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2024

March 15th, 2024


March 1st, 2024


February 15th, 2024


February 1st, 2024


January 15th, 2024


January 3rd, 2024


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

Letter To Providers From Twogether Consulting-March 14th, 2024

March 14th, 2024

From Twogether Consulting!

Hello IDD providers!

     We had an amazing turnout for our live nursing training in Houston, Tx in February. We have another wonderful group of people coming to our nurse training this Monday, March 18th, 2024 at the Harris Center for MH & IDD services.  We are excited to work with Pamela Long and Megan Hinds from Nursing Innovations as co-presenters, once again for this class, “Nursing Documentation & Billable Services” (HCS/TxHmL). Sadly it will be our last training at Harris Center for now, as they are revamping their policies on how they utilize their conference rooms for outside parties and so until we hear back from them, we may be looking for a different location to provide our live trainings in the Houston area. Please contact us if you have any ideas on a new location.
 
    It looks like the live 3-day Case Management training in Austin, Tx will still most likely be in April or early May (Care Coordination training series-Part I, II, III, IV & V).  We should have these posted by the near future.  I am still trying to nail down the dates.
      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 provide assistance to those working with the ICF/IID program as well and expect to have some webinars in the near future for ICF including nursing.
     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 have “mentoring” assistance (especially great for new nurses) from our RN consultant on an as-needed basis.  If you have new 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 also happy to schedule one-on-one training sessions and mentoring with either of our 2 nurse consultants.
     For HCS Providers who want to purchase the protective devices policy & assessment as well as the quarterly on-site review checklist for Host Homes and for site reviews in general, you can still purchase the form at the following link on our website: “purchase services” page. If you are having issues with the download, please contact us at info@twogetherconsulting.com and I will be happy to send the form.
Thank you,
Julie Blacklock/ Owner & IDD Waiver Consultant

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. 

“Lookup Tool” Unnecessary For HCS/TxHmL Cost Reporting

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.

PEMS: Update On HCS Revalidations For Current Providers

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.

ICF/IID Updates

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 SCCemail 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:

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


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.

December 15th, 2022

ICF Resources

These resources can also be found on the ICF Provider Portal page.


September 25th, 2022

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

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

The letter provides guidelines to assisted living facilities,

intermediate care facilities for individuals with an intellectual

disability or related conditions, and nursing facilities about

the amelioration of administrative penalties assessed for state licensure

violations.

Read the provider letter details.


June 12th, 2022

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

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

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

The following rules expired June 6:

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

Here is a copy of the previous rule that expired:

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

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

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

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

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

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

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

Email questions to LTCR Policy.


April 29th, 2022

ICF Visitation Rules Update

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

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


April 10th, 2022

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

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

The revised rule:

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

April 10th, 2022

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

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

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

– New Requirements for Infection Prevention and Control Policies and Procedures

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

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

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

-ANE & Incident definitions

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

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


April 6th, 2022

COVID Screening in ICF’s

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

.ICFs must screen individuals:

•upon admission or readmission to the facility; and

•at least once a day.

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

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

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

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

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

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

Screening Criteria:

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

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

•other signs or symptoms of COVID-19, including

-chills,

-new or worsening cough,

-shortness of breath or difficulty breathing,

-fatigue,

-muscle or body aches,

-headache,

-new loss of taste or smell,

-sore throat,

-congestion or runny nose,

-nausea or vomiting,

-or diarrhea;

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

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

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


April 6th, 2022

Reporting Confirmed Case of  COVID-19 in ICF/IID

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

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

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


April 6th, 2022

COVID-19 Mitigation and Response Emergency Rule Updated

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

It became effective April 6, 2022.

The revised rule:

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

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

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

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


February 27th, 2022

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

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

Key changes to the rule are to:

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

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

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

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

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

Listen to the webinar recording.

Email LTCR Policy for the transcript.


February. 20th, 2022

Mar. 07 ICF COVID-19 Webinar with HHSC LTCR

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

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

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

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


February 13th, 2022

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

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

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

The rule requires ICF/IIDs to:

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

January 7th, 2022

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

Document   Version    Date    Change    Comments

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

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

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

Update your Infection Control Policies and other related policies accordingly. 

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


November 21st, 2021

HHSC Publishes PL 2021-38 Medicaid Bed Reallocation

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


November 4th, 2021

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

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

October 24th, 2021

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

Super important!!!!

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

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

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

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September 15th, 2021

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

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

September 5th, 2021

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

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


September 5th, 2021

ICF/IID Leave During COVID-19 Rule Reinstated

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

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

August 1st, 2021

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

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

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

Read the updated ICF FAQs (PDF).


March 24th, 2021

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

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

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

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


March 22nd, 2021

ICF COVID-19 March 22 Webinar Recording Available

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

Listen to the COVID-19 Q&A recording.

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


March 11th, 2021

Recording of ICF COVID-19 March 8 Provider Webinar Available

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

Listen to the COVID-19 Q&A recording.

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


February 8th, 2021

Draft ICF/IID Rule Changes

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

February 7th, 2021

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

Reminder to Provide Letter to Families

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

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

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

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

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

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

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


January 19th, 2021

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

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

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

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

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

Read the updated ICF FAQs (PDF).

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

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

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

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

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

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

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

Listen to the COVID-19 Q&A recording.

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


January 10th, 2021

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

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

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


HHSC Publishes Revised Reporting Guidance for Long-Term Care Providers

(PL 20-37)

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


November 22nd, 2020

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

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

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

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

ICF Provider Webinar

November 30, 2020

11 a.m. – 12:30 p.m.

Register for the COVID-19 webinar.


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

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

View the COVID-19 Q&A recording.

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


10/16/20

Important Information!

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

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

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

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

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

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

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

or

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


LTCR Form 2195

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

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

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

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

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

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

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

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

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

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

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

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

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

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


10/05/20

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

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

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


10/03/20

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

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

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

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

Phase I Visitation Rules, no longer in effect!

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

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

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

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

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

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

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

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


 

FAQ’s (June 2020)

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

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

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

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

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

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

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

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

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

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


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

See the following pdf link from HHSC

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


March 13th ICF FAQ’s  See link below:

Survey Operations Resume as of June 15th, 2020

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

Providers Must Log Residents’ Leave

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

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

 

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

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


Provider Joint Training Opportunities

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

 


Survey Process for ICF Has Changed: Please Be Aware

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

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

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


Appendix Q of SOMA (Immediate Jeopardy) Changes

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

CMS clarifications letter

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

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

 

SOMA appendix Q Section  Immediate Jeopardy 

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


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

LON & Facility Size

Current Rates

Proposed Rates

SMALL

 

 

LON 1

$144.25

$150.31

LON 5

$160.74

$167.90

LON 8

$182.82

$191.85

LON 6

$223.88

$236.59

LON 9

$406.11

N/C

MEDIUM

 

 

LON 1

$118.04

$123.14

LON 5

$134.06

$140.24

LON 8

$158.90

$166.92

LON 6

$190.24

$200.79

LON 9

$385.84

N/C

LARGE

 

 

LON 1

$112.09

$116.30

LON 5

$119.64

$124.64

LON 8

$133.22

$139.44

LON 6

$179.40

$188.96

LON 9

$387.25

N/C

 

 

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

Provider Job Openings & Employment Opportunities: HCS/ICF/ISS

March 08th, 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

 

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 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.

 

 

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


 

 

 

ISS Updates & New Rules (HCS/TxHmL)

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.
~  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

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

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

Blackboard Connect sign-up process:

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

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

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


January 16th, 2023

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

ISS FAQs and Upcoming Webinars:

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

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


January 12th, 2023

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

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

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

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

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

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

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

IL-2023-03


January 3rd, 2023

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

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

HHSC Bulletin:

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

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

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

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

Read PL 2023-01.


December 23rd, 2022

NEW RULES FOR ISS & ISS LICENSE

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

December 18th, 2022

HHSC Adds Individualized Skills and Socialization to Email and Text Updates

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

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

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


November 28th, 2022

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

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

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

Register for the webinar: Licensing Process Webinar


November 19th, 2022

DAHS ISS Licensing Application Available!

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

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

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

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


October 13th, 2022

Licensing Application Process For ISS:  

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

October 2nd, 2022

Register for Individualized Skills and Socialization Provider Portal Trainings

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

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

Email questions to LTCR Policy.


September 24th, 2022

HHSC Moved The Individualized Skills and Socialization Webpage

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

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


August 23rd, 2022

No Public Hearing on ISS Licensing Rules

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

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


Public Hearing on ISS Program Rules

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

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


August 13th, 2022

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

August 8th, 2022
ISS Resources page

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

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

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

Provider Communications


August 6th, 2022

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

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

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

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 appropriatei.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

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.

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

Register for the ICF Webinar.

 

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

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

Training webinar pre-recorded video HCS/TxHmL/ICF/CFC Non-waiver programs


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.

Assistance With Medicaid Renewal & Eligibility Issues

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

Links to Long-Term Care Bulletins

Image result for Bulletin free clipart

 

See links to 2024 editions below:

February 2023 LTC Provider Bulletin No. 97

 


See links to the 2023 editions below:

May 2023 Long-Term Care (LTC) Provider Bulletin

February 2023 LTC Bulletin No. 93 (456.32 KB)

 

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

For questions, see the LTC Provider Resources Guide.


See links to the 2022 editions below:


See link to August 2021 edition below:

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

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

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


See link to February 2021 edition below:

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


See link to November 2020 edition below:

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

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:

**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

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.

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.

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

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

https://www.gotostage.com/channel/3b0bd3b1a47c4e80be974f4bcfa54d7b/recording/a35649ed23264fa787ba1d72f7e1d5e5/watch

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

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


September Webinar 2023

In case you missed the Town Hall Webinar from Sept. 13th, here are the links to the handouts

Presentation Handout

Provider Quick Reference Contact List (HCS/TxHmL) Update 091323

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.

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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

April Webinar 2023

March Webinar 2023

February Webinar 2023

January Webinar 2023

December Webinar 2022

November Webinar 2022

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



January 16th, 2023

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

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

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

 


Other Important Contacts:

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

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


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

Program Eligibility and Support (PES)

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

HCS & TxHmL Webinars & FAQ’s (Recordings)

For Previously Recorded Webinars & FAQ’s

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


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

September Webinar 2023

August Webinar 2023

July Webinar 2023

 

 


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.

Listen to the webinar recording.

Read the IDD and PI Webinar (PDF).

Any questions or requests for transcripts may be emailed to LTCR Policy.

 


November 1st, 2022

HCS & TxHmL Updates Provider Webinar from Oct. 13

For:  HCS/TxHmL program providers, LIDDA’s, and other interested parties

This webinar will provide information on the following:

  • Substantial changes are being made to the HCS and TxHmL Program rules.
  • IL 2022-49, assessments of HCS three-person residences, four-person residences and host home/companion care settings for compliance with the federal HCS settings rules.

HCS and TxHmL Program Updates Provider Webinar

Oct. 13

1–3 p.m.

Register for the Pre-Recorded Oct. 13 webinar.

 


September 25th, 2022

TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar

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

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

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

Save the Dates

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

Standing Meeting Agenda

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

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

Email Questions to TxHmL Policy.


September 25th, 2022

HCS and TxHmL Updates Provider Webinar

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

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

Email questions about the webinar to your program policy inbox:

HCS Policy

TxHmL Policy


September 12th, 2022

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

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

Read the full alert.


July 15th, 2022

HCS and TxHmL Webinar Recorded From July 14th, 2022

July 12, 2022

Webinar topic includes:

  • Forms Submission and Processing in TMHP LTCOP

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

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

Email questions about the webinar to your program policy mailbox:


 

July 13th, 2022

IDD and PI Quarterly Webinars

 


May 5th, 2022

HCS and TxHmL FAQ Updates Available May 9 and May 23

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

HCS-TxHmL-FAQ-TMHP-TexasMedConnect

Read the full alert here.


Updated HCS and TxHmL COVID-19 FAQ

May 6th, 2022 

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


September 1st, 2022

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


 

August 15th, 2021

 HCS and TxHmL Webinar Recording Available

” WSC Transition into HHSC LTCR”

(From August 10th, 2021)

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

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

Read the HCS and TxHmL Transformation Webinar (PDF).

Listen to the webinar recording here.

.


May 23rd, 2021

June Infection Control Basics for HCS and TxHmL Providers Webinars

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

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

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

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

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


 

.March 16th, 2021 Updated

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

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

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


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

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

Listen to the webinar recording here.


March 4 Recording of Writing Acceptable Plans of Correction Webinar Available

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

Listen to the webinar recording here.


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

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

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

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

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

Listen to the webinar recording here.


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

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

Listen to the webinar recording here.


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

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

View the video training

Provider Revalidations: Important Information

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 An Organizational NPI

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

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.

Update to Article “Provider Enrollment Revalidation Extensions to End”

              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

January 14th, 2024

Would You Like To Be A Member of The Long-Term Care Facilities Council?

Now is your chance. I would encourage providers of these services to think about being a part of the council.

From HHSC:

“If you’re interested in issues regarding a consistent survey and informal dispute resolution process for long-term care facilities, Medicaid quality-based payment systems for those facilities and the allocation of Medicaid beds in those facilities, you may want to apply to be a member of the Long-Term Care Facilities Council. The Texas Health and Human Services Commission executive commissioner will appoint members to the council to serve a term expiring Aug. 31, 2026.”

Applications are due by 11:59 p.m., Jan. 19.

HHSC will consider the applicants’ qualifications, background and interest in serving on the council and will try to choose council members who represent the diversity of all Texans. For this reason, HHSC considers applicants’ ethnicity, gender and geographic location.

A council member must regularly take part in council meetings. They may also have to take part in subcommittee meetings or other related activities. Council meetings are held about once every three months in Austin or at the call of the presiding officer. Council members aren’t paid to attend or travel to and from council meetings or related activities.

HHSC prefers that you submit your application electronically, but you may submit the application by email, mail or fax to the following addresses:

Email: HHS_Appointments@hhs.texas.gov Subject: LTCFC

Mail: Texas Health and Human Services Commission 701 W 51st Street Mail Code 0223 Austin, TX 78751 Attn: ACCO

Fax: 512-206-3984 Attn: LTCFC

For more information about the council visit the council website or email Laura Gutierrez.

For more information about the application process, email the Advisory Committee Coordination Office.

Revalidation Tools For Providers

January 13th, 2024

Revalidation Training Links to YouTube video:

Revalidating An Organizational NPI

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

New Critical Incident Management Reporting System: Updates

February 25th, 2024

Critical Incident Management System Monthly Provider Demonstrations

FEI Systems will host a monthly provider demonstration webinar on Jan. 9, 2024, from 10-11:00 a.m. Monthly provider demonstration webinars are offered to providers with access to the Critical Incident Management System (CIMS). The Texas Health and Human Services Commission 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 (LIDDA).

Register for the webinars by logging into CIMS and navigate 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.

 


June 2nd, 2023

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

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

This Information Letter applies to:

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

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

 


October 13th, 2022

Please Don’t Forget To Sign Up For CIMS Training

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

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


August 11th, 2022

Critical Incident Management System (CIMS) Now Live

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

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

See IL 2022-23 for more information about CIMS.

This alert applies to:

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

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

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

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

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

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

Email questions to the MCS-CIMS inbox.


April 12th, 2022

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

 


April 10th, 2022

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

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

Tuesday, April 26, 2022
2:30 – 4 p.m.

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

From HHSC I-2022-23 revised letter: 

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


 

April 10th, 2022

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

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

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

Submit questions to LTSS_Policy@hhs.texas.gov


February 27th, 2022

HHSC Publishes New Reporting System for Critical Incidents Management

 (CIMS) See Letter (IL 2022-14)

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

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

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

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


HCS and TxHmL Webinar Slated for March 10th, 2022

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

  • Webinar topics include:

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

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

    Email questions about the webinar to your program policy mailbox:

 

Revision To Billing Requirements

January 7th, 2024

HHSC Publishes Revision 24-1 of the HCS and TxHmL Program Billing Requirements

 

Revision 24-1 is effective Jan. 1, 2024. The Billing Requirements are located on the Long-term Care Providers webpage and Handbooks webpage and are outlined below:


May 1st, 2023

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

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

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

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

Email questions to TxHmL Policy.


September 11th, 2022

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

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

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

Email questions to TxHmL Policy.


May 8th, 2022

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

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

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

Email questions to TxHmL Policy.

EVV (Electronic Visit Verification) Updates

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


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:


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:


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.

Email questions to HHSC EVV Operations.


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.

Email questions to HHSC EVV Operations.


June 10th, 2023

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


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

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

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

Register for EVV GovDelivery to receive EVV notices by email, such as training updates and future webinar registrations.

Email questions to HHSC EVV Operations.


June 2nd, 2023

EVV Resources Updates

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

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

EVV Training Requirements Checklists

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

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

Getting Started with EVV

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

Program and Service Requirements for Schedules

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

Email EVV Operations for questions.


