Twogether Updates
Reminder: Implementation Plan Form 2125 (HCS/TxHmL)
June 5th, 2023
Form 2125 from HHSC used int the HCS and TxHmL programs as the Implementation Plan form, was updated in Oct. 2022. The form currently has a box to check this document if consent was obtained from the individual or LAR concerning receiving services via Synchronous Audio Visual Technology .
Per standards of care, any professional therapy service or nursing service delivered using synchronous audio-visual technology must be clinically appropriate, safe, and agreed to by the individual receiving services or by the LAR. Synchronous audio-visual technology requires consent from the individual or LAR. Verbal consent is permissible and should be documented in the individual’s record. Providers must ensure that the appropriate consent box on the IP is checked.
Important Reminder: Consent For Synchronous Audio-Visual Technology
June 5th, 2023
Just A Reminder About Consent For Synchronous Audio-Visual Technology
Revision 22-3; Effective Oct. 19, 2022
As appropriate for the individual and as permitted by service-specific requirements, the modalities for delivering services to an individual includes:
- In-person
- Synchronous audio-visual
- Audio only
In addition to meeting service requirements, providers must defer to the needs of the individual receiving services, ensuring the mode of service delivery is accessible, person-centered, and not driven by provider convenience.
Per standards of care, any professional therapy service or nursing service delivered using synchronous audio-visual technology must be clinically appropriate, safe, and agreed to by the individual receiving services or by the LAR. Synchronous audio-visual technology requires consent from the individual or LAR. Verbal consent is permissible and should be documented in the individual’s record.
****In addition: The Providers must ensure that the appropriate consent box on the IP is checked. (if you don’t use the IP form and you have another version, this information will have to be included as part of your IP.)
Employment First Assessment Tool: Proposed Rules (HCS/TxHmL/CLASS/DBMD)
June 5th, 2023
IL 2023-22
Employment First Assessment Tool: Proposed Rules
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
ISS (Individual Socialized Services) FAQ’s
June 5th, 2023
HHSC’s Response to Three Recent ISS-Related Questions From Providers
Question 1: May an Individualized Skills and Socialization (ISS) provider charge families for after-hour care? Many times families cannot get off work at the time the program closes/services stop. Some providers will keep their doors open until 5 or 6 (with staff present of course), until families get off work. In these cases, the ISS providers charge families for that service.
HHSC’s Response: If the individualized skills and socialization provider is also the program provider, the program provider would not be allowed to charge additional fees outside of the established HCS Waiver Program Payment rates, located here. According to 40 TAC §9.178(o):
(o) The program provider must not assess charges against the individual’s personal funds for costs for items or services reimbursed through the HCS Program or through CFC.
Additionally, according to 26 TAC §263.2015:
The service limit for the combined total of on-site, off-site, and in-home individualized skills and socialization is:
(1) 1560 hours during an IPC year;
(2) six hours per calendar day; and
(3) five days per calendar week.
If the individualized skills and socialization provider is a contractor of the program provider, the provider’s costs must be considered reasonable and necessary in regard to the Medicaid cost/accountability reports. Unless the program provider agrees to pay a higher amount, the individualized skills and socialization provider must provide the service at or below the direct services portion of the applicable HCS Program rate.
According to 40 TAC §9.177(b):
(b) The program provider must employ or contract with a person or entity of the individual’s or LAR’s choice in accordance with this subsection.
(1) Except as provided by paragraph (2) of this subsection, the program provider must employ or contract with a person or entity of the individual’s or LAR’s choice to provide an HCS Program service or CFC service to the individual if that person or entity:
(A) is qualified to provide the service;
(B) unless the program provider agrees to pay a higher amount, provides the service at or below:
(i) for any service except CFC ERS, the direct services portion of the applicable HCS Program rate; and
(ii) for CFC ERS, the reimbursement rate; and
(C) is willing to contract with or be employed by the program provider to provide the service in accordance with this subchapter.
As part of agreeing to provide the HCS Program service at the direct services portion of the applicable HCS Program rate, the individualized skills and socialization provider would not be allowed to charge an individual or family additional charges outside what is reimbursed through the HCS Program. (This means, the provider can pay all of the direct and indirect portions of the rate to the ISS provider if they want to or more, but they don’t have to pay more than the direct portion of the rate if they don’t want to. Many HCS/TxHmL providers choose to pay all of the rate amount, the direct and indirect side both, but most likely are not paying more than the total rate as this would not be feasible or affordable for many HCS providers.)
Question 2: According to the rules, a person may receive in-home ISS assuming certain criteria are met/justifications secured. Provision of the service does not require a license. If the person wants to also engage in off-site activities, such must be provided by a licensed ISS. In these cases,
~Can (as an example) the HH provider obtain a license for off-site only and provide the service as long as the HH provider was not the person delivering the service?
HHSC’s Response: In accordance with the HCS Billing Requirements, Section 43102.7 a host home/companion care provider is prohibited from being the service provider of in-home individualized skills and socialization. There is no prohibition on the host home/companion care provider being a service provider of on-site or off-site individualized skills and socialization but those services cannot be provided in the individual’s residence. The host home/companion care provider would need to either be employed by an individualized skills and socialization provider or obtain an individualized skills and socialization license.
~ Can the individual (again one who has a justification for in-home ISS) attend an ISS just to participate in off-site ISS only, or must that service be provided in an off-site only licensed ISS ?
HHSC’s Response: Yes, an individual who has a justification to receive in-home individualized skills and socialization may choose to also receive off-site individualized skills and socialization at a facility that provides both on-site and off-site individualized skills and socialization. It is not required that they receive off-site through an off-site only licensed individualized skills and socialization facility.
~ Can the program provider for an individual obtain an off-site only ISS license so the individual can participate in off-site ISS activities as long as the service provider of such is not the HH provider? And if so, could the person providing the in-home ISS work for or contract with the provider to provide off-site ISS to the individual?
HHSC’s Response: Yes, a program provider may become a licensed off-site only individualized skills and socialization provider so that an individual can participate in off-site individualized skills and socialization activities. The service provider providing in-home individualized skills and socialization would be allowed to become an employee or contractor of the program provider owned off-site only individualized skills and socialization provider, as long as they met all other service provider requirements outlined in program rule and in the HCS Program Billing Requirements.
Question 3: Concerning ISS notes, it’s been reported by some providers that some HHSC or TMHP reviewers have told them that the ISS notes cannot be handwritten rather must be electronic. Is that true? And if so, where is that stated?
HHSC’s Response: There is no requirement that service delivery logs for on-site, off-site, or in-home individualized skills and socialization must be electronic over handwritten. HCS Policy does not specify the modality of service delivery log notes, only that the written documentation must be legible. According to Section 3810 of the HCS Billing Requirements:
3810 General Requirements
Revision 23-2; Effective April 1, 2023
(a) Legible A program provider must have written, legible documentation to support a service claim.
January 13th, 2023
ISS FAQs: Updated January 13th, 2023
August 23rd, 2022
Frequently Asked Questions HHSC shared during the ISS draft rules webinar on August 23rd, 2022.
These are questions received during the ISS webinar on July 19th, 2022
Q1: Will current day hab providers be grandfathered into the new
program? Or do they have to be program provider to have a day hab
contract with HHSC?
