement to provide the full array of services includes individuals receiving Community First Choice (CFC) services and individuals who choose to receive some or all of their services through the Consumer Directed Services (CDS) option.

For a complete list of the program services, see the following TAC references:

HCS program services: 26 TAC §263.5
TxHmL program services: 26 TAC §262.5
CFC program services: 26 TAC §263.6 and 26 TAC §262.6

**If a LIDDA becomes aware that an HCS or TxHmL program provider is not offering the full array of program services, the LIDDA should report this information to the IDD Ombudsman at https://hhsportal.hhs.state.tx.us/heartwebextr/hhscIddo, or call 800-252-8154, from 8 a.m. – 5 p.m. Monday through Friday.

For any questions please email iddservicesacoffice@hhs.texas.gov.

Public Hearing Webcast & Presentation on Feb. 15th, 2024 (HCS/TxHmL/DBMD) Pre-Vocational & Similar Services

February 10th, 2024

Public Hearing Notice – Home and Community-based Services, Texas Home Living, and Deaf Blind with Multiple Disabilities Medicaid Waiver Programs

Public hearing will be held on:

February 15, 2024 – 2:30 pm

Texas Department of State Health Services, Moreton Building Room M-100, First Floor
1100 West 49th Street, Austin, Texas
78756

Webcasting Available

This public hearing will be webcast. Members of the public may attend the public hearing in person at the address above or access a live stream of the public hearing at https://texashhsmeetings.org/HHSWebcast. Select the tab for the Moreton M-100 Live on the date and time for this public hearing. Please e-mail Webcasting@hhsc.state.tx.us if you have any problems with the webcasting function.

Public Hearing. The Health and Human Services Commission (HHSC) will conduct a hybrid public hearing, at the date, time, and location stated above, to solicit feedback and public comment on the prevocational or similar services under Home and Community-based Services (HCS), Texas Home Living (TxHmL), and Deaf Blind with Multiple Disabilities (DBMD) Medicaid waiver programs, as related to House Bill 4169, 88th Regular Session, 2023. (Work Readiness Program)

Public hearing on prevocational or similar services under HCS, TxHmL, and DBMD Medicaid waiver programs as related to House Bill 4169, 88th Legislature, Regular Session, 2023

1. Overview presentation by HHSC staff
2. Public comment

Read more….

Contact: Questions regarding agenda items, content, or public hearing arrangements should be directed to Kaili Hintz, Long-Term Services and Supports (LTSS) Policy Manager, Medicaid and CHIP Services, at 512-632-6419 or LTSS_Policy@hhs.texas.gov.

Information Letter On New Application Process for HCS, coming soon

January 20th, 2024

Information Letter (IL) re: Changes to the Application Process Coming Soon:

HHSC indicated on January 9th that the IL would soon be posted, but HHSC/TMHP are still working on the IL.

Beware of Suspicious Email To DAHS ISS Only Providers

January 26th, 2024

We have received information that a suspicious email claiming to be from HHSC asking providers to verify information related to their DAHS ISS Only licenses has been received by some ISS providers. The email was not sent from an HHSC email address but instead from a mndschool.org domain. The email directs the provider to click on a link to verify information and that the provider has 24 hours to verify or they will revoke the license. Please do not click on the link.

ICF Webinar-Reporting Abuse, Neglect, Exploitation and Incidents

January 20th, 2024

Reporting Abuse, Neglect, and Exploitation Changes and Self-Reporting Incidents for Intermediate Care Facilities

Tuesday, Feb. 27
10–11:30 a.m.
Register here for webinar.

Entering IPC Revisions to Add Individual Skills and Socialization

January 20th, 2024

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.

MillinPro Billing Software: Helping Texas IDD Providers Become More Efficient

https://www.gotostage.com/channel/3b0bd3b1a47c4e80be974f4bcfa54d7b/recording/a35649ed23264fa787ba1d72f7e1d5e5/watch

January 18th, 2024

millin logo animated 1x

The Texas IDD billing process through TMHP has been burdening providers since its inception. HCS, TxHmL and ICF providers have been plagued with denied claims, decreased revenue, and inefficiencies in tracking and reporting.

In this video below (Hosted by Twogether Consulting 1/18/24), Millin addresses a range of best-practice topics to help you stay on top of your Texas HCS, TxHmL and ICF billing. They share the functionality they have built into the MillinPro software and their internal process that has led us to an incredible 99.2% collection rate on all eligible claims.