May 13th, 2023

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

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

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

Email EVV Operations for questions.


April 3rd, 2023

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

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

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

Email the TMHP EVV PSO inbox for questions.


January 12th, 2023

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

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

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

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

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

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

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

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

IL-2023-03


January 2nd, 2023

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

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

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

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

HHSC will continue posting related updates.

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

For other EVV questions, email the EVV Operations inbox.

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


December 17th, 2022

EVV Training Updates

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

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

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

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

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

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

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

Email EVV Operations for questions.


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

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

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


EVV Guidance on Program and Service Requirements for Schedules

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

Email HHSC EVV Operations for questions.


December 1st, 2022

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

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

  • STAR+PLUS
  • STAR Kids
  • STAR Health

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

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


December 1st, 2022

HCS and TxHmL Updates

The effective dates were updated for HCS and TxHmL services.

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

For questions, email EVV Operations.


October 16th, 2022

Potential Electronic Visit Verification Changes Coming in 2023

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

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

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

Notification of contract award is anticipated in March 2023.

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

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

Email questions about this solicitation to Andrick Reese.


September 25th, 2022

EVV Updates for HCS and TxHmL Program Providers and FMSAs

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

HHSC Notice

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

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

TMHP Notice

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

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

Email EVV Operations for questions.


September 25th, 2022

EVV Claims Matching Refresher for HCS and TxHmL

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

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

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

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

Click here for more information


September 18th, 2022

EVV Compliance Job Aids Updated

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

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

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

August 31st, 2022

Annual EVV Policy Webinars for Program Providers & FMSAs

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

July 28th, 2022

EVV Portal and Training Updates

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

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

Email questions to TMHP.


July 5th, 2022

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

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

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

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

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

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

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

Email EVV Operations for questions.


July 1st, 2022

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

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

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

Email EVV Operations for questions.


June 12th, 2022

EVV Portal and Training Updates

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

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

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

Email questions to TMHP.


June 6th, 2022

EVV Policy Handbook Revision and Training Updates

The Electronic Visit Verification Policy Handbook has been revised.

Revisions include:

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

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

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

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

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

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

Email HHSC EVV Operations for questions about this notice.


May 30th, 2022

EVV Claims Matching for HCS and TxHmL Will Resume July 1

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

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

Email EVV Operations for questions about this notice.


May 8th, 2022

EVV Portal and Training Updates

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

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

Email TMHP EVV Operations with questions


March 7th, 2022

EVV Notice for HCS/TxHmL Program Providers

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

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

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

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

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

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

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


March 3rd, 2022

EVV Policy Handbook Revisions Now Available

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

The handbook includes EVV standards and policy requirements for:

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

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

Email HHSC EVV Operations with questions.


February 28th, 2022

EVV Portal and Training Updates

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

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

For questions, email TMHP EVV Operations.


January 8th, 2022

EVV Policy Handbook Revisions – Jan. 7th, 2022

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

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

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

For questions, email HHSC EVV Operations.


November 21st, 2021

EVV Portal and Training Updates for November 2021

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

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

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

Email TMHP with questions about these updates.


November 18th, 2021

Revised EVV Policy Handbook Now Available

The Electronic Visit Verification Policy Handbook was revised.

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

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

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

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

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

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

Email questions to HHSC EVV Operations.


November 17th, 2021

EVV Visit Maintenance Unlock Request Updates

HHSC published EVV Visit Maintenance Unlock Request spreadsheet updates.

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

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

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

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

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

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

    Review the instructions on the spreadsheets for more information.

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


July 4th, 2021

EVV Visit Maintenance Policy Now Available

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

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

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


July 4th, 2021

HHSC EVV Webpage Updates Now Available

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

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


July 3rd, 2021

Revised EVV Visit Transaction Rejection Guide Now Available

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

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

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

Email TMHP with questions.


April 17th, 2021

EVV Policy Training for CDS Employers Now Available in Spanish

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

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

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

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

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

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


March 16th, 2021

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

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

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

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

For questions, email HCS Policy or CDS.


March 10th, 2021

Temporary EVV Policies for the Feb. 2021 Severe Winter Weather

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

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

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

Email questions to the HHSC EVV Mailbox.


February 7th, 2021

EVV Refresher Training on Feb. 19

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

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

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

Certificates of completion will not be issued.

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

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

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

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

Email HHSC EVV for questions.


Reminder:  Entering Schedules for EVV-Required Services

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

EVV is only required for the following services:

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

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


January 24th, 2021

EVV Portal and Training Updates for January

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

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

Email TMHP with questions about these updates.


January 24th, 2021

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

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

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

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

Email questions about EVV policy to HHSC EVV.


January 18th, 2021

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

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

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

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

Next Steps

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

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


January 10th, 2021

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

EVV Notification Requirement for HCS/TxHmL Program Providers 

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

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

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

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


January 4th, 2021

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

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

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

December 20th, 2020

Cures Act EVV:

Preparing for Jan. 1, 2021 Implementation

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

Beginning Jan. 1, 2021:

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

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

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

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

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

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

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

Visit the HHS EVV website for more information.


November 28, 2020

HCS and TxHmL CARE Service Authorization instructions for EVV

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

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

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


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

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

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

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

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

Best Practices for Temporary EVV Policies for COVID-19

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

Contact your payer for questions or email HHSC EVV.

Visit the HHS EVV webpage.


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

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

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

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

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

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


Deadline Approaching Soon!!

October 21, 2020

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

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

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

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

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

Contact EVV if you have questions about EVV requirements.


Oct. 11th, 2020

EVV Revised Policies Effective Oct. 1

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

Claims Matching Policy (PDF)

The policy:

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

Claims Submission Policy (PDF)

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

Email HHSC EVV with your questions.


Oct. 11th, 2020

Updated EVV Service Bill Codes Table Effective Oct. 1

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

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

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

Units Matching

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

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

Home and Community-based Services and Texas Home Living Programs

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

Email HHSC EVV for questions.


 

 

 

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

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

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

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

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

EVV is only required for the following services:

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

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

Additional Guidance on Day Habilitation Services

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

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

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


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

August 20th, 2020

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


CURES Act EVV Training is Underway for HCS/TxHmL Providers

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

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

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

To register, click the links below:

FMSAs

HCS/TxHmL

Additional Training Opportunities

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

Email TMHP for questions about registration or the EVV Portal.

Email questions about EVV training requirements.

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


 

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

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


 

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

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


Updated Timeline for Cures Act EVV Expansion     

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

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

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

For questions, contact EVV.



New EVV Proprietary System Onboarding Documents Available

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

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

Resources


Trainings Available:

EVV Policy Training (Provided by your payer)

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

EVV Aggregator and EVV Portal Training (Provided by TMHP)

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

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

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

 

Online, interactive EVV training courses are available

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

The HHS Learning Portal includes training about HHSC EVV Policy.

The TMHP Learning Management System includes training about:

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

January 31st IDD and PI Webinar with HHSC LTCR

IDD & PI Webinar January 31st, 2024

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

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

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

Register for the IDD/PI Webinar.

HCS Certification Standards Webinars & Recordings

January 2nd, 2023

New Rules

Certification Standards Modules

HCS/TxHmL Certification Standards Modules

Anyone new to the HCS waiver program should watch these modules!  This is especially true for both new and current HCS case managers, nurses or program managers to watch these modules/recorded webinars.  They are based on the new HCS Rules: Texas Administrative Code (TAC) Title 26 Part I Ch 565.

 

These were previously known as certification principles, now these are certification standards and the TAC moved to Ch 565 (Subchapters A-F).


June 14th, 2023

(No longer current)

In case you have not seen the answers to some of the unanswered questions at the time of the Certification Principles series recorded in 2021, please note you can find those at the Q&A doc below.

HCS/TxHmL Certification Principles Webinar Series Participant Q&A

FYI Current as of 9/22/21*


August 12th, 2021

HCS/TxHmL Certification Principles Interpretive Guidance Series

Starting August 12, 2021, the HCS/ TxHmL Joint Training Program began presenting a series of nine webinars designed to provide interpretive guidance on the HCS and TxHmL Principles of Certification, as outlined in the Texas Administrative Code.

You may click on the links to previously recorded trainings below to watch any of the nine sessions on Certification Principles from the Texas Administrative Codes.

Certification Principle Trainings

 These modules are designed to provide interpretive guidance on the certification principles found in TAC Title 40, Part 1, chapter 9.

E-mail LTCR Joint Training for a transcript of any of the recordings below.

ISS In-Home Attendant Base Wage Rate Requirement Clarification

January 1st, 2024

ISS in-Home Attendant Base Wage Rate Requirement

Clarification:

There seems to be a lack of clarification in the HCS program concerning if the ISS base wage rate requirement applies to “in-home ISS”.  It does apply to in-home ISS.  It would seem that most likely a significant number of providers are not aware the base wage requirement applies to in-home individualized skills and socialization (ISS) and that they are currently out of compliance.  That is because the rule applies to “individualized skills and socialization” not clarifying if it applies to all or a portion of the services that fall under that umbrella. Because in-home ISS has significant differences from facility-based and off-site ISS (e.g., in-home ISS does not require a license, typically only applies to one person, may only be delivered in a person’s own home, and the rate issue we have already discussed), providers have assumed the base wage requirement only applies to licensed services.

HHSC states: “The application of the minimum wage for direct care staff providing ISS was adopted in the Texas Administrative Code rules that were promulgated to incorporate the wage increase appropriated by the Texas Legislature. Historically, Day Habilitation did apply a minimum wage requirement for staff providing services to individuals in some waiver programs, but not all waiver programs; consistent with the legislative approach that the minimum wage be uniform across all programs, we also adopted in the TAC the requirement that the minimum wage be paid consistently across all services and waivers.”

Cost Reporting Update!

Cost Report/Accountability Reports

This notice applies to ICF/IID, HCS, TxHmL, CLASS and DBMD providers.  

HHSC Notice: 

The Texas Health and Human Services Commission (HHSC) has published Information Letter (IL) 2023-44 regarding the 2023 Cost Report and 2023 or 2024 Accountability Report Training Information.

Information on cost and accountability report training can be found on the Provider Finance web page.

Email PFD LTSS or call (737) 867-7817 with any questions.

Extreme Winter Weather Emergency Resources & Considerations

December 17th, 2023

HSC reminds long-term care facilities and agencies to review and update emergency plans for freezing temperatures and snow. Emergency plans for extreme weather should include the provider’s plan to address:

  • Power loss.
  • Water and food needs.
  • Communication with families and staff.
  • Staffing shortages.
  • Sheltering in place and evacuation, as applicable.

Providers must follow emergency preparedness rules and their own internal emergency preparedness policies and procedures.

Facilities with generators should perform any maintenance or needed testing while the weather is mild. This will ensure the equipment functions in case of extreme cold or power loss.

It’s important to review building integrity and identify any areas that may need repair, reinforcement or weatherproofing. Multi-story buildings should review any other needed measures should evacuation be required and have a plan in place for how to move residents around or out of the building if there’s a loss of power.

Preparing for disaster is the most important step in protecting the Texans we serve and reducing the risk for loss of life.

***To find your region and your Emergency Management Coordinator for your area, please go to: https://tdem.texas.gov/regions


LTC Provider Resources During an Emergency

Long-term care providers impacted by the current severe weather event should be implementing emergency management plans. LTC providers in need of resources or assistance during an emergency, such as the current severe weather, are reminded that you can:

  • Contact your LTCR regional office regarding events that are affecting residents (such as no heat, evacuation, frozen fire sprinkler systems, etc.). They can initiate an emergency request.
  • Contact your local emergency management or Regional Advisory Council, who can initiate a STAR request.
  • Contact your local power company if you are having power issues. Nursing facilities, assisted living facilities, and inpatient hospices should inform the power company that you are an LTC provider, as those providers are prioritized for service restoration per the Public Utility Commission rules.
  • Contact your Texas Department of Emergency Management District Contacts if you are having challenges getting generator fuel.

If you need guidance or assistance in relocating residents, work with your LTCR Regional Director. All requests to exceed licensed capacity must be approved by the Director of Survey Operations. If your facility is projected to exceed its licensed capacity because it is accepting residents who have been evacuated from another facility, email Renee Blanch-Haley and include State Capacity Increase Request in the subject line.

Please refer to Provider Letter 2018-19 (PDF) as applicable and to your program’s rules for additional important information regarding emergency preparedness. If you have any questions, contact your LTCR regional office, email LTCR Policy Rules and Training or call 512-438-3161.

E-Health Advisory Committee Applications Due Jan. 8

December 15th, 2023

If you’re interested in health information technology, health information exchange systems, telemedicine, telehealth and home telemonitoring services issues, you may want to apply to be a member of the e-Health Advisory Committee.

But act quickly as applications are due Jan. 8.

Click here to learn more and apply.

Joint Training From HHSC For Providers

Texas Health and Human Services

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.


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 

Register here for webinar


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

Register

 

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

Thursday, July 6, 2023

3:30 PM – 4:00 PM

Register

 

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

Wednesday, July 12

9:30 AM – 10:30 AM

Register

 

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

Register

 

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

Register

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

Register

 

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)

Register

 

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

Register here for webinar

 


February 2023 HCS/TxHmL Provider Training Opportunities

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

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

Register here for webinar

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

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

Register here for webinar


Dec. 2022 HCS/TxHmL Provider Training Opportunities

Emergency Preparedness 101 for HCS and TxHmL Providers

Tuesday, Dec. 1311:30 a.m.–12:30 p.m.

Register here for webinar

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

Wednesday, Dec. 211–2 p.m.

Register here for webinar

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

9 a.m.–4 p.m.Nacogdoches, Texas

Register here for in-person class


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

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

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

Register for webinar

 

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

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

Register for webinar

 

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

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

Register for webinar

 

Emergency Preparedness 101 for HCS Program Providers (course description)

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

Register for webinar


July 2022 HCS/TxHmL Provider Training Opportunities

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

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

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

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

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

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

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

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

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


July 5th, 2022

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

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

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

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

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


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.

Implementation of the Personal Needs Allowance (PNA) Adjustment

December 1st, 2023

ICF/IID Providers:

Implementation of the Personal Needs Allowance (PNA) Adjustment

As required by House Bill 54 (88th Legislature, Regular Session, 2023), the Health and Human Services Commission (HHSC) is directed to increase the minimum monthly personal needs allowance (PNA) for Medicaid beneficiaries of a nursing facility (NF) or related institution licensed under Chapter 242, Health and Safety Code, assisted living facility, intermediate care facility for individuals with an intellectual disability or related condition (ICF/IID), or other similar long-term care facility who receives medical assistance. The monthly PNA would increase from $60 to $75 for a person and from $120 to $150 for a couple.

The increase in the minimum PNA requires the Centers for Medicare & Medicaid Services (CMS) approval of a Medicaid State Plan Amendment (SPA). Subject to CMS approval, HHSC anticipates the increase in the PNA will be effective Jan. 1, 2024.

HHSC will publish a Provider Information Letter with more detaied later.

Email ICF/IID with any ICF/IID questions.

 

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

December 1st, 2023

As of Nov. 14, 2023, service coordinators and case managers in the CLASS, DBMD, HCS, TxHmL waiver programs and STAR+PLUS Home and Community-Based Services (HCBS) must use the Employment First Discovery Tool as part of the service planning process to explore an individual’s desire to work.

Review IL 2023-41 Employment First Discovery Tool for more information.

Be sure to sign up for :

Employment First Discover Tool Webinar

Jan. 10, 2024

10–11 a.m.

Register here to attend the webinar.

Email questions to John Huffine.


November 13th, 2023

Employment First Discovery Tool:

HHSC publishes a newly, updated Employment First Discovery Tool (Form 8401) and accompanying instructions based on the rule implementation related to Senate Bill 50, 87th Legislature, Regular Session, 2021. Effective November 14, 2023, use of the tool is required to ensure that individuals who want to work receive employment services from the Texas Workforce Commission (TWC) or through the Medicaid waiver program in which the individual is enrolled.

Impacted programs:

  • Community Living Assistance and Support Services (CLASS)
  • Deaf-Blind with Multiple Disabilities (DBMD) programs
  • Home and Community-Based Services (HCS)
  • Texas Home Living (TxHmL)
  • STAR+PLUS Home and Community-Based Services (HCBS)

HHSC has published IL 2023-41 Employment First Discovery Tool. Beginning on November 14, 2023, service coordinators and case managers in the CLASS, DBMD, HCS, TxHmL waiver programs, and STAR+PLUS Home and Community-Based Services (HCBS) must use the Employment First Discovery Tool as part of the service planning process to explore an individual’s desire to work.

The tool with instructions is located under the Forms section on the respective program areas HHSC webpage.