A1: No, Day Hab Providers are not grandfathered into the Individualized Skills and
Socialization program. Any provider who is interested in delivering Individualized
Skills and Socialization services must obtain a Day Activity Health Services or DAHS
– Individualized Skills and Socialization service category license, even those who
are currently providing day habilitation services.
Q2: Are the off-site activities generated from the individual PDPs or does the
ISS facility plan the activities?
A2: Off-site activities are generated from the individual’s Individual Plan of Care
and Individual Program Plan in the DBMD waiver program. In TxHmL and HCS, an
Individualized Skills and Socialization provider must provide off-site Individualized
Skills and Socialization in accordance with an individual’s PDP, IPC, and
implementation plan.
Q3: If the in-home service provider does not need to be an ISS
provider, does that mean that they can be a parent?
A3: A person who meets the Service Provider Qualifications for In-Home
Individualized Skills and Socialization, including a parent of an adult child
can provide Individualized Skills and Socialization.
Q4: What is the enhanced staffing rate? How does that work?
A4: An enhanced staffing rate is available in the HCS and TxHmL Programs
for an individual who requires more service provider support than the
individual would receive with the individual’s assigned LON. The requirement
for additional support may be because of the individual’s mobility, medical,
or behavioral needs. The program provider may request the enhanced
staffing rate for an individual with an LON 1 or LON 5 in the HCS Program, or
any LON in the TxHmL Program.
Q5: If the PDP do not specify how often a client needs to go out, will that be up
to the discretion of the individualized skills organization to decide how often
they go out?
A5: It is the individual’s choice for how they choose to receive off-site Individualized
Skills and Socialization and off-site Individualized Skills and Socialization must align with
the individual’s PDP, IPC, IP, and in DBMD the individual’s IPP.
Q6: Do we need to provide meals and snacks? Have a paid nurse on site? Can it
be an LVN?
A6: An Individualized Skills and Socialization provider does not need to provide meals
and snacks to the individuals, but they must provide personal assistance for an
individual who cannot manage personal care needs including eating during an
Individualized Skills and Socialization activity. An Individualized Skills and Socialization
provider must also be able to provide assistance with medications and the performance
of tasks delegated by a registered nurse.
Q7: Is there going to be an open enrollment period for ISS with times of the year
that are closed, or is it an open enrollment?
A7• An individual in the HCS, TxHmL, and DBMD Program can add Individualized Skills
and Socialization to their IPC at any point during the plan year. It is the individual’s or
their LAR’s choice if they would like to receive individualized skills and socialization.
• Any provider who is interested in delivering Individualized Skills and Socialization
services must obtain a Day Activity Health Services or DAHS – Individualized Skills
and Socialization service category license. The provider may apply at any time once
the online licensure portal (TULIP) is operational. HHSC anticipates that the license
application process will be available late November or December.
Q8: Are staffing ratios minimum or maximum? Will providers be reimbursed if
they go over the ratio?
A8: The staffing ratios described in the rule indicate that they are “no higher than” i.e.,
they describe the maximum ratio of individuals to service providers of Individualized
Skills and Socialization. To receive reimbursement and avoid recoupment of funds,
Individualized Skills and Socialization services (on-site, off-site, or in-home) must be
provided in accordance with the HCS, TxHmL, or DBMD Program rules.
Q9: Will ISS providers be required to have RNs as part of staff now that
medication management is part of the program? Additionally, our day hab does
not currently enroll individuals that need help with toileting or feeding needs,
will the program require that we do enroll these LONs individuals?
A9: If an individual receiving Individualized Skills and Socialization needs assistance
with medication or other nursing tasks, the HCS program provider’s nurse must ensure
the Individualized Skills and Socialization service providers are delegated/trained to
deliver the service. Individualized Skills and Socialization providers like day habilitation
providers can refuse to accept a person for services.
Q10: Is there any guidance regarding scheduling? For example, is the service
only Monday-Friday, etc.
A10: There is not a requirement for how many hours per day an Individualized Skills
and Socialization provider needs to provide services. There is a service limit for the
combined total of on-site, off-site, and in-home Individualized Skills and Socialization for
HCS and TxHmL of 1560 hours during an IPC year, six hours per calendar day, and five
days per calendar week.
Q11: Does an HCS, TxHmL or DBMD provider have to apply to be licensed as ISS
provider?
A11: An active day habilitation site could choose not to participate in Individualized Skills and
Socialization and not apply for a license. They would no longer be able to provide day
habilitation to individuals in HCS, TxHmL, and DBMD after March 1, 2023, since day hab will
no longer be a service at that point. Any provider who wishes to deliver Individualized Skills
and Socialization services will be required to have a Day Activity and Health Services –
Individualized Skills and Socialization license. A provider must obtain a temporary license
prior to delivering Individualized Skills and Socialization services and may choose to do so at
any time once the licensing system is available. HHSC Long-term Care Regulatory will issue a
provider a final license after conducting an on-site visit that results in final approval of the
license.
Q12: In the examples of ratios given, there was not an example that included an ICF
client. What are the expectations when mixing ICF clients with waiver clients?
A12: If a person is not in the TxHmL, HCS, or DBMD Program and is receiving services by a
staff member who is also providing on-site Individualized Skills and Socialization to an
individual in the DBMD Program or off-site to an individual in the HCS, TxHmL, and DBMD
Program, the appropriate HCS, TxHmL, and DBMD staffing ratio must be applied, and that
individual must be included in the staffing ratio.
Q13: If someone’s PDP says they need XX hours in the community, but we do
not have the manpower, are we still able to work with the client?
A13: Waiver providers can engage the Individualized Skills and Socialization
providers in the development of the implementation plan by identifying free or low-
cost activities (affordable by the individual) the Individualized Skills and Socialization
providers can offer within their community and match well with the individual’s
interests. Off-site Individualized Skills and Socialization is provided in a community
setting chosen by the individual from among available community setting options.
Community settings are settings accessible to the general public within an
individual’s community.
Q14: Day hab allowed for 5-hour minimum days, so now under ISS is it going
to be required to be 6 direct services timer?
A14: The service limit for the combined total of on-site, off-site, and in-home
Individualized Skills and Socialization for HCS and TxHmL is:
(1) 1560 hours during an IPC year;
(2) six hours per calendar day; and
(3) five days per calendar week.
Individuals can receive less than six hours per calendar day.
Q15: If the individual/LAR choses not to utilize the ISS program, will
they still be able to receive funding from TxHmL/HCS?
A15: The individual or LAR can choose to receive in-home Individualized
Skills and Socialization if the individual meets the policy for in-home
delivery. Individuals living in three and four person residences would need
to participate in employment or day activity with natural supports if the
LAR or individual does not choose to receive individualized skills and
socialization and does not meet the policy guidance for in-home
individualized skills and socialization. Access to HCS and TxHmL waiver
services is not dependent upon receiving individualized skills and
socialization.
Q16: Can we have a combination of HCS waivers and private pay? Does private
pay also need to be in the community?
A16: Individualized Skills and Socialization providers will have a choice about how to
conduct business. They will be allowed to accept all payor sources, or they may choose
to accept only waiver (HCBS) or non-waiver. The HCBS settings regulations do not apply
to ICF/IID, private pay or general revenue and therefore, day habilitation can continue
to be provided without changing the service to individualized skills and socialization;
however, if a provider wants to serve individuals in the waiver programs, the provider
must do so as a licensed individualized skills and socialization provider after March 1,
2023. Individualized skills and socialization has both on-site and off-site services that
must be offered to individuals in the waivers.