Millin aims to simplify the billing process by bypassing much of the manual work you need to do on TMHP.

Millin aims to automate most of the process with features that include eligibility checks, batch submission capabilities, issue-tracking and a library of reports designed to replace the R+S functions of TMHP.

Click on the link below to watch video

Texas Webinar Powerpoint for Twogether – January 2024

Twogether Consulting hopes that this has been a great resource for HCS/TxHmL/ICF providers. Mention that you are a client of Twogether Consulting for a 50% discount on all initial implementation fees.

Did You Know Millin Billing Pro Can Help Providers With TMHP Billing & EVV?

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

TMHP Portal Town Hall Webinars And FAQ’s

Provider Quick Reference Contact List (HCS/TxHmL) Update 091323

HCS and TxHmL Town Hall Webinars and FAQs

January 16th, 2024

November Webinar 2023

Recordings from November Townhall

Standing Meeting Agenda

Training and Information Sharing — provide relevant training and updates.
- November topics include:
  - Appendix A Scenario
  - Using “Submit Form” on IPC Renewals*

Question and Answer — HCS and TxHmL Providers and FMSAs will have the opportunity to ask questions** regarding the LTC Online Portal for HCS and TxHmL.

October Webinar 2023

October 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
October 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Claims Data Export Video
- Overlapping Claims Across Multiple Service Authorizations
- HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 24, TMHP
- Staff ID Assignments
- Best Practice and Troubleshooting: Transfers/Moves

September Webinar 2023

In case you missed the Town Hall Webinar from Sept. 13th, here are the links to the handouts

Presentation Handout

Panelists: • Ashley Wechsler –Program Eligibility and Support (PES) •Holly Lindsey –Utilization Review (UR) •Marie Redman –Provider Claims Services (PCS) • Rhonda Kay Richie –Local Procedure Development and Support (LPDS) • Kali Schmidt –Contract Administration & Provider Monitoring (CAPM) • Rick Bishop –Claims Management • Amy Aubin –Long-Term Services and Supports (LTSS) Policy Unit • Joan Workman –HHSC Information Technology (IT) •Depesh Shah -Texas Medicaid & Healthcare Partnership (TMHP)

Some of The Topics Discussed Included:

-Fiscal Year 2023 Year-End Closeout Process (CARE) & The Process For Closeout in LTC

-Claims Processing Update and Claims Overlapping With IPC’s

-Claims Data Export: How to Remove Duplicate Lines

-Suspensions, Terminations (In particular- screens/forms in TMHP for LIDDA and the Provider that need to be completed)

-How to Use Pivot Tables in Excel (There are training videos on Youtube for Pivot Tables and it is suggested that providers watch these videos. My understanding is that these tables may help some with cost reporting data that is needed)

-Requesting Inactivation

-Improvements to the phone system, including the Automated Inquiry System(AIS) as of Sept. 5th, 2023 and updated Contact List For TMHP

FYI- Trending Issues: Upcoming YoutubeTraining Video –Claims DATA Export will come out on September 18th, 2023

Some of the things that will be covered are: •How to convert the Claims Data Export file to a workable file. •Highlight some of the relevant data you can use. •Show how to work with the data.

August Webinar 2023

A recording of the Aug. 9 TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs webinar is available for those who could not attend. The webinar recording and slides have been posted to the HCS and TxHmL Webinars & FAQs webpage.

Listen to the webinar here.

Email TxHmL Policy for questions.

Topics:

Volume 22 and 23 additions
Span billing across IPC billings
Claims Data Export
Correction to overall enhancements (not RNS)
Revision and renewal IPCs
Clarification of Pending DADS Review Notification

July 24th, 2023

The July 12 recording of the TMHP LTC Portal Town Hall Webinar for HCS Providers, TxHmL Providers and FMSAs is now available. Topics included:

Trending Issues
Individual Movement Forms
Provider Location Updates
IPC Transfers

The June 14 recording of the TMHP LTC Portal Town Hall Webinar is also available. Topics included:

Trending Issues
Release 2 Enhancements
Navigating the TMHP website
Entering PC3s
Adding and Removing CDS Services

Visit HCS/TxHmL Webinars and FAQs for more details.

Contact HCS and TxHmL with any questions.