June 5th, 2023

IL 2023-22

Employment First Assessment Tool: Proposed Rules

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

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

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

Employment First Uniform Assessment   Form 8401

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

Dr. Ollie Seay Knowledge Award For Excellence In Education or Research

November 25th, 2023

I am happy to announce that I was presented with the Dr. Ollie Seay Knowledge Award For Excellence In Education or Research.  I was so honored to receive this award especially since I first met Dr. Seay when I first started working with IDD services at Austin Travis County MHMR (Now Austin Integral Care) in 1992 when she was head of the psychology department at our offices.  We lost Dr. Seay earlier this year and she will be missed by all who knew her, especially for her many years with the Texas chapter of AAIDD and for her time teaching at Texas State.

Julie Andrews Blacklock

 

Family Caregivers: HHSC Offers Webinars

November 12th, 2023

Texas HHS Aging Services Coordinationor will be presenting a webinar series during National Family Caregivers Month in November.

This webinar series is for caregivers, people who work with caregivers and anyone interested in caregiving.


November Caregiver Webinar Series

November 15, noon-1 p.m.
Cultivating Community and Support for the Lifespan: Caregiving for Children with Disabilities
Register here.

November 29, noon-1 p.m.
Overview of supports for caregivers and care recipients
Register here.

Contact

For more information visit the HHS website or email the Age Well Live Well inbox.

 

From Our Friends at IntellectAbility: Clinical Pearls in IDD Healthcare that are Important Knowledge for DSPs

November 11th, 2023

 

I thought this was a great article for providers and their DSP’s.  Please feel free to check out their other articles and resources and their training on person-centered practices!

Clinical Pearls in IDD Healthcare that are Important Knowledge for DSPs

As co-published by National Alliance for Direct Support Professionals (NADSP) and Research and Training Center on Community Living (RTC-CL) in the Frontline Initiative.

By Craig Escudé, MD, FAAFP, FAADM, President of IntellectAbility

I started practicing in the field of healthcare for people with intellectual and developmental disabilities (IDD) in the 1990s. I very quickly realized how little I knew about this field. I found myself being responsible for the healthcare of hundreds of people with IDD without fully understanding many concepts that I later learned were important. Most health professional schools do not provide training about the healthcare needs of people with IDD.  Click here to read more…

 

For more resources and articles from IntellectAbility, please go to: https://replacingrisk.com/idd-resources/

 

EVV HAAeXchange Townhall Meeting

November 11th, 2023

 

The Texas Health and Human Services Commission (HHSC), Texas Medicaid & Healthcare Partnership (TMHP), and HHAeXchange will have one last Town Hall webinar for all Electronic Visit Verification (EVV) stakeholders.

Attendees will have the opportunity to ask questions and provide input on the Texas EVV migration to HHAeXchange and the upcoming EVV expansion due to the Cures Act Home Health Care Services implementation.

Webinar Registration

Register ASAP!  If you did not register before, this is your last chance to see scheduled webinars. Participation is optional but encouraged, so sign up today. Webinars are scheduled from 9-11 a.m. Central Time.

  1. Register for the Friday, November 17 Webinar

Contact HHSC EVV Operations with any questions.

From Our Friends at IntellectAbility: Health Risk Mitigation Tools &Training

November 10th, 2023

From our friends at IntellectAbility. Apologies, just wanted to remind you all of this wonderful tool they created, that many providers asked me about in the past (Mostly nurses, lol).  Previously this tool was under a different company name.  There was a change sometime back in the name of the company. 

 

For those of you who want to learn more about IntellectAbility’s health risk mitigation tools and training by visiting ReplacingRisk.com

Feel free to call us at 727-437-3201 or email us at Inquiries@ReplacingRisk.com

They can provide a demo to help you detect health risks in at-risk populations and check out their helpful video about the screening tool by clicking on link below

Health Risk Screening Tool

 

Using Submit Form and Use as Template Options on IPC Renewals

November 8th, 2023

Just A Reminder (As of 10/11/23) Concerning IPC Renewals

Due to the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) rate changes effective September 1, 2023, providers and local intellectual and developmental disability authorities (LIDDAs) are advised to use the Submit Form option on Individual Plan of Care (IPC) renewals.

When to Use Submit Form Instead of Use as Template

Use Submit Form instead of Use as Template under these conditions:

  • There have been rate changes or enhancements.
  • A provider or financial management services agency (FMSA) has been removed, added, or changed.
  • The form is not autofilling with the most current information, and all other forms (e.g., transfers or individual updates) are correctly processed and in Processed/Complete status.

Complete Related Forms Prior to Selecting Use as Template

Before using the Use as Template option, ensure that all related forms are correctly processed and marked as Processed/Complete. For more information, contact the LTC Help Desk at 800-626-4117 (select option 1).

EVV Known Issues & Resolutions

November 2nd, 2023

HHSC Now Posting EVV Known Issues and Resolutions

Vol. 1 (Last updated on 10/18/2023)

The Texas Medicaid & Healthcare Partnership (TMHP) has recently received feedback from Electronic Visit Verification (EVV) program providers and financial management services agencies (FMSAs) about ways to enhance their user experience of the HHAeXchange system. The topics listed in this article highlight the most frequently occurring issues that EVV users have identified as areas in which they require additional support.

Topics:

-HHAeXchange System EVV Services Details Missing
-EVV Service Providers With an Older Version of the HHAeXchange Mobile Application (App)
-Large Number of Visits Pending Confirmation
-Mobile App and HHAeXchange System Times Not Matching
-Clocking In and Out Multiple Times During Night Shifts
-HHAeXchange Credentials/ Access Issues (System and Mobile App)
-HHAeXchange Learning Management System (LMS) Credentials/ Access Issues

Service providers and agencies must refer to the latest HHSC EVV PCS Service Bill Codes Table and EVV HHCS Service Bill Codes Table for narrative descriptions of the available bill codes.

Service providers must download the newest version (currently v23.10.03) of the HHAeXchange+ mobile app and check regularly for updates. The forced update function has been enabled so that future updates will be pushed directly to the user. Older versions of the app will no longer be supported after October 11, 2023.

Refer to the HHAeXchange update page for more information.

HHAeXchange will provide training to service providers on how to resolve automatic verification issues through Lunch and Learn sessions and a job aid. Refer to the training page on the HHAeXchange Texas Info Hub for upcoming Lunch and Learn training opportunities and to review the Call Dashboard recorded training.

Providers can email HHAeXchange at TXsupport@hhaexchange.com to have their credentials resent or for guidance on accessing the LMS test. Include the Agency name and NPI when submitting a request.


For questions or more information about HHAeXchange, email TXsupport@hhaexchange.com.

For general questions about EVV, email TMHP at EVV@tmhp.com.

Letter To Providers From Twogether Consulting-Oct. 31st, 2023

October 30th, 2023

Update From Twogether Consulting!

Hope you all are well. Happy Halloween! Here is the update on what is going on with Twogether Consulting
    For HCS Providers who want to purchase the quarterly on-site review checklist for Host Homes and for site reviews in general, you can now purchase the form at the following link on our website: “purchase services” page. If you are having issues with the download, please contact us at info@twogetherconsulting.com and I will be happy to send the form.  I am also working on a protective devices assessment (to go along with the risk assessment for restraints the provider has to complete currently) so providers can easily meet new certification standards, Title 26 Part 1 Ch Subchapter F: 565.37
     Twogether Consulting has been busy helping new ISS providers and we have a webinar scheduled for November 30th, 2023 posted on our website.  Twogether Consulting has been busy assisting HCS providers with survey prep. and plans of correction.  In addition, we have live classes scheduled in Houston, Tx for January 2024 for Nurses and Case Managers. We will be posting live sessions in San Antonio for December, before the next newsletter, so keep checking the website. (around November 10th, 2023).
     For those of you in need of full policy and procedures, I hope to have updated policies available for sale by mid-January 2024.
     Please contact us directly for your care coordination, QIDP, and nursing needs at info@twogetherconsulting.com or you may contact our assistant Meghan Jones at meghanjones.tx@gmail.com. We are happy to say that we can still continue to provide for most of your needs at this time.  We are happy to provide whatever assistance we can with questions you may have, especially concerning HCS/TxHmL Care Coordination, Nursing, or general survey requirements from LTCR department in these programs.  We also still provide assistance with the ICF/IID program and expect to have some webinars in the near future for ICF including nursing.  We are currently providing on-site live training at this time and live training is open to the public as well.
     
     FYI-We do still have “mentoring” assistance (especially great for new nurses) from our RN consultant on an as-needed basis.  If you have new 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 also happy to schedule one-on-one training sessions and mentoring with either of our 2 nurse consultants.
Thank you,
Julie Blacklock/ Owner & IDD Waiver Consultant
     

On-Site Residential Inspection Form To Address New HCS Rules: Now Available For Purchase

October 22, 2023

On-Site Residential Inspection Form

HCS Providers-
I was finally able to get the Twogether Consulting website updated to include this new product on our “purchase services” page.
We have our new on-site residential inspection form that can be used for Group Homes & Host Homes at initial inspection, annual renewal or when an individual moves to a new residence.
Most importantly, it can also be used for the new mandatory quarterly inspections for your host homes that are part of the new certification standards in Title 26 Part I Chapter 565 TAC codes.

 

 

TULIP Credentialing Transition Grace Period Extended

October 15th, 2023

Nurse Aides (NAs), Medication Aides (MAs), Nursing Facility Administrators (NFAs), and Nurse Aide Training Competency Evaluation Programs (NATCEPs) are now required to use the new credentialing system in the Texas Unified Licensure Information Portal (TULIP) for licensing certification or permitting activities.

Note: HHSC is extending a grace period for all NAs, MAs, NFAs and NATCEPs to allow users time to learn and understand the new credentialing system. All NAs certifications, MA permits, NFA licenses and NATCEP approvals active on June 16, 2023, will be considered active until April 30, 2024.

For registration issues in TULIP, email TULIP_Support@hhsc.state.tx.us.

For NA questions, email NurseAideRegistry@hhs.texas.gov.

For MA questions, email Medication_Aide_Program@hhs.texas.gov.

For NFA questions, email nfa_licensing_program@hhs.texas.gov.

For NATCEP questions, email Regulatory_NATCEP@hhs.texas.gov.

 

COVID-19 Resources

October 17th, 2023

COVID-19 Resources

COVID-19 Quick Reference (New Guidance)

From our friends at PharMerica, please go to the following link to get your free and current quick reference guide for Covid-19 

 


July 11th, 2022

July 7, 2022 MCS COVID-19 Stakeholder Information Session

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

The audio from this session can be found here.

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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


May 8th, 2022

May 5, 2022 MCS COVID-19 Stakeholder Information Session

Thank you for your interest in listening to the May 5 Texas Medicaid CHIP COVID-19 Information Session.

The audio from this session can be found here.

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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


April 10th, 2022

April 7, 2022 MCS COVID-19 Stakeholder Information Session

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

The audio from this session can be found here.

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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


 

January 9th, 2022

January 6, 2022 MCS COVID-19 Stakeholder Information Session

The audio from this session can be found here.

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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


 

December 30, 2021

COVID-19 Cases Rise – Guidance for LTC Providers

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

Please review the following guidelines and rules:

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

Find COVID-19 resources on:

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

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

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

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

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

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


 

December 30th, 2021

Dec. 13 ICF COVID-19 Webinar Recording Available

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

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

Listen to the webinar recording here.

Email LTCR Policy for the transcript.


 

December 29th, 2021

COVID RESOURCES FOR HCS/TXHML

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

Additional Guidance and Resources

 

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

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

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

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

Resources

 


November 5th, 2021

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

 

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

The audio from this session can be found here.

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

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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


 

September 15th, 2021

Oct. 4 ICF COVID-19 Webinar with HHSC LTCR

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

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

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


September 15th, 2021

Sept. 13 ICF COVID-19 Webinar Recording Available

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

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

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


August 30th, 2021

LTC Providers May Request COVID-19 Emergency Support

For Emergency Staffing Support:

The Office of the Governor directed DSHS to use staffing agencies to provide medical personnel from out-of-state to Texas health care facilities to assist in COVID-19 operations.

This support will be available to residential long-term care providers.

-Providers must demonstrate that they have exhausted all other options.

-Also that they have urgent need for assistance before requesting emergency staffing support.

The State is asking that jurisdictions and health care entities be judicious with requests for staffing, as the State will not be able to address all staffing needs, especially as the need for emergency staffing ramps up across the state.

LTC providers are always required to provide services to residents or clients before, during and after an emergency.

The emergency plan must include:

  • Planning for staff shortages
  • A back-up plan to ensure operations and care of residents continues

For COVID-19 Vaccination, Testing Kits, PPE, Disinfection, and HAI/EPI Support:

Long-term care providers can request:

  • COVID-19 mobile vaccine clinics for residents and staff
  • BinaxNow testing kits. Read PL 2020-49 for details.
  • PPE (providers should exhaust all other options before request)
  • Facility cleaning and disinfection
  • Healthcare-associated infection and epidemiological support

To Request Support:

To initiate a request for COVID-19 support described above, contact the HHSC LTCR Regional Director in the region where the facility is located.

HHSC LTCR staff are responsible for initiating a State of Texas Assistance Request on behalf of the long-term care provider.

HHSC LTCR staff may request supporting documentation to verify need.


 

August 15th, 2021

LTC Provider COVID-19 Resource Contacts Have Changed

Federal COVID-19 Local Fiscal Recovery Funds are being distributed to cities and counties throughout Texas. HHSC urges long-term care providers in need of COVID-19 resources to use the following resources:

  • Contact your city, county or regional advisory council to find out if resources or funds will be available for health care staffing support, testing services, resident or site assessment, and disinfecting services as these resources are no longer available through HHSC.
  • For mobile COVID-19 vaccination needs, call 888-90-TEXAS to ask for a Mobile Vaccination Team to come out to your facility.
  • Contact DSHS:
  • Reach out to the HHSC Long-Term Care Regulation Regional Director in your region to ask for:
    • BinaxNow testing kits. Review PL 2020-49 (PDF) for details.
    • Health care-associated infection and epidemiological support.
    • COVID-19 vaccine. Providers should go through all other options before this one.

LTC providers can now order COVID-19 therapeutics directly.


 

July 18th, 2021

August 2 ICF COVID-19 Webinar with HHSC LTCR

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

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

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


July 16th, 2021

July 6 ICF COVID-19 Webinar Recording Available

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

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

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


 

Illustration of two people looking at a computer screen

May 2021
Building COVID-19 Vaccine Confidence Webinar

The CMS Office of Minority Health, along with guest speakers from the FDA and CDC, hosted a webinar on May 13 to provide information and resources to help address vaccine hesitancy in your community.
  • Watch the recording and download the slide deck (PDF) from the presentation.
  • Download the supplemental handout (PDF) for information and outreach materials you can use to educate your community about the COVID-19 vaccine.
  • Download the Vaccinate with Confidence fact sheet (PDF) to learn about CDC tools and technical assistance available to state and territorial health departments to increase COVID-19 vaccine confidence and uptake.

 

May 12th, 2021

Quality In LTC Conference Online

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

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


From HHSC May Newsletter

COVID-19 updated resources, see link below:

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


May 6th, 2021

APR 29 MCS COVID-19 Stakeholder Update

The audio from this session can be found here.

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information


 

April 17th, 2021

March 18, 2021 MCS COVID-19 Stakeholder Information Session

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

The audio from this session can be found here.

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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


April 17th, 2021

Reminder: Providers Can Request Free COVID-19 Testing Kits

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

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

March 28th, 2021

Free BinaxNOW COVID-19 POC Tests Available for LTC Providers

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

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

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

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

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

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


March 22 ICF COVID-19 Webinar with HHSC LTCR

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

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

ICF Provider Webinar

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


Helpful Vaccination Information

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

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

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

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

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

 

CDC   Coronavirus Disease 2019 (COVID-19)

Resources For Posters For The Facility For Staff & Individuals

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


 

 


 

 


AADMD Webinar Series to Return in January 2021

Catch up on the webinars you may have missed.


 

https://open.texas.gov/


Texas HHS Home

HHSC COVID-19 Provider Information

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


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

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

The webinar will review the November 2020 updates.

Long-term Care Facility Webinar

November 24, 2020

10:00 – 10:45 a.m. CST

See Recording below

Register for the Webinar.


 

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

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

View the video training.


Coalition of Texans with Disabilities

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


ANCOR’s COVID-19 Resource Center

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

CDC information for persons with IDD

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

Resources from HRS

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

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

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

 

December 22, 2020

HRS Inc
Risk/Benefit Return to Activity Form (Free from our friends at HRS) 
This could be very helpful for considerations for returning to work, Day Hab, Volunteer Jobs, etc…
https://hrstonline.com/download/risk-benefit-return-to-activity-form/?wpdmdl=3104&refresh=5fc779cf9f80e1606908367

 

Risk/Benefit Return to Activity Form


 

Letter From Twogether Consulting To Providers-Sept 29th, 2023 Update

September 29th,  2023

Update From Twogether Consulting!