Q17: Will ISS provided in the client’s home require EVV verification for HCS and
TxHmL funded clients? If the client lives in a group home or a Host
Home/Companion Care home, will the EVV verification be required?
A17: In-home Individualized Skills and Socialization provided in the individual’s own
home or family home will require the use of EVV verification, similar to in-home day
habilitation today. If the individual lives in a 3-person or 4-person residence, or a host
home/companion care residence, EVV verification will not be required.
Q18: Will we need a separate license for each day hab our individuals
attend including any families that provided in-home day hab due to
their LON and medical need?
A18: Each physical location that provides on and off-site Individualized Skills
and Socialization services will require its own license and application process.
In-home services will not require a license.
Q19: Can you give a few examples of offsite locations?
A19:Visits to the museums, libraries and parks are examples of off-site
Individualized Skills and Socialization activities if they are chosen by the
individual, integrate the individual into the community, and promote the
development of skills and behavior that support independence and personal
choice.
For further questions, contact:
HCSPolicy@hhs.texas.gov
TxHmLPolicy@hhs.texas.gov
LTCRPolicy@hhs.texas.gov
HHSC will conduct a public hearing on the proposed HCS, TxHmL and DBMD ISS program rules on September 7, 2022 from 8:00 am. until Noon. To register for the virtual hearing, go to: https://attendee.gotowebinar.com/register/927810115195515152
New Critical Incident Management Reporting System: Updates
June 2nd, 2023
Critical Incident Management Reporting System (CIMS) Incident Report Submission Status
HHSC has published IL 2023-19, Critical Incident Management Reporting System Incident Report Status. This letter is an update on the form submission status of critical incident reports entered into CIMS.
This Information Letter applies to:
- Community Living Assistance and Support Services providers and case management agencies (CLASS)
- Deaf Blind with Multiple Disabilities providers (DBMD)
- Home and Community-based Services providers (HCS)
- Texas Home Living providers (TxHmL)
- Local intellectual and developmental disability authorities (LIDDAs).
Please contact MCS_CIMS@hhs.texas.gov with any questions.
October 13th, 2022
Please Don’t Forget To Sign Up For CIMS Training
Only 200 of the 800 providers/users have completed the training and have signed in/register
Providers must start using CIMS by November 1st, 2022. If you are a member of one of the 3 IDD associations, HHSC will provide each of these associations with the names of those entities so each association can reach out to their respective IDD waiver members who are not on the list/have yet to complete these steps.
August 11th, 2022
Critical Incident Management System (CIMS) Now Live
HHSC announces the new Critical Incident Management System is now live. CIMS is a statewide tool for reporting critical incidents.
All providers must begin entering critical incidents into CIMS no later than Nov. 1.
See IL 2022-23 for more information about CIMS.
This alert applies to:
- Community Living Assistance and Support Services providers
- Deaf Blind with Multiple Disabilities providers
- CLASS case management agencies
- Home and Community-based Services providers
- Texas Home Living providers
- Local intellectual and developmental disability authorities
INSTRUCTIONS FROM HHSC FOR COMPLETING TRAINING AND CORRECTING/ADDING USERS:
“The provider administrator with the active user account created in CIMS is required to complete the training in the system. Once the provider administrator completes the training, provider administrators can begin adding new users to their organization and reassigning roles so other members of the organization can enter critical incidents into CIMS.
If the designated provider administrator still works for an organization, HHSC will not change the designated administrator for a provider organization. If the designated provider administrator no longer works for the organization, HHSC will work with the current designated employee to ensure that person is added as a user in CIMS. HHSC staff must verify the employee requesting CIMS access works for a contracted provider or a local intellectual and developmental disability authority before access can be granted.
Now that CIMS has gone live, providers can no longer change contact information in CARE or send provider administrator contact updates to HHSC if the provider administrator is employed with the organization.”
Providers are required to use current systems for entering critical incidents until they have completed CIMS registration and training and begin entering critical incidents into CIMS.
Email questions to the MCS-CIMS inbox.
April 12th, 2022
- Revised IL 2022-23: https://www.hhs.texas.gov/sites/default/files/documents/il2022-23.pdf
- CIMS Part II Webinar on April 26th: https://www.hhs.texas.gov/provider-news/2022/04/04/register-now-april-26-webinar-hhscs-new-cims-part-ii
- Due date for Correcting/Updating Contact Information extended to April 15th:
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 webinarEmail questions about the webinar to your program policy mailbox:
IDD Ombudsman “Client’s Rights & Complaints”
May 28th, 2023
When to Call the IDD Ombudsman
The IDD Ombudsman receives complaints from individuals, family members, and the general public about the care, treatment, or services provided to an individual. Individuals receiving services or family members of the individual may prefer to call the IDD Ombudsman to assist in resolving an issue rather than speaking with their LIDDA service coordinator (SC) or HCS provider.
(In addition, if you are not sure where to make a complaint or who to make a complaint to, as it may not apply specifically to a specific individual in your program, the IDD Ombudsman will generally help you find out who you need to talk to.)
A complaint may be reported to the IDD Ombudsman by anyone by calling 1-800-252-8154 between 8 a.m. and 5 p.m. Monday through Friday.
OR
Email: OmbudsmanIDD@hhsc.state.tx.us.
Online: Submit your question or complaint online
Mail: Texas Health and Human Services Commission
IDD Ombudsman
P.O. Box 13247
Austin, TX 78711-3247
Fax: 888-780-8099
.
For Your Information: Rights Booklet and Handbook For Individuals In The HCS Program
The rights booklet, described in 40 Texas Administrative Code (TAC) §9.190(e)(2) and the rights handbook, described in 40 TAC §4.117(c) may be found on the HHSC website at https://hhs.texas.gov/about-hhs/your-rights/office-ombudsman/hhs-ombudsman-publications.
The booklet and handbook may also be obtained from HHSC by sending an email to OmbudsmanIDD@hhsc.state.tx.us.
Or click on the links below to download a copy
Resources for people with intellectual or developmental disabilities:
- Your Rights in the Home and Community-based Services Program (PDF)
- Your Rights in the Texas Home Living Program (PDF)
- Your Rights in Local Authority Services (PDF)
Resources for anyone looking for help resolving a problem concerning HHSC services:
- Have a question or problem with Texas Health and Human Services Office of the Ombudsman brochure (PDF)
- Office of the Ombudsman Reference Guide (PDF)
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
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”
Presenters
- Lydia Dawson, J.D., Director of Policy, Regulatory and Legal Analysis, ANCOR
- Eileen Maguire, J.D., Attorney & Legal Advisor, Gilliland, Maguire & Harper, P.C.
TMHP: HCS and TxHmL Waiver Programs: Trending Issue Support
May 15th, 2023
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 20
Since May 2, 2022, Home and Community-based Services and Texas Home Living program providers, local intellectual and developmental disability authorities, and financial management services agencies, billing on behalf of Consumer-Directed Services, have been submitting claims and forms to the Texas Medicaid & Healthcare Partnership (TMHP).
DH & ISS Billing
On March 1, 2023, day habilitation was replaced with individualized skills and socialization (ISS). To bill for day habilitation prior to March 1 and ISS after March 1, refer to the following unit information and prorating instructions.