June 14th, 2023

May Webinar 2023

May 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
May 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Pending DADS review for IPC forms
- EVV Claims Matching
- TMHP MESAV video (YouTube)
- Best Practice for IMT form
- Enrollment form sequence
- Location code issues
- Claim Adjustments recap
- TP2 Holds

April Webinar 2023

April 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
April 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- 2022 Cost reporting information
- Submitting multiple forms
- Accessing and Using R&S reports
- Purpose of a Provider Location Update Form
- Viewing Provider Locations on the Dashboard
- Billing for Individualized Skills and Socialization

March Webinar 2023

March 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
March 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Joint Training Provider Opportunities
- Trending Issue Support Volume 18
- Appendix A and Dashboard YouTube Videos
- Updated Quick Reference Guide
- Suspension Discussion and Training
- Placeholder/Admin Locations

February Webinar 2023

February 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
February 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- IPC Template and Location Code Field
- Cost Reporting Training
- Claims Adjustment follow-up

January Webinar 2023

January 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
January 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Enhancements to Individual Plan of Care (IPC) revisions and corrections, Individual Movement (IMT) correction forms have now been implemented.
- Trending Issue Support Volume 14 and 15 are now published.
- YouTube videos on the TMHP Remittance and Status (R&S) has now been published.

December Webinar 2022

December 2022 – TMHP LTC Portal for HCS and TxHmL Providers and FMSAs (PDF)
December 2022 – TMHP LTC Portal for HCS and TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Enhancements to 3608/8582, 3616, Individual Movement form (IMT) (Suspension), 3615 and Provider Location Update (PLU) forms will be available on the TMHP LTCOP on 12/12/22.
- Appendix B updated to include applicable action required when in specific statuses.
- YouTube videos on the TMHP Remittance and Status (R&S) will be published on 12/8.
- ID/RC purpose code 3 forms
- Suspension Reviews
- Renewal and Revision IPCs
- How to do batch billing using TexMedConnect (TMC)
- How to do claim adjustments

November Webinar 2022

November 2022 – TMHP LTC Portal for HCS and TxHmL Providers and FMSAs (PDF)
November 2022 – TMHP LTC Portal for HCS and TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Forms Sequencing
- Claims Submission (Rejected and Denied Claims)
- Changes to Service Coordinator ID
- Accessing the Dashboard
- Accessing the Individual Search Page
- What is MESAV?

HCS and TxHmL Rules Update and Site Assessments of 3-Person Residences, 4-Person Residences, and Host Home/Companion Care Settings Webinar

October Webinar 2022

October 2022 – TMHP LTC Portal for HCS and TxHmL Providers and FMSAs (PDF)
October 2022 – TMHP LTC Portal for HCS and TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- How is data updated in TMHP?
- Where can I find cost reporting data?
- What to do if you cannot access the dashboard.
- What is MESAV and how do access it.
- Creating a MESAV group template.
- Viewing a MESAV batch history
- Claims Status Inquiry

Provider Quick Reference Contact List (Updated 6/14/23)

** Don’t forget also the TMHP Help Desk 1-800-626-4117 option 1 and then option 7

January 16th, 2023

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

-In-Home ISS come March 1^st, 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

HCS & TxHmL Webinars & FAQ’s (Recordings)

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

For Previously Recorded Webinars & FAQ’s

January 16th, 2024

Past TMHP Town Hall & TxHmL/HCS Provider webinars- recordings from July-December 2023

December Webinar 2023

November Webinar 2023

October Webinar 2023

October 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
October 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Claims Data Export Video
- Overlapping Claims Across Multiple Service Authorizations
- HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 24, TMHP
- Staff ID Assignments
- Best Practice and Troubleshooting: Transfers/Moves

September Webinar 2023

September 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
September 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar Recording Topics Discussed:
- Suspensions
- Terminations

August Webinar 2023

August 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
August 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Volume 22 and 23 additions
- Span billing across IPC billings
- Claims Data Export
- Correction to overall enhancements (not RNS)
- Revision and renewal IPCs
- Clarification of Pending DADS Review Notification

July Webinar 2023

July 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
July 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Individual Movement Forms (IMT)
- Provider Location Updates (PLUs)
- Administrative Moves
- IPC Transfers

June 14th, 2023

July 19 IDD and PI Webinar with HHSC LTCR

June 8, 2023

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

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

July 19, 2023
10–11:30 a.m.
Register for the IDD/PI webinar.