Hope you all are well!  Just wanted to update you on what is going on with Twogether Consulting
I would like to reiterate again this newsletter, that there are new TAC codes for HCS under Title 26 Part I  Ch.263 and  Ch. 565.  Ch 565 went into effect June 21st, 2023 and the Certification Principles are now listed as Certification “Standards” in Ch 565. Again, please be sure that providers gather their administrative staff including case managers and nurses, and go over the new rules to make sure you are in compliance.  A lot of things have stayed the same, but there are definitely some major changes and additions.  I also want to remind providers that quarterly visits to HH/CC homes have been added to the rules as a provider responsibility and this means you will need to decide who is going to do the inspections and to update your on-site checklist to encompass the items discussed in Ch 565. Possibly the nurse or case manager, if they are going already for a visit or nursing assessment anyway.  I am almost done with my sample checklist for quarterly HH/CC checks.  You can also use it for the Group Homes to ensure the home is healthy and safe.  Feel free to contact Twogether Consulting if any providers would like to purchase it.  I may even post it on the “purchase services” page. 
Twogether Consulting is happy to announce that we continue to assist those interested in becoming ISS providers with the application process for licensure. Once they become providers, we also have ISS policies and procedures and some training material.  Twogether Consulting can help with survey prep. and any corrections.  In addition, we have provided a few on-site trainings for ISS providers (including direct support staff/ISS service providers and administrative staff) that have requested it, and we would be glad to continue to do so. Twogether Consulting plans on introducing live training for ISS providers hopefully sometime before Thanksgiving in Dallas &/or Houston.  Possibly another in early December in San Antonio. The training should be posted by early Oct. on the website and in the newsletters.   Most likely it will be in the form of a 1 or 2-day workshop.  Not sure exactly when, but I am hoping by early December 2023. In the meantime, we will come on-site to ISS providers if they contact us to help.

 

 Also, please continue to review the HCS & TxHmL Waiver Programs Trending Issues Volumes put out regularly by TMHP, with recommendations and “fixes” for those billing in TMHP as well as any current TMHP FAQ’s.

 

 

Please contact us directly for your care coordination, QIDP, and nursing needs at info@twogetherconsulting.com or you may contact our assistant Meghan Jones at meghanjones.tx@gmail.com. We are happy to say that we can still continue to provide for most of your needs at this time.  We are happy to provide whatever assistance we can with questions you may have, especially concerning HCS/TxHmL Care Coordination, IT and security, Nursing, or general survey requirements from LTCR department in these programs.  We also still provide assistance with the ICF/IID program and expect to have some webinars in the near future for ICF including nursing.  We continue to provide requested on-site live training at this time and we will resume regular live training after March of 2023.
Many of you have asked about whether or not we will provide additional training for billing/claims in TMHP and entering IPC’s and IDRC’s.  At this time we are not providing that service, but we will continue to keep providers updated on any fixes we learn for provider issues in TMHP.  Please continue to check our “Updates” posts on the Twogether Consulting website. We do have some subcontracted persons that can help with these areas and we can recommend some other options as well, such as companies who can provide either software and/or billing services.  FYI-We do still have “mentoring” assistance (especially great for new nurses) from our RN consultant on an as-needed basis.
     
Twogether Consulting added a new HCS/TxHmL consultant to our in May of 2022, Sheila Hanson. Congrats on your 1 year anniversary, Sheila! Sheila and Marcus Denman just recently taught our 2-day live workshop for HCS providers in Houston at “The Harris Center for IDD & MH Services”.  We had a great group of attendees and it was a really great training session Sheila has been so helpful  with  POC’s (Plans of Correction)  and POR’s (Plans of Removal) for Immediate Threats/Jeopardy for HCS/TxHmL and ICF as well as Directive Inservice Training as needed. Sheila has also been helping us with survey prep and assisting providers ICAPs, LON increases and ICAP scoring.  She is also an HCS provider herself in the San Antonio area, for the past 12 years or so and has been a much-needed member of the team this year.  We also want to thank Marcus Denman, who has been a member of our team for quite some time.  He continues to help us with so many needs of our providers.  Marcus has many years of experience in the HCS, TxHmL and ICF programs which is invaluable to Twogether Consulting. For many of you just starting out, he has been a  super resource for ISS needs, HR and New Hire practices, billing, budgeting, opening a group home and staff training, etc…  He also can help providers with POC’s for HCS, TxHmL and ISS.  Lastly, we would also like to give special thanks to our administrative assistant, Meghan Jones, without which I couldn’t function, lol. Many of you may know Meghan from registering for our classes and webinars. Meghan also assists me with the application process for many soon-to-be HCS & TxHmL providers and is our wonderful newsletter editor.
     
Twogether Consulting will be posting more of our upcoming webinar classes for October-December very soon, so feel free to check the website: www.twogetherconsulting.com or our next newsletter.
   
   We have recently updated a few items on our website:
1. The page on our website previously called “Shop” on the dropdown menu under “Services”, is now called “Service Pricing” I hope this makes it much easier for providers we currently serve and new providers to find some of our services with regular pricing posted.  We do not post all of our rates and fees as most of the services providers need our help with must be tailored to the client for their specific needs.
Before mid 2023, we hope to add a few packages with set prices for new providers.  Some examples are:
 “On-site Assistance With Opening A Group Home” for brand new HCS providers and  “On-site Assistance With a New Admission”  (GH or HH/CC clients in HCS only)
2. We have changed the look of our “Satisfied Customers” page a bit. Please submit any quotes you have by clicking on “Contact Us” and sending us a small statement of how you feel Twogether Consulting has helped your agency, the company name and your name, and contact information.  We could really use some new quotes.
3.  We do accept payments via Venmo, as well as Paypal now:  Our Venmo address is @Twogether2004
4.  We also gladly accept Zelle.  You may just use our phone # for payment:  512-294-8032.  Please inform us before you do so, thanks.
5. Once again, please don’t forget our “Updates” page on the Twogether Consulting website. This is where we post anything new from HHSC and anything going on with Twogether Consulting. It is fairly easy to navigate from one “post” to the other. If you want to read more on each section, just click on “read more”.
6.  I would like to remind everyone again, that if you need “Off-site Consultation” and you would like to purchase a block of time (1, 3 or 6 hrs at a time), please go to our  “Services” page to pay directly from the site.  There is a tab called “Service Pricing” in the drop-down menu where you pay your payment. Remember there is a discount for blocks of time larger than 3 hours, purchased on the site.  This discount is only available online on this page on the dropdown menu under “Service Pricing”.
7.There are also some additional services at a flat rate, for purchase on this page.  This includes “Off-site” ICAP Scoring, General or Nurse Consultation, and the initial consultation for HCS Provider Applicants.  

Currently, we do provide on-site (per request) and off-site training (webinars) but we are happy to announce that we have begun providing scheduled “live” training for small groups and on-site assistance to providers as well of course.  We hope to resume regular “live” sessions after March of 2023, so look for our website advertisements on social media-FB, Instagram, and Linkedin!

 

   

 Please see below for specific information for 2023 Services:

  • Live Trainings Are Back!!
  • In-person group trainings/conferences: Also available as requested. Most of these classes have already been moved to online webinars or training, but we can come on-site if you need us to do so.  We also have pre-recorded sessions of some of these trainings as well if you prefer.
  • Online training (Webinars): We will be posting upcoming webinars to the website regularly on the homepage: www.twogetherconsulting.com 
    • Webinar Registration:  Click on calendars on our website at www.twogetherconsulting.com or https://events.time.ly/anatx6f
    • Recordings of Free Webinar Series:  https://www.gotostage.com/channel/3b0bd3b1a47c4e80be974f4bcfa54d7b
    • “Updates Page”  https://twogetherconsulting.com/updates/
    • We will continue to provide 1 on 1 webinar training and any general trainings done for a specific facility/ provider for Care Coordination, QIDP’s, Nursing Services, Direct Support Staff, etc.…
    • We have pre-recorded sessions with handouts for those of you who can’t attend live sessions or can’t wait for a live session. They range from $45-$175 per session.  These range from 1 hr- 3.5 hrs per session.
    • “Pop-Up Webinars”:  We will occasionally send out invitations to some webinars to those of you who are already clients of Twogether Consulting or who are on our mailing listThese won’t be posted for the general public.  These will be fairly short notice and based on topics that we receive a large number of requests to provide.  They will also be limited registration.  (15-30 persons max).
    • Direct Support Staff Training Webinars:  We continue to offer DIT’s (Directive Inservice Trainings) for ICF as well as General Direct Support Training for HCS/TxHmL/ICF providers.  Here are just some of our training webinars currently available live and/or via pre-recorded sessions:  Abuse/Neglect/Exploitation, Direct Support Documentation (Service Delivery Logs/Residential Notes, Incident Reports, Behavioral Support Documentation and Data Collection, and Training Data Collection),  Elements of the Behavior Support Plan & The Importance of Your Documentation, Expectations From the Nurse of The DSP (Includes discussion of Medical Documentation as well-MARS, Medication Errors, Treatment Sheets, Significant Observations),  When and What to Report To The Nurse, SAM’s Training (Self-Administration of Medications Training To Staff-General Routes, Tasks, documenting), Preparing For Survey in the Group Home/Surveyor Expectations in the Group Home, Host Home/Companion Care Service Provider Responsibilities, What The Nurse Expects from the HH/CC Provider and/or CRA, and many other training webinars.
  • Consultant Support: Twogether Consultants continue to be available to assist with your HCS/TxHmL and ICF needs as usual.  We will provide anything you request of us, that we can off-site but also on-site now if requested..
  • Off-site Consultation:
    •  You may purchase a block of time for as-needed consultation:  Our current pricing will remain at $85/hr and we can offer blocks of time for more than 3 hrs at a slight discount if you pay online at: https://twogetherconsulting.com/services/off-site-services/
    • if there is an extensive project (anything over 6 hrs, we will discuss flat rate options or daily rates.)  This will involve a formal contract
    • We continue to provide as-needed off-site consultation including, but not limited to Development or assistance with policy and procedure, Monthly/Quarterly QA via Taskmaster Pro, or any other cloud-based services, Survey and Audit Prep, and you are welcome to contact us if you need us to QA or review documents through our secure cloud storage system. We also provide off-site case management and nursing consultation and mentoring for HCS/TxHmL and ICF programs,
    • And much more!
  • On-site Consultation:  This service is available as requested, but please understand we need ample time to schedule as we are backed up right now!:  
    • General On-Site Assistance is based on a daily flat fee (ranges from $550-$1050 per day), depending on your location and additional travel expenses.
    • On-site Training for groups is a daily flat fee however due to prep time, and additional costs for materials, # of attendees, the cost is a bit more (ranges from $850-$2800 per day).
  • The request for on-site is up to you and if you feel comfortable. We will of course respect any protocol you have for us if we do come on-site, including rapid testing for COVID (additional cost).
  • Remember for ICF we can still provide Directive Inservice Trainings (DIT) if necessary, but we prefer to provide these off-site via webinar as usually the time to complete them is limited and we are often booked already with appts. at such short notice, and most Regional Surveyors will accept a DIT via webinar, especially in these times. So please let us know.
  • Payments:  We prefer payment via Zelle or our PayPal Invoices, with Credit Card/Debit/ or PayPal or Venmo.  You are also welcome to pay via check,  e-check, or request to pay directly to Venmo.  You may also use our online link below to pay:  https://twogetherconsulting.com/payments/
    • If you must pay by check, please let us know prior to mailing the check.  Thank you.  Send all checks to:

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

 

 

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

 

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

 

Thank you and be well,

Julie Andrews Blacklock/Owner & IDD Waiver Consultant

 

TMHP: HCS and TxHmL Waiver Programs: Trending Issue Support

 

September 29th, 2023

HCS and TxHmL Waiver Programs: Trending Issue Support, Volumes 21-24

 


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

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

DH & ISS Billing

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

Units:

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

· ISS is an hourly unit with a maximum of 1560

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

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

Prorating instructions:

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

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

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

Other areas discussed were:

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

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

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

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

 

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

 


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

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


January 28th, 2023

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

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

Click on link below for full report

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

Highlights from Vol. 17

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

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

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

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

In addition:

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

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

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

 

Approved 3rd party biller list

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


January 15th, 2023

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

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

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

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

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

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

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

· IMTs field 18Location Code

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

· IMT LA Reassignment field 111: New Location Code

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

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

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


January 12th, 2023

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


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

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

 


December 16th, 2022

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

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

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


November 20th, 2022

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

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

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


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

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

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

 


October 17th, 2022

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

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

October 7th, 2022

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

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

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

 

-Preventing claim denials for invalid date spans

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

F0126: Claim line items cannot span current fiscal years.

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

F0326: Incorrect number of days billed for this service.

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

 


September 11th, 2022

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

-Termination Forms Submitted by LIDDAs

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

Read more on the following items:

Long-Term Care Online Portal Sessions Must Be Restarted Daily

Using the “Resubmit to SAS” Button

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

 


August 31st, 2022

Migration Trending Issue Support Vol 7:  

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

August 16th, 2022

HCS and TxHmL Waiver Programs:  Trending Issue Support Volume 6

Individual’s residential address in Individual Search

“Pending LA Review” status and action needed

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

HCS and TxHmL call queue

For  info on these trending issues see the following link:

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


August 13th, 2022

HCS and TxHmL Waiver Programs: Trending Issue Support  Volume 5

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

Here are the latest resolutions to trending issues below:

HCS and TxHmL Call Queue

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

Location Code Issue

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


See previous Volumes and info below:

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

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

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

HCS and TxHmL Waiver Programs: Trending Issue Support

Important Claims Submission Information for HCS and TxHmL Programs

LTC Online Portal Dashboard Accessibility Issue Resolved

IPC Forms 3608 and 8582 Issue Resolved

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

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

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

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

 


June 1st, 2002

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

 

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

View previous postings:

Employment First Assessment Tool: Meaningful Skills Development and Employment Services for ISS

September 28th, 2023

On September 28, 2023, the Meaningful Skills Development and  Employment Services subcommittee of the IDD System Redesign Advisory Committee will meet at 1:00 p.m.  Members are encouraged to listen to the meeting which is accessible via webcast.   To view the agenda and link to access the meeting go to:  https://www.hhs.texas.gov/about/communications-events/meetings-events/2023/09/28/intellectual-developmental-disability-system-redesign-advisory-committee-idd-srac-meaningful-skills
The discussion will include an update on ISS, as well as on HB 4169 (88th session related to including pre-vocational services as a part of ISS) and SB 50 (87th session related to competitive and integrated employment).  The discussion regarding SB 50 will focus on the employment-first assessment tool.
 HHSC is hoping for the adoption of the rules by November 2023 at which time the assessment tool will be mandatory.  

TMHP Claims Vendor Contract Change Coming December 2024

September 28th, 2023

Beginning December 2024 a third TMHP contract for Claims Processing and Adjudication and Financial Services (Claims) with Conduent State Healthcare, LLC(Conduent) will be implemented.

  • The TMHP Claims vendor will perform fee-for-service claim processing and fiscal agent responsibilities such as claim payment and recovery of overpayments.

TMHP claims processing will continue as-is until the new TMHP Claims contract is fully implemented in December 2024.

Remember, if you haven’t already, please sign up for GovDelivery to receive email updates and check tmhp.com regularly, and be on the lookout for HHSC providing more info about the transition prior to Dec. 2024..

HCS Provider Letters, Contacts and Resources

September 13th, 2023

Home and Community-based Services (HCS)

 

Provider Letters/Provider Communications!!!

Click here for news, information letters (ILs) & provider letters (PLs).


Receive Emails from HHS Every Sunday

The Texas Health and Human Services Commission contracts with a company called Granicus to provide email updates, called GovDelivery. In accordance with your contract, and contracting rules at 40 Texas Administrative Code §49.302(g), you must subscribe to receive HHSC email updates, using this GovDelivery signup, and select Information Letters, Provider Alerts and the contract program type(s).

When you sign up for email updates, you are giving your information to both HHSC and to Granicus. When HHSC has your information, it is subject to the HHSC privacy policy. When Granicus has your information, it is subject to the Granicus GovDelivery privacy policy.


Contact Program Staff


Resources

COVID FAQ’s & Guidance

Infection Control & Vaccine Resources

HB 3720

State Rules (Title 40 Subchapter D replace with Title 26 part I  Ch 263 & 565)

Surveyor Review Tools and Forms
Additional Resources

VERY IMPORTANT:  Provider Enrollment Revalidation Requirements

September 4th, 2023

VERY IMPORTANT:  Provider Enrollment Revalidation Requirements

Provider Enrollment Revalidation Requirements  https://www.tmhp.com/news/2023-09-01-reminder-provider-enrollment-revalidation-requirements

Providers must complete their revalidation enrollment before the end of their enrollment period. Providers can revalidate their enrollment in the Provider Enrollment and Management System (PEMS) up to 120 calendar days before their current revalidation due date.