Units:
· Day habilitation is a daily unit with a maximum of 260
· ISS is an hourly unit with a maximum of 1560
· 260 daily units of day habilitation equal 1560 hourly units of ISS
· The 1560 ISS unit maximum covers the extra day for leap year
Prorating instructions:
1. Determine how many days were used for day habilitation. (Example: 55 days used)
2. Subtract the number of days used for day habilitation from 260 (or the number of days requested) to determine the remaining days. (Example: 260 – 55 days used = 205 remaining days)
3. Multiply the remaining days by 6 (derived from dividing 1560 by 260) to determine how many hours remain to bill as ISS. (Example: 205 remaining days * 6 = 1230 ISS hours)
Other areas discussed were:
Dental Claims Units: Providers must bill dental claims with the dollar amount as the units.
Example: If the billed amount is $100, enter “100” as the number of units.
If previous claims were paid incorrectly because the dollar amounts were not billed as units, providers can rebill correctly by performing adjustments on the paid claims. Refer to the “Adjustments” section of the Long-Term Care (LTC) User Guide for TexMedConnect for assistance.
Submitting Transfer Forms: To avoid delays when submitting forms after transfers, the receiving providers should obtain confirmation that a transfer Individual Plan of Care (IPC) form is in Processed/Complete status before proceeding to the subsequent form
TMHP has received feedback from providers indicating additional support is needed. Resolutions regarding the most frequently reported issues may be found by reading the full alert.
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 19
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 18
January 28th, 2023
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 17
Trending Support Issues, Vol. 17: Access to PDF R&S and 835 Electronic R&S Reports, R&S Report Information and Videos
Click on link below for full report
https://www.tmhp.com/news/2023-01-27-hcs-and-txhml-waiver-programs-trending-issue-support-volume-17
Highlights from Vol. 17
Providers are encouraged to use both the PDF version and the American National Standards Institute (ANSI) 835 electronic version of their Remittance and Status (R&S) Reports.
Providers can view and save the PDF version of their R&S Reports through TexMedConnect. The PDF files are available for 90 days following the publication date of the R&S Reports.
To access their ANSI 835 electronic R&S Reports, providers must submit an Electronic Data Interchange (EDI) Agreement and set up ANSI 835 access. In addition, providers must use an approved third-party billing software vendor from the following list. Providers can retrieve their ANSI 835 electronic R&S Reports dating back to when their submitter number was linked to their contract number.
Providers should refer to the 835 Long Term Care Companion Guide for more information about the 835 Electronic R&S Reports.
In addition:
Providers can refer to the Remittance and Status (R&S) Reports for LTC Providers Quick Reference Guide (QRG) for more information.
Additionally, a three-part educational video series is available on TMHP’s HCS and TxHmL YouTube playlist and discusses the following topics:
- General R&S Report information and instructions for account administrators on how to set permissions for users to access R&S Reports (Part 1).
- How to read and understand the first section of the R&S Report: Non-Pending Claims (Part 2).
- How to read and understand the second, third, and fourth sections of the R&S Report: Pending Claims, Financial Summary, and EOB Codes and Descriptions (Part 3).
Approved 3rd party biller list
Don’t forget our friends at Millin Billing are on this list. Contact us at info@twogetherconsulting.com for assistance with getting a demo and discount on your rate.
January 15th, 2023
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 16
Trending Support Issues, Vol. 16: IPC Use as a Template button and Location Code Field on Individual Movement and IPC forms
https://www.tmhp.com/news/2023-01-13-hcs-and-txhml-waiver-programs-trending-issue-support-volume-16
**When creating IPC renewals, the Use as Template button can now be used to populate form data from the original form into the new form. This is incredibly helpful to providers now and less time-consuming.
*Another major issue that slowed down transfers I believe with LIDDA’s and also caused glitches for providers, in terms of wrong locations noted in the dropdown menu and then not being able to revise those location errors was also addressed. See “fix” below:
Effective January 13, 2023, a text box will replace the location code drop-down box on the following IMT and IPC form fields:
· IPC transfers (3608/8582) field 39a: Receiving Program Provider Location Code
· IMTs field 18: Location Code
· IMT Individual Update fields 122: Current Location Code and 123: New Individual Location Code
· IMT LA Reassignment field 111: New Location Code
The manually entered text will be validated upon submission to ensure that the submitted location code is valid for the provider. This enhancement will improve the overall system performance related to the location code fields.
The following item-by-item (IBI) guides have been updated to reflect enhancements:
For further information, contact the TMHP LTC Help Desk at 800-626-4117. Select option 1 and then option 7.
January 12th, 2023
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 15
- Trending Support Issues, Vol 15: If you missed it, know that it includes information about determining your ARPA payments: https://www.tmhp.com/news/2022-12-30-hcs-and-txhml-waiver-programs-trending-issue-support-volume-15
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 14
Trending Support Issues, Vol 14: PEMS Revalidation and Enhancements to updating effective date of some forms : https://www.tmhp.com/news/2022-12-30-hcs-and-txhml-waiver-programs-trending-issue-support-volume-14
December 16th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 13
Since May 2, Home and Community-based Services and Texas Home Living program providers, local intellectual and developmental disability authorities, and financial management services agencies billing on behalf of Consumer-Directed services have been submitting claims and forms to the Texas Medicaid and Healthcare Partnership (TMHP).
TMHP has received feedback from providers and LIDDAs indicating additional support is needed. Resolutions regarding the most frequently reported issues may be found by reading the full alert.
November 20th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 12
Since May 2, Home and Community-based Services and Texas Home Living program providers, local intellectual and developmental disability authorities, and financial management services agencies, billing on behalf of Consumer-Directed Services, have been submitting claims and forms to the Texas Medicaid and Healthcare Partnership (TMHP).
TMHP has received feedback from providers indicating additional support is needed. Resolutions regarding the most frequently reported issues may be found by reading the full alert.
HCS and TxHmL Waiver Programs: Migration Trending Issue Support, Volume 11
The following is a list of common form submission statuses with descriptions and actions needed:
- Pending DADS Review
- Description: The form is pending Texas Health and Human Services Commission (HHSC) long-term care (LTC) staff review.
- Action:
- Forms 8578, 3608, and 8582: For Change LON on Existing Assessment, renewals and revisions, the submitter may need to submit a review packet to the HHSC Utilization Review (UR) department. For questions and to provide supplemental documentation, submitters can contact the HHSC UR department at 512-438-5055 or email deskURLONIPC@hhs.texas.gov.
- 8578, 3608, 8582, and 3615 Forms: For questions and to provide supplemental documentation about enrollments, transfers, or continuation of suspensions, LIDDAs can contact HHSC Program Eligibility and Support (PES) at 512-438-2484.
- 3616 Termination Forms: For questions and to provide supplemental documentation, providers and LIDDAs can contact HHSC Program Eligibility and Support (PES) at 512-438-2484.
- Suspensions Pending….. read more
October 17th, 2022
HCS and TxHmL Waiver Programs: Migration Trending Issue Support, Volume 10
October 7th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 9
Since May 2, Home and Community-based Services and Texas Home Living program providers, local intellectual and developmental disability authorities, and financial management services agencies, billing on behalf of Consumer-Directed Services, have been submitting claims and forms to the Texas Medicaid and Healthcare Partnership.