February 5th, 2023

IDD and PI Quarterly Webinar with HHSC LTCR Recording Available

The January 26 recording of the Intellectual and Developmental Disability (IDD) Programs and Provider Investigations (PI) Quarterly Webinar with Long-term Care Regulation (LTCR) is available.

Read the IDD and PI Webinar (PDF).

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

November 1st, 2022

HCS & TxHmL Updates Provider Webinar from Oct. 13

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

This webinar will provide information on the following:

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

HCS and TxHmL Program Updates Provider Webinar

Oct. 13

1–3 p.m.

September 25th, 2022

TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar

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

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

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

Save the Dates

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

October 2022: Wednesday, Oct. 5, 1–2 p.m. Register for the webinar.
November 2022: Wednesday, Nov. 9, 10–11 a.m. Register for the webinar.
December 2022: Thursday, Dec. 8, 1–2 p.m. Register for the webinar.

Standing Meeting Agenda

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

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

Email Questions to TxHmL Policy.

September 25th, 2022

HCS and TxHmL Updates Provider Webinar

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

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

Email questions about the webinar to your program policy inbox:

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

July 12, 2022 IDD and PI Quarterly Webinar (PDF)
- July 12, 2022 IDD and PI Quarterly Webinar Recording

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).

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

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.

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.

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.

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.

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.

April 2020 COVID-19 Webinar

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

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

View the video training

October Webinar 2020

September Webinar 2020

July Webinar 2020

May 2020 Webinar

January 2020 Webinar

September 2019 Webinar

August 2019 Webinar

May 2019 Webinar

February 2019 Webinars

November 2018 Webinar

October 2018 Webinar

May 2018 Webinar

April 2018 Webinar

February 2018 Webinar

January 2018 Webinar

Provider Revalidations: Important Information

Revalidating An Organizational NPI

January 15th, 2024

Revalidations: Important Updates

When completing revalidations for HCS, providers must list all non-family operated HH locations and 3/4 bed HCS group home locations as practice locations. It would appear that TMHP is just realizing this and is contacting providers whose applications are in some stage of approval.

HHSC stated that if a provider has already completed the process (and been approved) and did not include non-family operated HH and 3/4 bed group home locations, the provider can wait until its next revalidation to add them.

The revalidation process does not apply to ISS at this time.

HHSC stated that if there are providers whose applications have been pending for some time with no communication as to their status or have other application issues, you can contact your provider associations to contact HHSC or you can contact PEMS directly.

HHSC/TMHP PEMS Notice:

The Health and Human Services Commission (HHSC) and TMHP are collaborating on distributing information regarding the need to revalidate and how to obtain assistance for this.

Videos have been created showing how to complete a revalidation request from start to finish for an organization’s NPI or a performing provider through PEMS.

Links to YouTube video:

Revalidating a Performing Provider

TMHP also has a Provider Enrollment Instructional Site which provides written instructions for what is required when completing any type of enrollment request including a revalidation request.

PEMS Instructional Site

PEMS Instructional Site

TMHP has also put together an Enrollment Revalidation Quick Reference Guide (QRG) that goes over the steps to get started, information that is required to be updated or confirmed, along with handbooks and user guides that are helpful for any account assistance that may be necessary.

Enrollment Revalidation Quick Reference Guide

Enrollment Revalidation QRG

These are valuable resources that should be able to assist most providers through their revalidation request. Additionally, please see the posts HHSC has provided on their LinkedIn and Twitter (X) accounts with these reminders.

LinkedIn

https://www.linkedin.com/feed/update/urn:li:activity:7125134416267411456

Twitter (X)

https://x.com/TexasHHSC/status/1719369023580676295?s=20

For additional assistance please have the Providers reach out to our contact center at 800-925-9126.

Final Extension for Providers With Revalidation

Update to Article “Provider Enrollment Revalidation Extensions to End”

January 15th, 2024

HHSC has issued one final extension for Providers with revalidation dates from May 12, 2023, until November 11, 2023, granting these providers an additional 6 months from their revalidation date to submit the request.

Please be sure to check the Provider Enrollment and Management System (PEMS) for your current revalidation date.

After the November 11th date, providers are required to submit revalidation requests again per Federal guidelines. Revalidation is the process by which a provider updates or confirms information with their enrollment record every 3-5 years. Revalidation requests can be started up to 120 days prior to this date.

Long-Term Care Facilities Council