Providers who do not complete the revalidation process by their deadline will be disenrolled from all Texas state healthcare programs, and claims and prior authorization requests will be denied.

Providers may find more information and begin their revalidations in PEMS through the tmhp.com website at tmhp.com/topics/provider-enrollment/how-apply-enrollment under “Determine Your Application Type.”

 

For more information, call the TMHP Contact Center at 800-925-9126.


Provider Requirements

Revalidating providers may need to provide fingerprints, submit additional documentation, or complete other screening requirements.

Providers may view and confirm their revalidation date and enrollment information in PEMS. To reduce application time, we encourage providers to have the following information available:

  • First and last name
  • Organization name
  • Social Security number
  • Date of birth
  • Employer’s Tax Identification Number and legal name
  • Licenses or certifications, if applicable
  • Identification for the provider and any person who meets the definition of owner, creditor, principal, subcontractor, or managing employee
  • Documentation related to disclosures, if needed
  • Additional documentation required for program participation

Providers revalidating an existing enrollment should continue to submit claims to meet their timely filing requirements.


Certain revalidating providers must pay an application fee. Please see: State of Texas Provider Types Required to Pay an Application Fee to determine which type of providers must pay the provider enrollment application fee and  for additional information, please look at the Texas Medicaid Provider Procedures ManualVol. 1, Provider Enrollment and Responsibilities

 

New Phone System-TMHP (HCS/TxHmL)

September 5th, 2023

As of Sept. 5th, TMHP had implemented improvements to the phone system, including the Automated Inquiry System (AIS).

Here are some of the improvements:

A. Some of the menu options and messages have changed.

B.TMHP is adding direct transfers where applicable.

The new system has the ability to recognize menu options through touch-tone keypad selection or speech recognition to engage callers. For more information call the TMHP help desk at 800-626-4117


 

LONG Term Care 800-626-4117

Option 1 LTC Customer Service

Option 2 LTC Nurse

Option 3 EDI

Option 4 EVV

Option 5 Fair Hearing (Providers only)

Option 6 Third Party Liability (TPL) , Other Insurance (OI) , Update to MESAV


 

Customer Service Line: Option 1 (Sub-Options below)

Sub-Option 1 HCS/TxHmL Forms and Claims Inquiries

Sub-Option 2 MN

Sub-Option 3 Claims

Sub-Option 4 All Other Forms

Sub-Option 5 All Other Inquiries

PPAT Fall Conference For September 6th-8th, 2023-Update

August 31st, 2023

26th ANNUAL PPAT CONFERENCE

Doubletree Hotel Austin

6505 IH-35 North, Austin, TX 78752

*Twogether Consulting will have an exhibitor booth at this event. Please come by and meet us and our friends from ADP Payroll & HR Services

Join PPAT for Their Annual PPAT Conference, September 6-8, 2023!

 


Though not inclusive, below are a few conference sessions topics:

 

Wednesday, September 6, 2023                            (Subject To Change)

CONFERENCE AT A GLANCE

1:15-2:30

Welcome & Keynote: (Phoenix North) TBD

2:30-3:00

Refreshment Break with Exhibitors: Cookie, Cupcake & Dessert Bar with Exhibitors (Phoenix Central)

3:00-4:45

Opening Session: (Phoenix North) TBD

4:45-6:45

Reception & Silent Auction Opening: Hors D’oeuvres & Cash Bar (Phoenix Central)

Thursday, September 7, 2023

7:00-6:00

Exhibit Hall Open (Phoenix Central)

7:00-8:00

Breakfast Buffet with Exhibitors: (Phoenix Central)

Phoenix North

Austin

Robertson

8:10-9:10

Guardianship Program, Rose Cohen, Attorney at Law, Law Office of Mark Cohen and Rose Cohen, Bernadette Richardson, VP of Operations, Kenmar Residential Services, Inc.

Overview of the Olmstead Decision

Emergency Telemedicine for Persons with IDD, Kaylee Graham, R.N., StationMD

9:15-10:15

SB 944 (Kolkhorst):  Panel discussion of what it requires and its impact on IDD services

TMHP Issues

How to Be An Effective Advocate

10:15-10:45

Refreshment Break with Exhibitors (Phoenix Central)

10:45-Noon

Coffee with Clair, Clair Benitez, HHSC

Individualized Skills and Socialization (policy and enforcement)

Topic TBD, Jerri Ward, Attorney at Law, Garlo Ward, P.C.

1:15-2:45

EVV, Tricia Barrett, HHSC

Another Year in Review. Joanalys Smith, Attorney at Law, Smith & Associates

Topic TBD, Jerri Ward, Attorney at Law, Garlo Ward, P.C.

2:45-3:15

Refreshment Break: Cookie, Cupcake & Dessert Bar with Exhibitors (Phoenix Central)

3:15-4:45

Overview and Discussion of Newly Adopted HCS Standards

Poems, Prayers & Penalties, Joanalys Smith, Attorney at Law, Smith & Associates

Collaboration with LIDDAs

4:45-6:30

Happy Hour & Silent Auction Closing: Appetizers & Cash Bar (Phoenix Central)

Friday, September 8, 2023

Phoenix North

Austin

Robertson

8:30-10:00

End of Continuous Medicaid Coverage & related Medicaid Eligibility Issues

HCBS Settings Rules & Statewide Transition Plan

Closed

10:00-10:15

Refreshment Break: Continental Breakfast (Phoenix North)

10:15-Noon

Closing Session: (Phoenix North):  TBD

 

Hotel Reservation Link – 2023PPATConfHotelReservations

Registration is Closed!

Program Schedule PDF


(Exhibitor schedule below. Subject to change.)

Wednesday, September 6th

Exhibitor Hall Open:  1:30 p.m. to 7:00 p.m.

Exhibitor Set-up:  8:00 a.m. to 1:00 p.m.

Location:  Phoenix North Ballroom – Exhibitor’s Hall

Break Service with Exhibitors:  2:30 p.m. to 3:00 p.m.

Reception, Hors D’oeuvres, Cash Bar & Silent Auction Opening:  4:45 p.m. to 7:00 p.m.

The silent auction will remain open until the end of the night. It will re-open at the Thursday Breakfast Buffet with Exhibitors.

Thursday, September 7th

Exhibitor Hall Open:  7:00 a.m. to 6:00 p.m.

Exhibitor Set-up:  6:00 a.m. to 7:00 a.m.

Breakfast with Exhibitors:  7:00 a.m. to 8:00 a.m.

Break Service:  10:15 a.m. to 10:45 a.m.

Cookie, Cupcake & Dessert Bar with Exhibitors:  2:45 p.m. to 3:15 p.m.

Appetizers, Happy Hour, Cash Bar & Silent Auction Closing:  4:45 p.m. to 6:30 p.m.

BREAKDOWN Exhibitor Booths:  6:30 p.m.

Friday, September 9th

Although booths are closed on Friday, Exhibitors are encouraged to stay and attend the last day of the conference.

All break services and the Silent Auction will be held in the Exhibit Hall throughout the entire day on Wednesday and Thursday. Winners for the Silent Auction will be announced at the end of the Thursday night Happy Hour. At that time, Exhibitors will need to break down their booths.


 

Rates For HCS, TxHmL, ICF & DBMB Effective Sept. 1, 2023

August 24th, 2023

Note:  The reimbursement rules which proposed changes to the Attendant Compensation Rate Enhancement programs and the mandated wage requirements for certain programs are also posted.
*HHSC removed the mandated wage requirement for group homes.
*HHSC did not remove the requirement from ISS.

HCS Survey Process Changes

August 24th, 2023

Overview of the new HCS survey process 
See (PL) 2023-09 below
FYI, the letter from HHSC does not provide all the details about the survey process and does not address the provider-required HH quarterly visits and related expectations.
Providers may still have many questions and we urge you to contact your provider associations.  You can also feel free to contact us at: info@twogetherconsulting.com or javasbja@gmail.com and I will be happy to pass them on.
 As a reminder, the next HHSC webinar on this subject is September 28th, 2023.

HHSC New HCS Provider Letter 2023-09 HCS Survey Process and Expectations

HHSC published Home and Community-Based Services (HCS) provider letter (PL) 2023-09 HCS Survey Process and Expectations on August 23. This letter provides guidance for HCS program providers on the revised HCS survey process that begins on September 1, 2023.

Read PL 2023-09.


August 16th, 2023

HCS Survey Process:

HHSC is preparing a provider letter for distribution to stakeholders to explain the revised survey process (i.e., the unannounced surveys – no more advance notice.

  • In addition,  it will discuss the new health and safety checks that will be conducted.
  • The letter should be issued before September 1, 2023.
  • The letter will explain the changes and what providers should expect.
  • We do realize there has been some confusion in what has been relayed previously at different times and the 3 IDD Provider Associates have requested a meeting to discuss these issues, which will take place on August 21st, 2023.

Person Centered Planning/ Practices Training Opportunities

August 23rd, 2023

Person-Centered Training Opportunities

Our good friend at IntellectAbility, Patrick Lane has provided a link where providers or anyone else interested can register for online Person-Centered Thinking training.  FYI-this is a requirement in the HCS/TxHmLTAC rules for all persons who are a part of the development of the Implementation Plan (IP), to have this training within the first 2 year of hire.

Staff Member and Service Provider Requirements

The session is a $275 per person.

This is a 3-day series of zoom sessions, each 6 hrs long.

There are multiple live Zoom training dates listed, so take your pick.

https://replacingrisk.com/virtual-person-centered-thinking-training/ 

To learn more about IntelectAbility, here is their main website page https://replacingrisk.com/

 


HHSC Person-Centered Planning/Practice Training Information

What Training Is Required?

Online Introductory Course

The Texas Health and Human Services Online Introductory Course is appropriate for any member of the planning team, including:

  • Legally authorized representatives
  • Family members
  • Friends
  • Nurses (required in some instances)
  • Behavior specialists (required in some instances)
  • Employment specialists (required in some instances)
  • Attendants (required in some instances)
  • Direct support professionals (required in some instances)
  • Anyone asked to be a member of the planning team

Note: To access and complete this free online training, please go to the HHS Learning Portal, create a user login, and follow instructions to complete the training.

 

Person-Centered Thinking Classroom Course

To register for the Person-Centered Thinking 2-day classroom course, please go to the HHS Learning Portal, create a user login, and follow instructions to register for a class that is most convenient to your location. Begin Training An introductory course also is offered by DirectCourseOnline. The online offering includes courses in Person-Centered Counseling (PCC) and Person-Centered Thinking and Practice. There are 12 lessons in all.

2-Day Online Training for Person-Centered Training (with virtual classroom).  Be sure to sign up for the e-learning portal from HHSC, if you have not done so already, before taking the course.


HHS Approved Full Training

The following training is approved by Texas Health and Human Services for people required to take the full training, specifically case managers, service managers and service coordinators. If you would like to submit a training course to HHS for approval, email: Medicaid_HCBS_Rule@hhsc.state.tx.us. Remember to keep your training certificate.

Provider Resource: ADP Payroll & HR Services

Get Your Promotions for Becoming A New ADP Client:

 – 1st  3 months free 

 – Other Discounts Available!

*Please Let ADP know how you found out about their services to get your 1st 3 months free!

 


August 21st, 2023

Twogether Consulting strives to find a variety of good resources for our IDD providers and hope that ADP may be able to help some of you out there with Payroll and HR needs.

Our newest contact from ADP is, Sophia Luna. She is the Small Business Consultant For Central Texas.  She is located in the Austin Area, but can help you with your business needs anywhere in Texas  She can assist our HCS/TxHmL/ICF & ISS providers that have 50 or fewer employees, although she is able to refer those with more than 50 employees to an appropriate consultant from ADP.  ADP works with many partners that may be able to help with ADP packages and partners to work with you on your HR concerns such as employee onboarding/new hire process and keeping track of background checks (including monthly OIG/LEIE checks) and tracking employee training-initial and renewal, EVV (Electronic Visit Verification), and assistance with your 1099 contractors.  In addition, some of the other needs we see from our providers are help with finding insurance (they have great insurance brokerage partners) as well as general policies and procedures that ADP can assist with or provide some resources.

Sophia is our main provider liaison with ADP and she also works with other health related programs such as home health agencies, hospice ahd behavioral health programs.  Some of you may also be providers of these services as well, so please don’t hesitate to reach out to her..

Sophia’s contact info: 956-648-1265 and his email is, Sophia.Luna@ADP.com

Tanner Harmon is our ADP contact for programs with 50 + employees.  You can contact Tanner at 214-802-6966 or his email is Tanner.Harmon@ADP.com

 

 


November 15th, 2021

From Stevie Laas at WorldMarket  (ADP Company/Partner):

WorldMarket Platform Overview-Youtube video

1099 Solutions

“When I think of clients in the healthcare industry, we know they are facing a few outside factors:

 With the aging population there is a greater demand for services in nursing facilities and home health

 Healthcare services companies are looking to quickly onboard and maintain talent pools of highly skilled health professionals

 These organizations are facing inefficient and outdated solutions to maintain 1099s resulting in increasing administrative burden

 Due to the nature of this sector, utilizing secure and reliable systems are important to stay in compliance.”

WorkMarket can help in a many ways. A few that stand out:

  • Streamlined onboarding
  • Automated vetting to quickly ensure all workers have up to date and accurate certifications, background checks, etc
  • Streamlined payment process that allows flexibility on payments, as often as daily pay if needed
  • Compliance safeguards
  • Year-end 1099 administrative burden offloaded so the business can focus on generating revenue

I have included a few items that will help give you an overview of WorkMarket. Please see the 2 attachments. This video is also a quick way to highlight what we do for clients. WorkMarket Overview  Keep in mind, the system is very customized so not all clients would need everything outlined in the video. We build it out to be specific to what they need!

Stevi Laas/Enterprise Sales Executive   
Cell: 830 708 3384
Stevi.Laas@adp.com

WorldMarket At A Glance PDF

 

 


September 13th, 2021

Attention:
ADP  has provided Twogether Consulting and our clients with some new information that many of you may be interested in hearing about, regarding 
 The Summary of the Executive Order from President Biden:  Vaccine Mandate and what it means to employers. 
Below is the ADP link that discusses how they are helping companies track all of what they are expected to put in place, based on the new vaccine mandate
 
https://mediacenter.adp.com/2021-09-13-ADP-Bolsters-Return-to-Workplace-Mobile-Solution-with-COVID-19-Test-Result-Tracking
 
Here is the link to PDF Handout as well:   ADP’s Informational Handout About the Vaccine Mandate From President Biden.  

Employees Returning From COVID-19

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

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

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

Click here for ADP’s COVID-19 Resource Center



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

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

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

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

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


 

 

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

August 19th, 2023

Exception Extended to August 31st, 2024

In March 2020, HHSC started a temporary policy change for respite and Community First Choice (CFC) Personal Assistance Services (PAS)/Habilitation (HAB) provided in the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver programs.

This change allows service providers of respite and CFC PAS/HAB to live in the same home as the person receiving these services. A person’s spouse, or parent if the person is under 18, is not allowed to be a paid service provider of these services in accordance with the HCS, TxHmL and CFC Billing Requirements.

This temporary policy change is effective March 27, 2020, through Aug. 31, 2024. HHSC will provide guidance if anything changes.

Program providers must complete the required background checks for all service providers, including respite and CFC PAS/HAB providers living in the same home as the individual receiving services. Requirements can be found in the following references:

  • The Texas Administrative Code (TAC), Title 26, Part 1, Chapter 263, and Chapter 262.
  • HCS and TxHmL Rules, 26 TAC §565.9(b) and §566.9(r) and (s).
  • The HCS Program Billing Requirements and the TxHmL Program Billing Requirements, Section 3400 for service provider qualifications, and the CFC Billing Requirements for HCS and TxHmL Program Providers.

Exception Ending August 31st, 2023

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

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

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

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

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

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

 

October 4th, 2022

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

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

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

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

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

Email questions to HCS Policy.


May 30, 2022

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

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

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

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


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

Please Fill Out The ISS Survey!

August 16th, 2023

 ISS Survey From July 2023:
HHSC posted a survey (9 questions) asking comprehensive service providers to complete.  The survey is intended to gather information about ISS network adequacy and to determine what, if any changes, are needed.   CMS  is hoping to use the data to find out how the transition is going.
HHSC stated that it only received 262 responses, some were incomplete, and some were completed by an ISS only (independent ISS) provider.
Action Needed:  HHSC is reopening the survey and asked that we urge all of our members who are comprehensive survey providers (not independent ISS providers) to complete the survey.  The deadline for completing the survey is August 31, 2023. 

 ISS Remediation & Validation Process

August 15th, 2023

Remediation & Validation Process

 This is a process of performing on-site visits to determine compliance by ISS providers, with certain HCBS Settings rules and other rules:   HHSC reviewed the process and the assessment tool being used.  Here is the information letter sent out previously. IL-2023-28  https://www.hhs.texas.gov/sites/default/files/documents/il2023-28.pdf
Please note the information about the required attestation form that must be completed by all ISS providers.
  If you are an ISS provider and have not completed the attestation, please do so.