TMHP has received feedback from providers indicating additional support is needed. Resolutions regarding the most frequently reported issues may be found by reading the full alert
-Preventing claim denials for invalid date spans
Claims billed with date spans may deny with one of the following explanations of benefits (EOBs):
F0126: Claim line items cannot span current fiscal years.
The new state fiscal year (SFY) runs from September 1, 2022, through August 31, 2023. Claims will be denied with EOB F0126 if they are submitted with line item dates of service (DOS) spanning the previous SFY ending August 31, 2022, and the current SFY. Providers and LIDDAs submitting claims with DOS spanning the previous and current SFYs should submit separate claims for each SFY.
F0326: Incorrect number of days billed for this service.
Services that only allow billing for individual DOS may be denied with EOB F0326 if they are billed with date spans. These services should be billed as separate line items for each service date.
-Claims adjustments reminder
Claims that have processed successfully can be adjusted. For instructions on how to adjust claims, refer to the “Adjustment” section of the LTC User Guide for TexMedConnect.
Providers can also adjust a previously adjusted claim in TexMedConnect. For instructions, refer to HCS and TxHmL Waiver Programs: How to Adjust a Previously Adjusted Claim
September 11th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 8
-Termination Forms Submitted by LIDDAs
For clients who have CDS services only, termination forms are submitted by LIDDAs. After form submission, LIDDAs need to contact HHSC Program & Eligibility Support (PES) to acknowledge and review the forms. LIDDAs can contact HHCS PES by calling 512-438-2484, faxing 512-438-4249, or emailing enrollmenttransferdischargeinfo@hhs.texas.gov.
Read more on the following items:
–Long-Term Care Online Portal Sessions Must Be Restarted Daily
–Using the “Resubmit to SAS” Button
Access to Electronic R&S and PDF R&S Reports
August 31st, 2022
Migration Trending Issue Support Vol 7:
August 16th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support Volume 6
–Individual’s residential address in Individual Search
–“Pending LA Review” status and action needed
–Using the correct IMT Form to update the service coordinator (SC)
–HCS and TxHmL call queue
For info on these trending issues see the following link:
https://www.tmhp.com/news/2022-08-16-hcs-and-txhml-waiver-programs-trending-issue-support-volume-6
August 13th, 2022
HCS and TxHmL Waiver Programs: Trending Issue Support Volume 5
Since May 2, 2022, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers, local intellectual and developmental disability authorities (LIDDAs), and financial management services agencies (FMSAs) that bill on behalf of consumer-directed services (CDS) have been submitting claims and forms to Texas Medicaid & Healthcare Partnership (TMHP). TMHP has received feedback from providers indicating that additional support is required.
Here are the latest resolutions to trending issues below:
HCS and TxHmL Call Queue
Status: When contacting TMHP, providers need to select option 1 then option 7 to enter the HCS and TxHmL Waiver Programs queue. The full number is 800-626-4117, Option 1, then Option 7.
Location Code Issue
Resolution: LIDDAs submitting Individual Plan of Care (IPC) transfers for clients were receiving incorrect location codes. This issue has been resolved. Providers that received an incorrect location code need to resubmit the IPC transfer.
See previous Volumes and info below:
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 4
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 3
HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 2
HCS and TxHmL Waiver Programs: Trending Issue Support
Important Claims Submission Information for HCS and TxHmL Programs
LTC Online Portal Dashboard Accessibility Issue Resolved
IPC Forms 3608 and 8582 Issue Resolved
HCS and TxHmL FAQ Updates Available May 9, 2022, and May 23, 2022
Individual Plan of Care (IPC) Training Materials for HCS and TxHmL Waiver Programs
Now Available: HCS and TxHmL Programs Forms and Claims Submissions to TMHP
EVV Updates for the HCS and TxHmL Transition to TMHP for Claims Submission
June 1st, 2002
Resolutions to the most frequently reported issues may be found at the following link for TMHP issues concerning entering IPC’s, dual entry into CARE, submitting claims, and more: “Trending Issue Support” Table
In addition, please see helpful links below including recent HCS/TxHmL FAQ’s in May of 2022.
View previous postings:
- Important Claims Submission Information for HCS and TxHmL Programs
- LTC Online Portal Dashboard Accessibility Issue Resolved
- IPC Forms 3608 and 8582 Issue Resolved
- HCS and TxHmL FAQ Updates Available May 9, 2022, and May 23, 2022
- Individual Plan of Care (IPC) Training Materials for HCS and TxHmL Waiver Programs
- Now Available: HCS and TxHmL Programs Forms and Claims Submissions to TMHP
- EVV Updates for the HCS and TxHmL Transition to TMHP for Claims Submission
Resources on Aging From HHSC
May 15th, 2023
From HHSC
Resources on Aging
Direct Care Careers Connect Coming Soon!
May 15th, 2023
New Tool To Help Providers & Direct Support Staff/Community Attendants With Employment!
HHSC is launching Direct Care Careers Connect to help community attendants and employers connect beginning June 1, 2023.
The online platform will allow community attendants to list work history, skills, certifications, trainings, and other job qualifications. Employers will be able to post job descriptions, job specifications, and other information to help find quality candidates. Employers can also contact job candidates about posted positions.
HHSC does not play a role in the hiring process.
HHSC invites community attendants and employers to use this new online platform at no cost. Alternative terms for community attendants can include: attendant; care attendant; caregiver; direct care staff; direct service worker; direct support; home care attendant; home health aide; patient care assistant; personal care assistant; personal care attendant; special caregiver; care assistant; direct support professional; or direct care staff.
(Host Home/Companion Care Providers would seem to fall under this, but I am unclear at this time. I would contact the email below to ask.)
Email any questions to HHSCOfficeofDisabilityServicesCoordination@hhs.texas.gov.
Long-Term Care Provider Webinar Recording on the End of Continuous Medicaid Coverage (ALF’s, NF’s, ICF’s & HCS)
May 15th, 2023
Recording Available of Webinar For LTC Provider Webinar on the End of Continuous Medicaid Coverage!
HHSC hosted additional live webinars in March and April of 2023, to inform providers about the end of continuous Medicaid coverage.
The webinar provided information about how long-term care providers (including nursing facilities, assisted living facilities, home and community support services agencies, Medicaid waiver providers, and intermediate care facilities for individuals with intellectual and developmental disabilities) can assist their Medicaid clients as continuous Medicaid coverage ends.
This is from the March 29 webinar. A recording is available here.
Email questions to: update@hhs.texas.gov
Entering IPC Revisions to Add Individual Skills and Socialization
May 15th, 2023
Reminder for HCS and TxHmL Providers Concerning ISS on IPC’s
HCS & TxHmL program providers, and LIDDA authorities who are submitting an Individual Plan of Care (IPC) revision to add Individualized Skills and Socialization (ISS) on the IPC plan year.
When entering IPC revisions, if you update the effective date in field 12a, you must click the search icon located next to the date field. This will allow the individual’s data to refresh and prepopulate from the web service based on the new effective date.
Contact the Texas Medicaid and Healthcare Partnership Long-Term Care Help Desk at 800-626-4117 or 800-727-5436 for assistance with submitting forms.
Links to Long-Term Care Bulletins
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:
See link to November 2020 edition below:
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
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:
- IPC Cover Sheet (form 8599, which can be found at https://www.hhs.texas.gov/regulations/forms/8000-8999/form-8599-individual-plan-care-ipc-cover-sheet)
- Copy of signed IPC, all pages
- Person-Directed Plan
- Implementation Plans for all services on the IPC, including breakdown of nursing and behavior hours, if requesting
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:
- A list of items to be purchased, the number of each item needed, and the cost (based on the lowest bid) for each item
- Three bids for each item. Bids from online vendors are acceptable. If using an annual vendor, three bids are needed only if an item costs $500 per month or more; otherwise, annual vendor bid can be submitted.
- Proof of Medicaid denial and professional recommendations, as required in Appendix VII of the HCS Program Billing Requirements
- Please see Section 6100 of the HCS Billing Requirements at https://www.hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/long-term-care/hcs-billing-requirements.pdf for more information.
- 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.
Avoid Recoupment From TMHP (HCS/TxHmL)
May 14th, 2023
On a quarterly basis, TMHP will calculate all services that have been paid through Client Assignment and Registration System (CARE) and TMHP and will recoup services that exceed the authorized IPC amount. (From May 1st, 2023 forward)
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:
- Senator Lois Kolkhorst (Article II): 512-463-0118, 512-463-0360
- Representative Jacey Jetton (Article II): 512-463-0710
mySchedules Training Webinars & Other Resources From MITC
May 13th, 2023
“The labor shortage has made it more important than ever to manage available resources effectively. Allowing existing employees to view and request open shifts can be a big help to over-stressed managers.”
Our friends at MITC have asked us to share some information on one of their very important resources, scheduling software for your shift staff in group homes and employees in general. Please check all their info below and feel free to go to their website for more info on their other products for IDD providers and service providers. https://mitcagencies.com/
myScheduling is just one of the tools from MITC that might be helpful to both IDD providers (i.e. HCS, TxHmL and ICF) as well as Day Hab/ ISS (Individualized Skills and Socialization) and Supported Employment Providers
Check out some of their previously recorded videos at the links below.
Make Scheduling Easier! Let Employees Request Extra Work 01/12/23
Scheduling for Group Homes and In-Home Programs 03/02/23
How a Provider with 2,000 Employees Deployed mySchedules 04/13/23
Download These Fact Sheets:
Integrating mySchedules with Kronos and Other Time and Attendance Systems
Integrating Maps and Mileage into Scheduling
Encouraging Employees to Request Extra Hours
UPCOMING EVENTS & WEBINARS
“MITC’s Staff and Client Solutions are designed specifically for providers serving the I/DD and behavioral health communities.
MITC’s solutions are perfect for agencies that manage group homes, HCBS, or day, vocational, and supported employment programs! Because we’ve worked with thousands of agencies like yours, MITC delivers the most cost-effective solutions that lead to lower payroll costs, higher performance, and compliance with state and DOL regulations.”
Important- Recordings Available From HCS and ICF Webinar COVID-19 from HHSC
May 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 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.
For additional questions, please write to Medicaid_COVID_Questions@hhsc.state.tx.us.
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.
For additional questions, please write to Medicaid_COVID_Questions@hhsc.state.tx.us.
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.
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.
For additional questions, please write to Medicaid_COVID_Questions@hhsc.state.tx.us.
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.
Listen to the webinar recording here.
Email LTCR Policy for the transcrip
COVID-19 ICF/IID Webinar Recording from Feb. 14 Available
A recording of the Feb. 14 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions COVID-19 Q&A with HHSC Long-term Care Regulation and DSHS is available for those who could not attend.
There have been changes made to the PowerPoint based on the information provided by DSHS during the webinar.
Listen to the webinar recording.
Email LTCR Policy for the transcript.
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.
HCS and ICF/IID providers who attended the webinar from HHSC on 1/19/22.
- Recently HHSC re-issued and, in some cases, issued updated policies and guidance for all IDD COVID-related documents.(1/5/22 and 1/7/22 for HCS concerning guidance booklet updates).
- HHSC is working to reorganize the COVID-related information, including COVID flexibilities and Appendix K waivers, on the ICF/IID and HCS home webpages to facilitate ease in access.
- HHSC did communicate the above and other changes and policy clarifications with providers via a webinar on January 19th, 2022, however many questions were still unanswered and attendees were told that questions that were not answered should be addressed in an FAQ from HHSC within 2 weeks of the webinar.
Jan. 19 Recording of HCS and ICF/IID COVID-19 Webinar Available
A recording of the Jan. 19 for Home and Community-based Services and Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions webinar with LTCR is now available.
Listen to the webinar recording here.
Read the webinar slide presentation (PDF).
Email LTCR Policy for the transcript.
EVV (Electronic Visit Verification) Updates
June 2nd, 2023
EVV Resources Updates
HHSC has updated three Electronic Visit Verification resources that are located on the EVV webpage:
- EVV Training Requirements Checklists
- Getting Started with EVV
- Program and Service Requirements for Schedules
EVV Training Requirements Checklists
The EVV Required Training Checklists (PDF) is a resource for those required to use EVV due to all previous and upcoming EVV implementations (personal care services and home health care services). This resource was updated with the following:
- Aligns with EVV Policy Handbook revisions
- Lists training course names
- Describes required trainings
- Defines EVV Portal users, EVV system users and billing staff
- Includes link to sign up for GovDelivery
- Has interactive (fillable form) features to help document completed trainings
Getting Started with EVV
Getting Started with EVV is a guide that lists steps and resources to start using EVV. HHSC has created a single-page guide for each of the following stakeholders:
- Program providers (PDF)
- Financial management services agencies (PDF)
- Consumer Directed Services employers (PDF)
- Service providers (PDF)
- Consumer Directed Services employees (PDF)
Program and Service Requirements for Schedules
The document, Program and Service Requirements for Schedules (PDF), is a resource that describes requirements related to using schedules in the EVV system. HHSC added managed care organization programs to the document.
Email EVV Operations for questions.
May 13th, 2023
Reminder: EVV Claims Matching for HCS and TxHmL Will Begin for Dates of Service Starting May 1, 2023
This is a reminder that Electronic Visit Verification claims matching for Home and Community-based Services and Texas Home Living will begin on May 1, 2023. EVV claims with dates of service of May 1, 2023, and after that do not have an EVV visit match will deny.
For more information about billing updates for HCS and TxHmL, including resources to help avoid future payment denials or recoupments, reference the notice located on the EVV web page, “EVV Claims Matching for HCS and TxHmL Will Begin for Dates of Service Starting May 1, 2023”.
Email EVV Operations for questions.
April 3rd, 2023
Session 4 ORR Schedules Added to TMHP EVV Proprietary Systems Web Page
HHSC created the Session 4 Operational Readiness Review, which is a special abbreviated Electronic Visit Verification Proprietary System Operator onboarding path that supports additional PSO ORRs. This additional path allows program providers and financial management services agencies to onboard with a previously approved proprietary system or a proprietary system that is participating in the Session 3 Standard Path ORR.
The Texas Medicaid and Healthcare Partnership has updated the EVV ORR section of the EVV Proprietary Systems web page to include ORR schedules, requirements and information about the Session 4 ORR.
Email the TMHP EVV PSO inbox for questions.