New Quarterly HH/CC On-Site Visits/Reviews

August, 15th, 2023

Compliance with new rules in Ch 565 on additional oversight for HH/CC service providers & Individuals receiving services

  • Concerning the now required quarterly HH/CC On-site Visits to review specific areas that providers must conduct, providers have expressed concerns about HH/CC service providers being very upset with this new change of more oversight by the provider and HHSC, and they have concerns that it will be too intrusive.
  • There are also concerns that this will be an added cost to the provider to add these additional visits..  HHSC has explained that the purpose of the change was to ensure the health and safety of persons receiving HH services.  
  • HHSC stated they would discuss the increased cost matter, as well as the concerns about the type of documentation surveyors would expect providers to maintain as evidence that the visits were made, internally and follow up with providers.
  • HHSC also stated that as the rule is new, there is no expectation (at least for now) on behalf of Regulatory that providers should have already initiated the visits!
  •   Surveyors will expect to see a plan of action or schedule for conducting the visits.

HELPFUL TIPS: For Individualized Skills & Socialization (ISS) Providers

July 31st, 2023

Just wanted to post some helpful tips for all of the new ISS providers out there. 

#1. Be sure you date your ISS policies, and specifically for any Evacuation &/or Emergency Response Procedures  When you revise them, show the revision dates on those policies. ISS Service Providers can receive a violation from the survey team for not doing so.

#2. Be sure to get with your local emergency response coordinators in your areas, to help you with developing your Evac/ER Response procedures.

#3  Be sure to utilize a Hazard Valuation Assessment Tool to evaluate the potential hazards and issues for emergencies that occur in your area (fire, flood, hurricane, tornado, earthquake, chemical spills, active shooters, etc..) and assess how you are preparing currently and again re-assess after any emergencies to see how your ISS facility did in responding to the situation and how you could improve.

#3. Be sure you review your ISS policies and procedures and discuss how you will implement those policies and/or procedures, as part of the implementation process involves training staff/employees.

 

For example:

  1. Can you show in-service/training resources or material used to teach employees about what is expected for documenting ISS services or documenting critical incidents?
  2. Can you show that employees are trained on how and where to report critical incidents?
  3. Can you show what resources you will use to train the staff about fire drills, fire evacuation, and other emergency protocols for the facility, including during off-site ISS?
  4. Can you show how you trained employees on the complaint process and the individuals in the program or about Abuse, Neglect and Exploitation and how to report it?

 

We will continue to add “TIPS” for ISS Service Providers periodically on this page!

FREE 2023 Positive Behavior Management and Support (PBMS) Zoom Workshop

July 29th, 2023

Texas HHSC is hosting a FREE 2023 Positive Behavior Management and Support (PBMS) Zoom Workshop.

HHSC will be providing Continuing Education Units (CEUs) for:            Social workers, certified nurse aides, licensed nursing facility administrators, nursing facility activity directors, assisted living facility managers, day activity and health services managers, qualified developmental disabilities professionals, and qualified intellectual disabilities professionals.

See Registration Link Below:

PBMS 2023: Zoom, September 20th and 21st, 2023 (alchemer.com)

Please carefully fill out all questions asked as part of the registration form for the workshop scheduled for September 20th and September 21st, 2023.

The training can be accessed with the Zoom link below:

https://unt.zoom.us/j/85740807478 
The training begins promptly at 9:00 a.m. on both days.
9:00 a.m. – 5:00 p.m. first day
9:00 a.m. – 12:30 p.m. second day

 

For questions, please contact LaQuette Newsome at laquette.newsome01@hhs.texas.gov

Abuse, Neglect, & Exploitation Training for ISS

July 6th, 2023

If you need some help with training your On-Site and Off-Site ISS staff on Abuse, Neglect, and Exploitation, Twogether Consulting has developed a short 45 min-1hr training to address everyone from direct support staff at your ISS to your Administrator.

Included are but not limited to: definitions of Abuse (Physical, Mental, and Sexual), Neglect, Exploitation, and Mistreatment as well as signs and symptoms of each one of these. This session also discusses who to report to, CII (Critical Incident Intake), and some discussion about the 3613-A  PIR (Provider Investigation Report) Form, as well as which other critical incidents need to be reported to CII.

We provide handouts, ppt with narrative and recording of the training.  You will need to have your staff sign off on training inservice/signature sheet for proof of training or contact us to discuss other options

(we can set it up as a scheduled pre-recorded webinar for you and staff. Each person registered will receive a certificate at the end of watching the entire video and filling out the post-test or post-survey).

Cost:  $75

You may use this general payment link to pay and notify us before doing so, so we can send you the training once payment is made. Or you may ask to make payment via Zelle or our business Venmo account.

TxHmL & CFC Certification Standards-New TAC Rules-Adopted

June 20th, 2023

TxHmL & CFC Certification Standards Adopted 
As of June 21st, 2023 the new HCS & CFC Standards will be effective.
These rules were transferred from Chapter 9 to Chapter 566, including both newly added rules (Ch. 262) and rules from Chapter 9  which have been revised to ensure clarity.  HHSC intends to post an Information Letter regarding the rules which will review each section of the rules in the document we have included below, as well as, those rules which have been removed.

HHSC will also conduct several webinars to review the rules with providers.  Providers can already register for the webinars.
July 5th from 11:30 a.m. to 1:30 p.m.
July 11th from 4:00 p.m. to 6:00 p.m.

 

-The rules describe the following certification standards

Service Delivery

Requirements related to abuse, neglect, and exploitation

Staff Member and Service Provider requirements

Quality Assurance

Prohibitions

ERS

Other Program Provider Requirements

And more

Blackboard Connect Emergency System (HCS, TxHmL, ICF, & DAHS-ISS Providers)

June 26th, 2023

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

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

(This  also applies to DAHS-ISS Providers)

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

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

Blackboard Connect sign-up process:

Go to this link and click “Sign Me Up!”

If you have any questions, please contact the Policy and Rules Section by email at LTCRPolicy@hhs.texas.gov or call (512) 438-3161.

 

Don’t forget, this also noted in the Rules under 565 for HCS ( §565.1 Emergency Response System)  and 566 for TxHmL

Medicaid Resource: State Strategies & Programs To Support Adults with IDD & Their Caregivers

July 25th, 2023

Thought I would share this information from a recent Linkedin post I received.

“Centers for Medicare & Medicaid Services (CMS) offers this resource for state Medicaid and partner agencies seeking to address the needs of adults with intellectual and developmental disabilities (I/DD) and their aging caregivers with the aim of improving access to high-quality home and community-based services (HCBS) for people eligible for Medicaid. This resource synthesizes information on innovative state strategies and programs designed to strengthen supports for adults with I/DD and their aging caregivers.”

*Interagency Partnerships & Relationships
*Engagement and Navigation Supports
*Person- and Family-Centered Systems of Support
*Planning for the Future
*Data Resources

Click on link below:
https://lnkd.in/gVFNf6vg

HCS & CFC Certification Standards-New TAC- Adopted- Effective June 21st, 2023

June 19th, 2023

HCS & CFC Certification Standards Adopted 
As of June 21st, 2023 the new HCS & CFC Standards will be effective.
These rules were transferred from Chapter 9 to Chapter 565, including both newly added rules (Ch. 263) and rules from Chapter 9  which have been revised to ensure clarity.  HHSC intends to post an Information Letter regarding the rules which will review each section of the rules in the document we have included below, as well as, those rules which have been removed.

HHSC will also conduct several webinars to review the rules with providers.  Providers can already register for the webinars.
July 5th from 11:30 a.m. to 1:30 p.m.
July 11th from 4:00 p.m. to 6:00 p.m.

 

-The rules describe the following certification standards

Service Delivery

Rights of individuals

Requirements related to abuse, neglect, and exploitation

Staff Member and Service Provider requirements

Quality Assurance

 

-In Addition:

Requirements from The Residential Checklist

New Requirements for Emergency Preparedness, Fire Drills, and Evacuation Drills in all residential types in the HCS program.

The Rules will have increased oversight of HCS host home/companion care homes

There is a clarification of Restraint and Seclusion Requirements

Adds language for Restricting the Use of Enclosed Beds.

 

-In addition, there is the modification of The HHSC surveyor requirements that will allow for survey flexibility as the HCS waiver program evolves.

Recent Legislative Bills Passed during 88th Legislature

June 15th, 2023
 Legislative Bills: 
The following 3 bills passed by the 88th Legislature were discussed:
~   HB 4169 (Price) relating to prevocational services:  The bill directs HHSC to either add pre-vocational services as part of ISS or to create a stand alone pre-vocational service.
~  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.  HHSC was not able to confirm if there would be an adjustment to the rates to account for the increase.  HHSC stated it will research and get back to us.
~  HB 1009 (Turner) relating to criminal history background checks.  The bill applies to HCS group homes only.  Though providers are not opposed to the checks the bill now requires federal checks including fingerprinting.  [The bill itself does not mention fingerprinting,  It does though reference obtaining DPS ‘electronic updates’ which is the trigger for or prompts the need for fingerprints.] External workgroup members expressed concerns with the requirement ranging from the cost (which was not funded) to the length of time it takes for federal checks to be completed.  HHSC was not clear on what it would do with the concerns expressed. We fully anticipate there will be more conversation with HHSC about this bill.

NewTMHP Portal Enhancement Training Information HCS/TxHmL

June 15th, 2023

New Portal Enhancement Training Information:

More Info and Registration

From the TMHP website:

“Registration is now available for two training webinars to discuss the Long-Term Care (LTC) Online Portal enhancements for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs. The webinars are offered by the Texas Medicaid & Healthcare Partnership (TMHP).

A TMHP training services representative will conduct the webinars, which will include question-and-answer sessions. During the live webinars, attendees can access training materials and submit questions.

Note: Attendees should already be familiar with the LTC Online Portal. Those who are not familiar with the portal should complete parts 1 and 2 of the LTC Online Portal Training for HCS & TxHmL Waiver Programs Webinar in the TMHP Learning Management System (LMS) before participating in the enhancements webinar. A TMHP LMS account is required to access and view these recordings. Note that webinars are no longer accessible through Internet Explorer. The preferred browsers are Google Chrome or Microsoft Edge.”

For HCS and TxHmL Providers Webinar

Select one of the following dates to register:

Tuesday, June 20, 2023, 10 a.m.–11:30 a.m.

Tuesday, July 11, 2023, 10 a.m.–11:30 a.m. (repeat)

 

Note: The webinars will not provide billing training.

For information about TMHP billing, refer to the “Claims Resources” section of the 1915(c) Waiver Programs Reference Material web page.

For more information, email TMHPWebinarSupport@tmhp.com, or contact the TMHP LTC Help Desk at 800-626-4117 (select option 1 and then option 7).

HCS Certification Rule-Transfer from Ch.9 to Ch.565 -June 21st, 2023

June 14th, 2023

New!

HCS Certification Rule:  HHSC announced that the rules being transferred from Chapter 9 to Chapter 565 will be published in the June 21, 2023 Texas Register 
The announcement will be accompanied by an Information Letter.
According to HHSC, the letter will explain rules and specify which rules are new, which have been revised to ensure clarity and which have been removed.
**In addition, HHSC will conduct several webinars to review the rules with providers.
Providers can already register for the first webinar, to be held July 5th from 11:30 a.m. to 1:30 p.m.,  at:  https://apps.hhs.texas.gov/providers/training/HCS-TxHmL-Training.cfm

Registration is Open: 2023 Quality in Long-Term Care Conference-August 22nd and 23rd (Austin, Tx)

June 10th, 2023

HHS, in collaboration with The University of Texas Steve Hicks School of Social Work, will host an informative two-day, free conference on quality in long-term care.

Aug. 22-23

This year’s theme is, “Making a Commitment to Person-Centered Long-Term Care.”

The conference offers presentations from nationally and internationally recognized experts.

Topics include:

  • Caring for people with dementia.
  • Infection prevention and control.
  • Long COVID considerations in long-term care
  • Current health care trends.

Cutting-edge advances in long-term care, aging and disability services.

The conference is free to attend, and continuing education credit will be available for various healthcare disciplines.

Renaissance Austin Hotel

9721 Arboretum Blvd.

Austin, TX 78759

mySchedules Training Webinars & Other Resources From MITC

May 13th, 2023

“The labor shortage has made it more important than ever to manage available resources effectively. Allowing existing employees to view and request open shifts can be a big help to over-stressed managers.”

Our friends at MITC have asked us to share some information on one of their very important resources, scheduling software for your shift staff in group homes and employees in general.  Please check all their info below and feel free to go to their website for more info on their other products for IDD providers and service providers.  https://mitcagencies.com/

myScheduling is just one of the tools from MITC that might be helpful to both IDD  providers (i.e. HCS, TxHmL and ICF) as well as Day Hab/ ISS (Individualized Skills and Socialization) and Supported Employment Providers

Check out some of their previously recorded videos at the links below.

Make Scheduling Easier! Let Employees Request Extra Work 01/12/23

Scheduling for Group Homes and In-Home Programs 03/02/23

How a Provider with 2,000 Employees Deployed mySchedules 04/13/23

 

Download These Fact Sheets:

mySchedules

Integrating mySchedules with Kronos and Other Time and Attendance Systems

Client Scheduling

Integrating Maps and Mileage into Scheduling

Encouraging Employees to Request Extra Hours


UPCOMING EVENTS & WEBINARS

 

Webinar: Using Scheduling to Share the Work Around

Jun 8 @ 2:00 pm – 3:00 pm ET

Allowing existing employees to swap shifts and request extra hours can be a big help for over-stressed managers. It also helps retention!

Learn more about allowing employees to swap shifts and request extra hours.

Register Here

Webinar: Client Profiles: A New, Easier, Cheaper Way to Manage EHR

Jun 15 @ 2:00 pm – 3:00 pm ET

Looking for a modern, more affordable Electronic Health Records system? Client Profiles is the easier and cheaper way to manage EHR, and has already proved popular with providers.

The latest technology is used to provide unrivaled flexibility to share information but restrict access on a need-to-know basis and generate user-defined alerts.

Learn more about how your agency could benefit from Client Profiles.

Register Here

 

Webinar: Managing Community and Facility-Based Programs

Jun 22 @ 2:00 pm – 3:00 pm ET

The day-to-day job of managing community, day and facility-based services has become more complex in recent years as providers are encouraged, incentivized or mandated to transition to community-based services.

Learn about technology other agencies have used successfully to tackle issues in community and facility-based programs.

Register Here

 

Scheduling Webinar Presented By MITC For Texas (HCS/TxHmL/ICF/ISS Providers)

Hosted by Twogether Consulting

June 26, 2023 @ 12:00 pm – 1:00 pm CT

Twogether Consulting is happy to have Jonathan Morris with, MITC (Staff & Client Solutions), to discuss some of the management solutions they offer providers concerning scheduling and staffing. This session may be of particular interest to those of you who are newly licensed ISS (Individualized skills and socialization) providers in the state of Texas and many of you who may be HCS (Home & Community Based Services) & ICF/IID (Intermediate Care Facilities For Individual With Intellectual Disabilities) providers with group homes. MITC’s staff and client solutions are designed for providers working with the IDD population and behavioral health communities. In this presentation, we will also touch on some other services such as EVV (Electronic Visit Verification) solutions from MITC concerning Texas providers.  This is a wonderful resource for IDD service providers and waiver programs. Jonathon is part of our free webinar series for the month of July 2023.

Register Here

 

 

Webinar: New Ways to Ensure Documentation Gets Captured

Jun 29 @ 2:00 pm – 3:00 pm ET

Capturing documentation in a timely manner is a task many providers struggle with. Luckily, there are plenty of ways to improve documentation capture, so providers can use one that works best for them.

Learn about the different ways your agency can ensure documentation is captured.

Register Here


Managing Group Homes? Calculate Your Payroll Savings Opportunities

With payroll costs rising, agencies need better control over time and attendance. These seven features all help to minimize unauthorized attendance. The latest time and attendance software provides agencies methods to not only collect payroll but also control payroll.

Use this spreadsheet to estimate your potential savings.

Not all these new features will work for every agency, but customers using some of these features are telling us it is saving them thousands of dollars a year. Don’t miss out!

  1. Stop employees clocking-in early using schedules
  2. Stop employees clocking-in early using job restrictions
  3. Stop employees clocking-in on block-out dates
  4. Stop employees clocking-in in overtime without permission
  5. Stop employees clocking-in if client is over authorization
  6. Worried about buddy punching and fake employees? Use two-factor authentication
  7. Track whether managers and employees are colluding to inflate payroll

Email agencysuccessteam@mitcsoftware.com to discuss your potential ROI.