January 12th, 2023
Electronic Visit Verification (EVV) for Individualized Skills and Socialization (ISS) IL-2023-03 alert letter
Electronic Visit Verification (EVV) for Individualized Skills and Socialization
Program providers must ensure EVV is used when delivering in-home individualized skills and socialization in an own home/family home (OHFH) setting. For dates of services on and after March 1, 2023,
HHSC will deny or recoup a claim for in-home individualized skills and socialization in the own home/family home setting without a matching EVV visit record. For more information about EVV claims matching, refer to the EVV notice, “EVV Claims Matching for HCS and TxHmL Starts March 1, 2023”.
Program providers must input the Texas EVV Attendant ID for in-home EVV individualized skills and socialization OHFH claims.
Email TMHP EVV Operations for questions or refer to the document, HCS and TxHmL Best Practices to Avoid EVV Claim Mismatches (PDF), for more information to help avoid EVV claim mismatches.
to the LTC Billing Crosswalk for more information about Staff ID requirements.
By January 13, 2023, HHSC will update the EVV Personal Care Services Bill Codes Table, located on the HHSC EVV web page, to include the specific Individualized Skills and Socialization billing codes which require EVV. Sign up for EVV GovDelivery to receive updates by email.
For EVV-related contact information, reference the EVV Contact Information Guide for Program Providers and FMSAs (PDF).
To read more, please click on link below, for Information Letter 2023-03 related to ISS automatic service authorizations and EVV
January 2nd, 2023
EVV Vendor Systems Will Display Individualized Skills and Socialization Services Starting 1/1/2023 Before New Authorizations Are Available
This notice is for Home and Community-based Services program providers, Texas Home Living program providers and financial management services agencies required to use Electronic Visit Verification.
As shared in the EVV notice published on Oct. 26, Individualized Skills and Socialization bill codes will replace day habilitation bill codes; therefore, the EVV vendor systems will display 1/1/23 as the effective date for these new services; however, HHSC has extended the date when the new authorizations for Individualized Skills and Socialization services will be available, which is the week of 1/9/23.
Program providers and FMSAs required to use EVV must continue to use EVV.
HHSC will continue posting related updates.
As a reminder, EVV claims matching for HCS and TxHmL starts March 1, 2023. EVV Operations will be posting the updated bill codes, including helpful information to avoid future payment denials or recoupments, following the publication of other HHSC materials.
For other EVV questions, email the EVV Operations inbox.
For questions about Individualized Skills and Socialization services, email the Long-Term Services and Supports Policy inbox.
December 17th, 2022
EVV Training Updates
This notice from HHSC lists Electronic Visit Verification training updates for program providers, financial management services agencies and Consumer Directed Services employers required to use EVV.
Resources from the following training webinars are now available in the HHS Learning Portal by selecting EVV Policy Training – Webinar Recordings FY23:
- Español – EVV Compliance for CDS Employers (PDF) – Aug. 25 non-required training webinar
- Annual EVV Policy Training for Program Providers and FMSAs – Sept. 30 and Oct. 27 webinars
If new to EVV and need to complete the EVV policy training requirement, complete one of the applicable computer-based training courses located in the HHS Learning Portal:
- EVV Policy Training for Program Providers and FMSAs FY23
- Initial EVV Policy Training for CDS Employers FY23
An account is required to access the training webinar resources and CBTs, including to obtain a certificate of completion. Note that a “non-required training” does not include a completion certificate because it is considered optional training. Reference the EVV HHS Learning Portal Guide (PDF) for instructions.
For more information on EVV training requirements, reference section 4200 from the EVV Policy Handbook.
Sign up for GovDelivery to receive EVV updates, such as training updates, by email.
Email EVV Operations for questions.
2023 EVV Operational Readiness Review Session & Business Rules for Proprietary Systems Version 3.0
EVV Operations has posted the following notice: Notice of 2023 EVV Operational Readiness Review Sessions and EVV Business Rules for Proprietary Systems Version 3.0 (PDF).
This notice is to inform program providers and financial management services agencies about the publication of the 2023 Operational Readiness Review Sessions, as well as the new EVV Business Rules for Proprietary Systems Version 3.0.
EVV Guidance on Program and Service Requirements for Schedules
HHSC has published the document, Program and Service Requirements for Schedules (PDF), under the Resources section on the Electronic Visit Verification web page. This document describes HHSC requirements related to using schedules in the EVV system.
Email HHSC EVV Operations for questions.
December 1st, 2022
Reminder for STAR+PLUS, STAR Kids and STAR Health: New EVV Bill Codes and Modifier Combinations Effective Dec. 1
As a reminder, starting Dec. 1, new Electronic Visit Verification personal care services Healthcare Common Procedure Coding System and modifier combinations will be effective for:
- STAR+PLUS
- STAR Kids
- STAR Health
Refer to HHSC’s Oct. 31 notice for more information.
Contact your managed care organization for questions about these updates. Refer to the last page of the EVV contact guide (PDF) for MCO contact information.
December 1st, 2022
HCS and TxHmL Updates
The effective dates were updated for HCS and TxHmL services.
Refer to the bill codes table’s revision history dated Dec. 1, 2022, for more information.
For questions, email EVV Operations.
October 16th, 2022
Potential Electronic Visit Verification Changes Coming in 2023
The purpose of this notice is to inform stakeholders that HHSC’s contract for the current Electronic Visit Verification vendor systems (AuthentiCare and Vesta EVV) is scheduled to expire on Aug. 31, 2023.
On April 26, 2022, HHSC posted a competitive solicitation on the Electronic State Business Daily for EVV System Management Services. Contractor responsibilities will include:
- Providing and managing a single EVV vendor system
- Review and approval of provider-operated EVV proprietary systems If you have an outside vendor (proprietary vendor), these will be reviewed as well.
- Coordinating EVV system integration with the EVV aggregator
- Providing operational and technical support for the functions listed above
Notification of contract award is anticipated in March 2023.
HHSC, at its sole discretion, may publish updates about the anticipated award date to the Procurement Forecast on the HHS Procurement Opportunities web page. Respondents are responsible for periodically checking the ESBD and the HHSC Procurement Forecast web page for updates.
HHSC must maintain the confidentiality and integrity of the procurement process; therefore, no additional information is available at this time. HHSC will provide more information in future announcements.
Email questions about this solicitation to Andrick Reese.
September 25th, 2022
EVV Updates for HCS and TxHmL Program Providers and FMSAs
HHSC and the Texas Medicaid and Healthcare Partnership posted helpful information for Home and Community-based Services program providers, Texas Home Living program providers and financial management services agencies required to use Electronic Visit Verification.
HHSC Notice
This notice is to help program providers and FMSAs that are receiving EVV mismatches for Day Habilitation services.
Refer to the Sept. 15 notice for information on billing requirements, such as which Day Habilitation bill codes to use.
TMHP Notice
This notice provides information about EVV requirements for In-Home Day Habilitation and about EVV claims matching starting Nov. 1 for HCS and TxHmL.
Refer to the Sept. 19 notice for more information and resources.
Email EVV Operations for questions.
September 25th, 2022
EVV Claims Matching Refresher for HCS and TxHmL
Electronic Visit Verification claims matching for Home and Community-based Services and Texas Home Living will begin for dates of service starting Nov. 1.