“MITC’s Staff and Client Solutions are designed specifically for providers serving the I/DD and behavioral health communities.
MITC’s solutions are perfect for agencies that manage group homes, HCBS, or day, vocational, and supported employment programs!  Because we’ve worked with thousands of agencies like yours, MITC delivers the most cost-effective solutions that lead to lower payroll costs, higher performance, and compliance with state and DOL regulations.”

 

Reminder: Implementation Plan Form 2125 (HCS/TxHmL)

June 5th, 2023

Form 2125 from HHSC used int the HCS and TxHmL programs as the Implementation Plan form, was updated in Oct. 2022.  The form currently has a box to check this document if consent was obtained from the individual or LAR concerning receiving services via Synchronous Audio Visual Technology .

Per standards of care, any professional therapy service or nursing service delivered using synchronous audio-visual technology must be clinically appropriate, safe, and agreed to by the individual receiving services or by the LAR. Synchronous audio-visual technology requires consent from the individual or LAR. Verbal consent is permissible and should be documented in the individual’s record. Providers must ensure that the appropriate consent box on the IP is checked.

Important Reminder: Consent For Synchronous Audio-Visual Technology

June 5th, 2023

Just A Reminder About Consent For Synchronous Audio-Visual Technology

Revision 22-3; Effective Oct. 19, 2022

As appropriate for the individual and as permitted by service-specific requirements, the modalities for delivering services to an individual includes:

  • In-person
  • Synchronous audio-visual
  • Audio only

In addition to meeting service requirements, providers must defer to the needs of the individual receiving services, ensuring the mode of service delivery is accessible, person-centered, and not driven by provider convenience.

Per standards of care, any professional therapy service or nursing service delivered using synchronous audio-visual technology must be clinically appropriate, safe, and agreed to by the individual receiving services or by the LAR. Synchronous audio-visual technology requires consent from the individual or LAR. Verbal consent is permissible and should be documented in the individual’s record.

****In addition:  The Providers must ensure that the appropriate consent box on the IP is checked.  (if you don’t use the IP form and you have another version, this information will have to be included as part of your IP.)

ISS (Individual Socialized Services) FAQ’s

June 5th, 2023

HHSC’s Response to Three Recent ISS-Related Questions From Providers

 

Question 1: May an Individualized Skills and Socialization (ISS) provider charge families for after-hour care?  Many times families cannot get off work at the time the program closes/services stop.  Some providers will keep their doors open until 5 or 6 (with staff present of course), until families get off work.  In these cases, the ISS providers charge families for that service.

HHSC’s Response: If the individualized skills and socialization provider is also the program provider, the program provider would not be allowed to charge additional fees outside of the established HCS Waiver Program Payment rates, located here. According to 40 TAC §9.178(o):

(o) The program provider must not assess charges against the individual’s personal funds for costs for items or services reimbursed through the HCS Program or through CFC.

 

Additionally, according to 26 TAC §263.2015:

The service limit for the combined total of on-site, off-site, and in-home individualized skills and socialization is:

  (1) 1560 hours during an IPC year;

  (2) six hours per calendar day; and

  (3) five days per calendar week.

 

If the individualized skills and socialization provider is a contractor of the program provider, the provider’s costs must be considered reasonable and necessary in regard to the Medicaid cost/accountability reports. Unless the program provider agrees to pay a higher amount, the individualized skills and socialization provider must provide the service at or below the direct services portion of the applicable HCS Program rate.

According to 40 TAC §9.177(b):

(b) The program provider must employ or contract with a person or entity of the individual’s or LAR’s choice in accordance with this subsection.

  (1) Except as provided by paragraph (2) of this subsection, the program provider must employ or contract with a person or entity of the individual’s or LAR’s choice to provide an HCS Program service or CFC service to the individual if that person or entity:

    (A) is qualified to provide the service;

    (B) unless the program provider agrees to pay a higher amount, provides the service at or below:

      (i) for any service except CFC ERS, the direct services portion of the applicable HCS Program rate; and

      (ii) for CFC ERS, the reimbursement rate; and

    (C) is willing to contract with or be employed by the program provider to provide the service in accordance with this subchapter.

As part of agreeing to provide the HCS Program service at the direct services portion of the applicable HCS Program rate, the individualized skills and socialization provider would not be allowed to charge an individual or family additional charges outside what is reimbursed through the HCS Program.  (This means, the provider can pay all of the direct and indirect portions of the rate to the ISS provider if they want to or more, but they don’t have to pay more than the direct portion of the rate if they don’t want to.  Many HCS/TxHmL providers choose to pay all of the rate amount, the direct and indirect side both, but most likely are not paying more than the total rate as this would not be feasible or affordable for many HCS providers.)

 

Question 2: According to the rules, a person may receive in-home ISS assuming certain criteria are met/justifications secured.  Provision of the service does not require a license.  If the person wants to also engage in off-site activities, such must be provided by a licensed ISS.  In these cases,

~Can (as an example) the HH provider obtain a license for off-site only and provide the service as long as the HH provider was not the person delivering the service?

HHSC’s Response: In accordance with the HCS Billing Requirements, Section 43102.7 a host home/companion care provider is prohibited from being the service provider of in-home individualized skills and socialization. There is no prohibition on the host home/companion care provider being a service provider of on-site or off-site individualized skills and socialization but those services cannot be provided in the individual’s residence. The host home/companion care provider would need to either be employed by an individualized skills and socialization provider or obtain an individualized skills and socialization license.

~  Can the individual (again one who has a justification for in-home ISS) attend an ISS just to participate in off-site ISS only, or must that service be provided in an off-site only licensed ISS ?

HHSC’s Response: Yes, an individual who has a justification to receive in-home individualized skills and socialization may choose to also receive off-site individualized skills and socialization at a facility that provides both on-site and off-site individualized skills and socialization. It is not required that they receive off-site through an off-site only licensed individualized skills and socialization facility.

~  Can the program provider for an individual obtain an off-site only ISS license so the individual can participate in off-site ISS activities as long as the service provider of such is not the HH provider?  And if so, could the person providing the in-home ISS work for or contract with the provider to provide off-site ISS to the individual?

HHSC’s Response: Yes, a program provider may become a licensed off-site only individualized skills and socialization provider so that an individual can participate in off-site individualized skills and socialization activities. The service provider providing in-home individualized skills and socialization would be allowed to become an employee or contractor of the program provider owned off-site only individualized skills and socialization provider, as long as they met all other service provider requirements outlined in program rule and in the HCS Program Billing Requirements.

 

Question 3: Concerning ISS notes, it’s been reported by some providers that some HHSC or TMHP reviewers have told them that the ISS notes cannot be handwritten rather must be electronic.  Is that true?  And if so, where is that stated?

HHSC’s Response: There is no requirement that service delivery logs for on-site, off-site, or in-home individualized skills and socialization must be electronic over handwritten. HCS Policy does not specify the modality of service delivery log notes, only that the written documentation must be legible. According to Section 3810 of the HCS Billing Requirements:

3810 General Requirements

Revision 23-2; Effective April 1, 2023

(a)        Legible A program provider must have written, legible documentation to support a service claim.

 


January 13th, 2023

ISS FAQs:  Updated January 13th, 2023

HHSC posted updated FAQs for the new service. Read the FAQ here.

August 23rd, 2022

Frequently Asked Questions HHSC shared during the ISS draft rules webinar on August 23rd, 2022.

These are questions received during the ISS webinar on July 19th, 2022

Q1: Will current day hab providers be grandfathered into the new
program? Or do they have to be program provider to have a day hab
contract with HHSC?
A1: No, Day Hab Providers are not grandfathered into the Individualized Skills and
Socialization program. Any provider who is interested in delivering Individualized
Skills and Socialization services must obtain a Day Activity Health Services or DAHS
– Individualized Skills and Socialization service category license, even those who
are currently providing day habilitation services.

Q2: Are the off-site activities generated from the individual PDPs or does the
ISS facility plan the activities?
A2: Off-site activities are generated from the individual’s Individual Plan of Care
and Individual Program Plan in the DBMD waiver program. In TxHmL and HCS, an
Individualized Skills and Socialization provider must provide off-site Individualized
Skills and Socialization in accordance with an individual’s PDP, IPC, and
implementation plan.

Q3: If the in-home service provider does not need to be an ISS
provider, does that mean that they can be a parent?
A3: A person who meets the Service Provider Qualifications for In-Home
Individualized Skills and Socialization, including a parent of an adult child
can provide Individualized Skills and Socialization.

Q4: What is the enhanced staffing rate? How does that work?
A4: An enhanced staffing rate is available in the HCS and TxHmL Programs
for an individual who requires more service provider support than the
individual would receive with the individual’s assigned LON. The requirement
for additional support may be because of the individual’s mobility, medical,
or behavioral needs. The program provider may request the enhanced
staffing rate for an individual with an LON 1 or LON 5 in the HCS Program, or
any LON in the TxHmL Program.

Q5: If the PDP do not specify how often a client needs to go out, will that be up
to the discretion of the individualized skills organization to decide how often
they go out?
A5: It is the individual’s choice for how they choose to receive off-site Individualized
Skills and Socialization and off-site Individualized Skills and Socialization must align with
the individual’s PDP, IPC, IP, and in DBMD the individual’s IPP.

Q6: Do we need to provide meals and snacks? Have a paid nurse on site? Can it
be an LVN?
A6: An Individualized Skills and Socialization provider does not need to provide meals
and snacks to the individuals, but they must provide personal assistance for an
individual who cannot manage personal care needs including eating during an
Individualized Skills and Socialization activity. An Individualized Skills and Socialization
provider must also be able to provide assistance with medications and the performance
of tasks delegated by a registered nurse.

Q7: Is there going to be an open enrollment period for ISS with times of the year
that are closed, or is it an open enrollment?
A7• An individual in the HCS, TxHmL, and DBMD Program can add Individualized Skills
and Socialization to their IPC at any point during the plan year. It is the individual’s or
their LAR’s choice if they would like to receive individualized skills and socialization.
Any provider who is interested in delivering Individualized Skills and Socialization
services must obtain a Day Activity Health Services or DAHS – Individualized Skills
and Socialization service category license. The provider may apply at any time once
the online licensure portal (TULIP) is operational. HHSC anticipates that the license
application process will be available late November or December.

Q8: Are staffing ratios minimum or maximum? Will providers be reimbursed if
they go over the ratio?
A8: The staffing ratios described in the rule indicate that they are “no higher than” i.e.,
they describe the maximum ratio of individuals to service providers of Individualized
Skills and Socialization. To receive reimbursement and avoid recoupment of funds,
Individualized Skills and Socialization services (on-site, off-site, or in-home) must be
provided in accordance with the HCS, TxHmL, or DBMD Program rules.

Q9: Will ISS providers be required to have RNs as part of staff now that
medication management is part of the program? Additionally, our day hab does
not currently enroll individuals that need help with toileting or feeding needs,
will the program require that we do enroll these LONs individuals?
A9: If an individual receiving Individualized Skills and Socialization needs assistance
with medication or other nursing tasks, the HCS program provider’s nurse must ensure
the Individualized Skills and Socialization service providers are delegated/trained to
deliver the service. Individualized Skills and Socialization providers like day habilitation
providers can refuse to accept a person for services.

Q10: Is there any guidance regarding scheduling? For example, is the service
only Monday-Friday, etc.
A10: There is not a requirement for how many hours per day an Individualized Skills
and Socialization provider needs to provide services. There is a service limit for the
combined total of on-site, off-site, and in-home Individualized Skills and Socialization for
HCS and TxHmL of 1560 hours during an IPC year, six hours per calendar day, and five
days per calendar week.

Q11: Does an HCS, TxHmL or DBMD provider have to apply to be licensed as ISS
provider?
A11: An active day habilitation site could choose not to participate in Individualized Skills and
Socialization and not apply for a license. They would no longer be able to provide day
habilitation to individuals in HCS, TxHmL, and DBMD after March 1, 2023, since day hab will
no longer be a service at that point. Any provider who wishes to deliver Individualized Skills
and Socialization services will be required to have a Day Activity and Health Services –
Individualized Skills and Socialization license. A provider must obtain a temporary license
prior to delivering Individualized Skills and Socialization services and may choose to do so at
any time once the licensing system is available. HHSC Long-term Care Regulatory will issue a
provider a final license after conducting an on-site visit that results in final approval of the
license.
Q12: In the examples of ratios given, there was not an example that included an ICF
client. What are the expectations when mixing ICF clients with waiver clients?
A12: If a person is not in the TxHmL, HCS, or DBMD Program and is receiving services by a
staff member who is also providing on-site Individualized Skills and Socialization to an
individual in the DBMD Program or off-site to an individual in the HCS, TxHmL, and DBMD
Program, the appropriate HCS, TxHmL, and DBMD staffing ratio must be applied, and that
individual must be included in the staffing ratio.

Q13: If someone’s PDP says they need XX hours in the community, but we do
not have the manpower, are we still able to work with the client?
A13: Waiver providers can engage the Individualized Skills and Socialization

providers in the development of the implementation plan by identifying free or low-
cost activities (affordable by the individual) the Individualized Skills and Socialization

providers can offer within their community and match well with the individual’s
interests. Off-site Individualized Skills and Socialization is provided in a community
setting chosen by the individual from among available community setting options.
Community settings are settings accessible to the general public within an
individual’s community.

Q14: Day hab allowed for 5-hour minimum days, so now under ISS is it going
to be required to be 6 direct services timer?
A14: The service limit for the combined total of on-site, off-site, and in-home
Individualized Skills and Socialization for HCS and TxHmL is:
(1) 1560 hours during an IPC year;
(2) six hours per calendar day; and
(3) five days per calendar week.
Individuals can receive less than six hours per calendar day.

Q15: If the individual/LAR choses not to utilize the ISS program, will
they still be able to receive funding from TxHmL/HCS?

A15: The individual or LAR can choose to receive in-home Individualized
Skills and Socialization if the individual meets the policy for in-home
delivery. Individuals living in three and four person residences would need
to participate in employment or day activity with natural supports if the
LAR or individual does not choose to receive individualized skills and
socialization and does not meet the policy guidance for in-home
individualized skills and socialization. Access to HCS and TxHmL waiver
services is not dependent upon receiving individualized skills and
socialization.

Q16: Can we have a combination of HCS waivers and private pay? Does private
pay also need to be in the community?
A16: Individualized Skills and Socialization providers will have a choice about how to
conduct business. They will be allowed to accept all payor sources, or they may choose
to accept only waiver (HCBS) or non-waiver. The HCBS settings regulations do not apply
to ICF/IID, private pay or general revenue and therefore, day habilitation can continue
to be provided without changing the service to individualized skills and socialization;
however, if a provider wants to serve individuals in the waiver programs, the provider
must do so as a licensed individualized skills and socialization provider after March 1,
2023. Individualized skills and socialization has both on-site and off-site services that
must be offered to individuals in the waivers.

Q17: Will ISS provided in the client’s home require EVV verification for HCS and
TxHmL funded clients? If the client lives in a group home or a Host
Home/Companion Care home, will the EVV verification be required?
A17: In-home Individualized Skills and Socialization provided in the individual’s own
home or family home will require the use of EVV verification, similar to in-home day
habilitation today. If the individual lives in a 3-person or 4-person residence, or a host
home/companion care residence, EVV verification will not be required.

Q18: Will we need a separate license for each day hab our individuals
attend including any families that provided in-home day hab due to
their LON and medical need?
A18: Each physical location that provides on and off-site Individualized Skills
and Socialization services will require its own license and application process.
In-home services will not require a license.

Q19: Can you give a few examples of offsite locations?
A19:Visits to the museums, libraries and parks are examples of off-site
Individualized Skills and Socialization activities if they are chosen by the
individual, integrate the individual into the community, and promote the
development of skills and behavior that support independence and personal
choice.

For further questions, contact:

HCSPolicy@hhs.texas.gov
TxHmLPolicy@hhs.texas.gov
LTCRPolicy@hhs.texas.gov

HHSC will conduct a public hearing on the proposed HCS, TxHmL and DBMD ISS program rules on September 7, 2022 from 8:00 am. until Noon.  To register for the virtual hearing, go to:  https://attendee.gotowebinar.com/register/927810115195515152

IDD Ombudsman “Client’s Rights & Complaints”

May 28th, 2023

When to Call the IDD Ombudsman

The IDD Ombudsman receives complaints from individuals, family members, and the general public about the care, treatment, or services provided to an individual. Individuals receiving services or family members of the individual may prefer to call the IDD Ombudsman to assist in resolving an issue rather than speaking with their LIDDA service coordinator (SC) or HCS provider.

(In addition, if you are not sure where to make a complaint or who to make a complaint to, as it may not apply specifically to a specific individual in your program, the IDD Ombudsman will generally help you find out who you need to talk to.)

A complaint may be reported to the IDD Ombudsman by anyone by calling 1-800-252-8154 between 8 a.m. and 5 p.m. Monday through Friday.

                                                                                                                  OR

Email: OmbudsmanIDD@hhsc.state.tx.us.

Online: Submit your question or complaint online

Mail: Texas Health and Human Services Commission
IDD Ombudsman
P.O. Box 13247
Austin, TX 78711-3247

Fax: 888-780-8099

 


.

For Your Information:  Rights Booklet and Handbook For Individuals In The HCS Program

The rights booklet, described in 40 Texas Administrative Code (TAC) §9.190(e)(2) and the rights handbook, described in 40 TAC §4.117(c) may be found on the HHSC website at https://hhs.texas.gov/about-hhs/your-rights/office-ombudsman/hhs-ombudsman-publications.

The booklet and handbook may also be obtained from HHSC by sending an email to OmbudsmanIDD@hhsc.state.tx.us.

Or click on the links below to download a copy

Resources for people with intellectual or developmental disabilities:


Resources for anyone looking for help resolving a problem concerning HHSC services:

 

Reminder: Complete Attestation & Reporting For HCBS Provider Retention Payments To Prevent Recoupment

May 27th, 2023

 Attestation and Initial & Final Reports

 HHSC’s Home and Community-Based Services (HCBS) Provider Retention Payments are part of the HHSC ARPA (American Rescue Plan Act) Spending Plan. These “Retention Payments” were meant to be a temporary rate add-on on eligible service claims with dates of service from March 1, 2022 to August 31, 2022, to agency providers and consumer-directed services (CDS) employers.

HHSC adopted 1 Texas Administrative Code Section 355.207 governing the ARPA HCBS Provider Retention Payments, including the attestation and reporting requirements. Eligible providers who receive the add-ons but fail to complete the required attestation and reporting will be subject to recoupment of the associated payment add-ons.

HHSC has updated the ARPA HCBS Provider Retention Payments Compliance List on the Provider Finance Department (PFD) website. The list of providers who have submitted an attestation and reporting requirements will be updated every 14 calendar days until the attestation is closed.

 Failure to comply will result in recoupment.  Please check HHSC’s most current HCBS Provider Retention Payment compliance list to be sure it accurately reflects your submissions. The list is available at:  https://pfd.hhs.texas.gov/sites/rad/files/documents/long-term-svcs/arpa-hcbs-list.pdf

If you are an eligible provider who is not yet in compliance, please visit the PFD website to access and complete the attestation and reports. The deadline for the attestation and reports is 90 calendar days after the federally-declared COVID-19 PHE expired.  The federally-declared PHE expired on May 11, 2023.  The deadline for the ARPA HCBS Provider Retention Payments attestation and reporting has been extended to August 9, 2023.

For more information regarding ARPA HCBS provider recruitment and retention payments, please visit the PFD website.

Webinar From ANCOR: What You Need to Know to Comply with Wage and Hour Laws Now that the Public Health Emergency Has Ended

May 10th, 2023

The PHE is Over, Now What?  What You Need to Know to Comply with Wage and Hour Laws Now that the Public Health Emergency Has Ended

 

Check out this webinar from ANCOR. This webinar does have a registration fee.  It is open to members and non-members of ANCOR!

Wednesday, May 24, 1-2 pm EDT

“The Impact of the PHE Unwinding On Wage and Hour Compliance”

A clock and a calendar.
Now that the public health emergency (PHE) has ended, providers are navigating how to unwind from emergency flexibilities and funding—both of which may have implications regarding compliance with wage and hour laws.
For example, many states included reimbursement rate increases or hazard bonuses for direct support professionals through time-limited Appendix Ks or American Rescue Plan Act funding, and the rules governing these pay increases may be viewed differently now compared to during the PHE.
Through the unwinding, it is critical that providers have a clear understanding of when to exclude and include increases from overtime pay calculations and remain in compliance when discontinuing the use of premiums.
To help you make sense of it all, this webinar will provide participants with a better understanding of the Fair Labor Standards Act, with emphasis on emerging topics from the unwinding of the PHE.

Presenters

  • Lydia Dawson, J.D., Director of Policy, Regulatory and Legal Analysis, ANCOR
  • Eileen Maguire, J.D., Attorney & Legal Advisor, Gilliland, Maguire & Harper, P.C.

Direct Care Careers Connect Coming Soon!

May 15th, 2023

New Tool To Help Providers & Direct Support Staff/Community Attendants With Employment!

HHSC is launching Direct Care Careers Connect to help community attendants and employers connect beginning June 1, 2023.

The online platform will allow community attendants to list work history, skills, certifications, trainings, and other job qualifications. Employers will be able to post job descriptions, job specifications, and other information to help find quality candidates. Employers can also contact job candidates about posted positions.

HHSC does not play a role in the hiring process.

HHSC invites community attendants and employers to use this new online platform at no cost. Alternative terms for community attendants can include: attendant; care attendant; caregiver; direct care staff; direct service worker; direct support; home care attendant; home health aide; patient care assistant; personal care assistant; personal care attendant; special caregiver; care assistant; direct support professional; or direct care staff.

(Host Home/Companion Care Providers would seem to fall under this, but I am unclear at this time. I would contact the email below to ask.)

Email any questions to HHSCOfficeofDisabilityServicesCoordination@hhs.texas.gov.

Long-Term Care Provider Webinar Recording on the End of Continuous Medicaid Coverage (ALF’s, NF’s, ICF’s & HCS)

May 15th, 2023

Recording Available of Webinar For LTC Provider Webinar on the End of Continuous Medicaid Coverage!

HHSC hosted additional live webinars in March and April of 2023, to inform providers about the end of continuous Medicaid coverage.

The webinar provided information about how long-term care providers (including nursing facilities, assisted living facilities, home and community support services agencies, Medicaid waiver providers, and intermediate care facilities for individuals with intellectual and developmental disabilities) can assist their Medicaid clients as continuous Medicaid coverage ends.

This is from the March 29 webinar. A recording is available here.

Email questions to: update@hhs.texas.gov

Guidance for HCS, HCSSA, ICF, and TxHmL Providers Related to Cooperation with HHSC Provider Investigations (PL 2023-11)

May 14th, 2023

 Guidance Related to Cooperation with HHSC Provider Investigations (PL 2023-11)

HHSC has published PL 2023-11 Cooperation with HHSC Provider Investigations (PDF). The letter reminds providers that they must cooperate with Health and Human Services Commission Provider Investigators who are conducting investigations of abuse, neglect, and exploitation.

Clarification on HCS and TxHmL IPCs status in “Pending DADS Review”

May 14th, 2023

Reminder

Last updated on 12/7/2022

Since May 2, 2022, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers, local intellectual and developmental disability authorities (LIDDAs) and financial management services agencies (FMSAs) billing on behalf of consumer-directed services (CDS) have been submitting forms and claims to the Texas Medicaid & Healthcare Partnership (TMHP). In response to questions and concerns related to the processing of Individual Plan of Care (IPC) forms, HHSC is clarifying required actions by submitters and how they parallel to processes in Intellectual Disability (ID) Client Assignment and Registration System (CARE).

Renewal and Revision IPCs

Renewal and Revision IPCs in either “Pending DADS Review” or “Pending Coach Review” require action from the submitter. This is typically the submission of supporting documentation. The IPC will not be reviewed until action is taken. This is the same process in place for “Exceeds” flags in ID-CARE.

A packet submitted to UR must include:

A packet may include, depending on the services requested:

  • Comprehensive Nursing Assessment (Form 8584 or a form with all of the same elements) for nursing hours
  • Occupational Therapy (OT) evaluation, treatment plan or assessment (include orders) for OT hours
  • Physical Therapy (PT) evaluation, treatment plan or assessment (include orders) for PT hours
  • Speech/Language Therapy evaluation, plan or assessment (include orders) for Speech hours
  • Dietary evaluation for Dietary hours (include orders)
  • Dental treatment plan, if applicable
  • Behavior Support Plan for Behavioral Support hours that meets HHSC criteria
  • PAS/HAB Assessment (form 8510) for PAS/HAB hours
  • Transportation Plan (form 3598) for Transportation hours
  • Audiology Treatment plan (and orders), if applicable
  • Cognitive Rehabilitation Therapy plan, if applicable (in HCS)
  • Support Consultation plan, if applicable (in HCS)
  • Social Work plan, if applicable (in HCS)
  • All documentation for Adaptive Aids, if requesting, including the following:
  • All documentation for Minor Home Modifications (3 bids based on the specs, specs from licensed professional recommendation), if requesting (please see Section 6200 of the HCS Billing Requirements).

 

Enrollment and Transfer IPCs

Enrollment and transfer IPCs remain in “Pending DADS Review while the enrollment or transfer is being processed.

Enrollment IPCs may require additional documentation to be submitted to Program Eligibility and Support (PES). If an enrollment requires additional documentation, PES will contact the LIDDA who submitted the enrollment IPC.

Transfer IPCs always require a “transfer packet” to be submitted to PES. If a transfer packet requires additional documentation, PES will contact the LIDDA who submitted the transfer IPC.

A “transfer packet” submitted to PES must include:

  • Request for Transfer of Waiver Program Services (form 3617)
  • HCS Only: Individual Plan of Care (IPC) – HCS/CFC (form 3608)
  • TxHmL Only: Individual Plan of Care – TxHmL/CFC (form 8582)

If an enrollment or transfer requires utilization review, Utilization Review (UR) will contact the LIDDA who submitted the enrollment or transfer packet.

 

Packet/Documentation Submission Details

The most efficient mode of submission for HCS/TxHmL documentation is through the IDD Operations Portal. To learn how to register and use the IDD Operations Portal or for answers to any questions, please visit https://hhs.texas.gov/doing-business-hhs/provider-portals/resources/idd-ops-portal or email IDD_Ops_Portal@hhsc.state.tx.us. Packets may also be submitted via fax at 512-438-4249.

 

Questions

For questions about review packets, submitters can contact HHSC UR department at 512-438-5055 or email deskURLONIPC@hhs.texas.gov.

For questions about enrollments or transfers, submitters can contact PES at 512-438-2484 or email enrollmenttransferdischargeinfo@hhs.texas.gov.

Upcoming Provider Webinar

HHSC will discuss this topic during the December 8th, 2022, TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar.

Please click on this link to register for this webinar.

If you are unable to attend the webinar, please click on this link to access the December 8th, 2022, TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar recording. Please note: this recording should be available by December 15th, 2022.

Pay Increase For Community Attendants & Direct Care/Support Workers: 

May 13th, 2023

Community Attendants & Direct Care/Support Workers:

Direct care/support workers & community attendants are a huge part of the Medicaid long-term services and supports system. Without these persons working with our individuals, HCS, TxHmL, CLASS, ICF and other programs would not be able to provide services. The long-term services and supports system in Texas would simply not exist without a workforce of direct care/support workers. The Texas House and Senate have passed their budgets and are now in a conference committee to finalize the ‘Texas’ budget for the state fiscal year 2024 through 2025. (Prior to this meeting the Senate ad House have not been in agreement on how much the increase of funding will be)

The Senate version of the state budget raises attendant wages by almost 40 percent. And while it is still not the $17 per hour we were initially asking for, it would still be a large increase from what providers have at this time and it would really help with staff retention and attracting more DCS/DSW workers to these programs.  Numerous Texans with disabilities rely on direct care/support workers every day.  Without these workers, many of them could not remain in their community and might end up placed in more restrictive settings like institutions such as an SSLC (State Supported Living Center).

 

Please take time to call:

Important- Recordings Available From HCS and ICF Webinar COVID-19 from HHSC

May 13th, 2023

May 2023 MCS COVID-19 Stakeholder Information Session

Thank you for your interest in listening to the May 2023 Texas Medicaid CHIP COVID-19 Information Session.

The audio from this session can be found here.

The presentation can be found here.

This is the last scheduled stakeholder recording for COVID-19 updates.

For additional questions, please write to Medicaid_COVID_Questions@hhsc.state.tx.us.


January 12th, 2023

 January 12 Texas Medicaid CHIP COVID-19 Information Session.

These sessions will continue to share information with stakeholders about the implementation of various Medicaid/CHIP flexibilities in response to the COVID-19 pandemic.

 The audio from this session can be found here.

The presentation can be found here.

Future meeting notices and information will continue to be shared on these sites, so please check back regularly.

COVID-19 Provider Information

COVID-19 Client Information

For additional questions, please write to Medicaid_COVID_Questions@hhsc.state.tx.us.


December 1st, 2022

December 1 Texas Medicaid CHIP COVID-19 Information Session.

These sessions will continue to share information with stakeholders about the implementation of various Medicaid/CHIP flexibilities in response to the COVID-19 pandemic.

 

The audio from this session can be found here.

The presentation can be found here.

Future meeting notices and information will continue to be shared on these sites, so please check back regularly.

COVID-19 Provider Information

COVID-19 Client Information

For additional questions, please write to Medicaid_COVID_Questions@hhsc.state.tx.us.


November 8th, 2022

Medicaid and CHIP Services Has Updated Its Process of Sending Monthly COVID-19 Updates

In the past, these updates were sent via an email from Outlook. Beginning with the December update, the MCS COVID-19 Stakeholder Update will be sent via GovDelivery.

If you wish to be removed from the MCS COVID-19 Stakeholder Update distribution list and not receive anymore alerts, please reply with “OPT OUT”.

Future meeting notices and information will continue to be shared on these sites, so please check back regularly.

COVID-19 Provider Information

COVID-19 Client Information


Sept. 7th, 2022

 September 1 Texas Medicaid CHIP COVID-19 Information Session

These sessions will continue to share information with stakeholders about the implementation of various Medicaid/CHIP flexibilities in response to the COVID-19 pandemic.

The audio from this session can be found here.

The presentation can be found here.

Future meeting notices and information will continue to be shared on these sites, so please check back regularly.

COVID-19 Provider Information

COVID-19 Client Information

For additional questions, please write to Medicaid_COVID_Questions@hhsc.state.tx.us.


April 28th, 2022

COVID-19 ICF/IID Webinar Recording from April 11 Available

The April 11 recording of the Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions COVID-19 Q&A with HHSC Long-term Care Regulation and DSHS is available.

The PowerPoint is updated with information given in the DSHS webinar.

Read the COVID-19 Q&A (PDF).

Listen to the webinar recording here.

Email LTCR Policy for the transcrip


February 27th, 2022

COVID-19 ICF/IID Webinar Recording from Feb. 14 Available

A recording of the Feb. 14 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions COVID-19 Q&A with HHSC Long-term Care Regulation and DSHS is available for those who could not attend.

There have been changes made to the PowerPoint based on the information provided by DSHS during the webinar.

Read the COVID-19 Q&A (PDF).

Listen to the webinar recording.

Email LTCR Policy for the transcript.


February 1st, 2022

HCS, TxHmL COVID-19 Response Webinar Recording: Jan. 27 and Jan. 30

This webinar reviewed information from the revised COVID-19 Response Plan for HCS and TxHmL.

This includes strategies to rapidly identify COVID-19 and:

  • Prevent its spread
  • Protect individuals, staff, and visitors
  • Provide care to infected people
  • Recover from an outbreak

They also addressed the surge of COVID-19 across the state, address staffing shortages and provide you guidance from the CDC.

. A recording of this webinar is now available as of Jan. 31 at GoToStage.


January 27th, 2022

 HCS and ICF/IID providers who attended the webinar from HHSC on 1/19/22.

The webinar below was held in response to discussions between the 3 IDD associations and HHSC regarding the increase in COVID cases, ongoing staff (direct care and nurse) shortages (which have now been exacerbated because of COVID), limited to no access to PPE and testing resources and inconsistent (and at times unclear) rules and policies related to COVID and infection control.  
Providers have still not been able to find a resolution as of to date to these issues (i.e. staffing shortages and shortages in PPE, status of ARPA funds).
Below, however, are several actions HHSC has taken to improve communications with providers, streamline current COVID processes and policies and clarify current policies and practices:
** Note: Twogether Consulting does understand that many providers have been unsatisfied with the efforts HHSC has made to assist with staff shortages, especially since even if you do complete the checklist before requesting emergency staffing, it does not mean they will honor your requests.  I have informed at least one of the IDD associations about this concern.
  • Recently HHSC re-issued and, in some cases, issued updated policies and guidance for all IDD COVID-related documents.(1/5/22 and 1/7/22 for HCS concerning guidance booklet updates).
  • HHSC is working to reorganize the COVID-related information, including COVID flexibilities and Appendix K waivers, on the ICF/IID and HCS home webpages to facilitate ease in access. 
  • HHSC did communicate the above and other changes and policy clarifications with providers via a webinar on January 19th, 2022, however many questions were still unanswered and attendees were told that questions that were not answered should be addressed in an FAQ from HHSC within 2 weeks of the webinar.

Jan. 19 Recording of HCS and ICF/IID COVID-19 Webinar Available

A recording of the Jan. 19 for Home and Community-based Services and Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions webinar with LTCR is now available.

Listen to the webinar recording here.

Read the webinar slide presentation (PDF).

Email LTCR Policy for the transcript.