To help prepare, the Texas Medicaid and Healthcare Partnership will host a refresher webinar on Oct. 13, for:
- HCS program providers
- TxHmL program providers
- Financial management services agencies
Refer to TMHP’s Sept. 15 notice for more information and to registerl
Click here for more information
September 18th, 2022
EVV Compliance Job Aids Updated
The Electronic Visit Verification Compliance Job Aids have been updated. They are in the compliance section on the EVV web page.
The job aids were simplified and provide updated information about the following EVV Compliance standards:
- EVV Usage Scores and reviews
- Required free text reviews
- Landline phone verification reviews
August 31st, 2022
Annual EVV Policy Webinars for Program Providers & FMSAs
July 28th, 2022
EVV Portal and Training Updates
Texas Medicaid and Healthcare Partnership updated the Electronic Visit Verification Portal and related training materials on July 14.
Refer to the EVV Portal and Training Updates notice on TMHP’s EVV webpage for more information.
July 5th, 2022
EVV Claims for HCS and TxHmL Will Deny for Dates of Service Starting Sept. 1
HHSC has extended the start date when Electronic Visit Verification claims for Home and Community-based Services and Texas Home Living will deny for no matching EVV visit. This will begin for the dates of service of Sept. 1, 2022, and after.
The extension gives HCS and TxHmL program providers and financial management services agencies more time to improve their claims matching. Texas Medicaid and Healthcare Partnership will provide more outreach and training on this topic. Trainings will be announced at a future date.
Refer to the HCS and TxHmL Best Practices to Avoid EVV Claim Mismatches (PDF) for technical guidance.
HCS and TxHmL EVV claims must continue to be submitted through the Client Assignment and Registration System or TMHP.
- Submit EVV claims to CARE for dates of service before May 1, 2022.
- Submit EVV claims to TMHP for dates of service of May 1, 2022, and after.
Program providers, FMSAs and Consumer Directed Services employers must continue to use EVV during this period. However, HCS and TxHmL claims will not be denied for an EVV mismatch. HCS and TxHmL claims during this period are still subject to HHSC provider fiscal compliance reviews conducted by HHSC Provider Fiscal Compliance..
Email EVV Operations for questions.
July 1st, 2022
EVV Claims for HCS and TxHmL Will Deny for Mismatched Visits Starting July 1
Starting July 1, Electronic Visit Verification claims for Home and Community-based Services and Texas Home Living must have a matching EVV Visit, or claims will deny.
Refer to the June 20 notice for more information and resources.
Email EVV Operations for questions.
June 12th, 2022
EVV Portal and Training Updates
Texas Medicaid and Healthcare Partnership updated the Electronic Visit Verification Portal and related training materials on June 9.
There are also two new visit rejection codes related to EVV system transfers.
Refer to the EVV Portal and Training Updates notice on TMHP’s EVV webpage for more information.
June 6th, 2022
EVV Policy Handbook Revision and Training Updates
The Electronic Visit Verification Policy Handbook has been revised.
Revisions include:
- Adding new sections for the Consumer Directed Services option.
- Updating Schedules policy.
- Updating Visit Maintenance Reduction Features policy.
These revisions are effective June 1 and are outlined in the new revision log (PDF), located on the EVV webpage.
The handbook’s policies include EVV standards and policy requirements for:
- Program providers
- Financial Management Services Agencies
- Consumer Directed Services employers
- Payers, such as HHSC and managed care organizations
Computer-based training on the HHS Learning Portal were updated to include the policy revisions.
- EVV Policy Training for Program Providers and FMSAs CBT
- Initial EVV Policy Training for CDS Employers CBT
- Note: The updates to the Spanish CBT will publish in June.
Email HHSC EVV Operations for questions about this notice.
May 30th, 2022
EVV Claims Matching for HCS and TxHmL Will Resume July 1
Electronic Visit Verification claims matching will resume for all Home and Community-based Services and Texas Home Living billing code combinations with dates of service of July 1, 2022 or after.
HHSC will post another notice with more information and resources to avoid EVV claims mismatches before July 1, 2022.
Email EVV Operations for questions about this notice.
May 8th, 2022
EVV Portal and Training Updates
Texas Medicaid and Healthcare Partnership updated the Electronic Visit Verification Portal and related training materials on April 29.
Refer to the EVV Portal and Training Updates notice on TMHP’s EVV webpage for more information.
Email TMHP EVV Operations with questions
March 7th, 2022
EVV Notice for HCS/TxHmL Program Providers
The migration of Home and Community-based Services (HCS) and Texas Home Living (TxHmL) forms and claims entry to Texas Medicaid & Healthcare Partnership (TMHP) has been moved from March 1, 2022, to May 1, 2022. The postponement allows more time for program providers to set up the necessary TMHP accounts and take relevant training courses. HCS and TxHmL program providers must continue to use the Client Assignment and Registration (CARE) system to submit claims using existing billing code combinations for service groups 12 and 15 for dates of service prior to May 1, 2022.
HHSC is aware that some program providers updated authorizations in the EVV systems to reflect the new billing code combinations for service groups 21 and 22 that were scheduled to take effect March 1. To avoid the re-entry of authorizations, HHSC and TMHP will take the following actions:
- By March 4, the EVV Aggregator will accept billing code combinations for service groups 12, 15, 21 and 22 on EVV visits for dates of service through April 30, 2022, to prevent visit rejections.
- For dates of service on or after May 1, 2022, the EVV Aggregator will only accept billing code combinations for service groups 21 and 22.
- Turn on the EVV07 claims matching bypass for all HCS and TxHmL billing code combinations to avoid claim denials through May 31, 2022.
- Claims matching for all HCS and TxHmL billing code combinations will resume June 1, 2022.
- Publish an updated EVV Service Bill Codes Table to reflect these changes.
HCS and TxHmL claims will not be denied for an EVV mismatch. HCS and TxHmL claims during this period are still subject to HHSC provider fiscal compliance reviews conducted by HHSC Provider Fiscal Compliance.
**For visits that have been rejected by the aggregator due to incorrect billing code combinations, program providers must re-export the visit and ensure it is accepted in the EVV aggregator prior to submitting claims.
Please refer to HHSC’s ‘Continue Submitting Claims and Forms Using CARE System Until May 1, 2022’ notice for more information.
For technical questions related to the EVV Aggregator, contact TMHP. For other general EVV inquiries, contact HHSC EVV Operations.
March 3rd, 2022
EVV Policy Handbook Revisions Now Available
HHSC revised sections and appendices of the Electronic Visit Verification Policy Handbook.
The handbook includes EVV standards and policy requirements for:
- Program providers.
- Financial Management Services Agencies.
- Consumer Directed Services employers.
- Payers, such as HHSC and managed care organizations.
The revisions are effective March 1 and are briefly described in the 22-2 notice. For more information about the policy changes, refer to the new revision log (PDF) located on the EVV webpage.
Email HHSC EVV Operations with questions.
February 28th, 2022
EVV Portal and Training Updates
Texas Medicaid and Healthcare Partnership updated the Electronic Visit Verification Portal and related training materials on Feb. 28.
For more information, refer to the EVV Portal and Training Updates article on TMHP’s EVV webpage.
For questions, email TMHP EVV Operations.
January 8th, 2022
EVV Policy Handbook Revisions – Jan. 7th, 2022
HHSC revised parts of the Electronic Visit Verification Policy Handbook. These revisions are effective Jan. 7 and are listed in Revision Notice 22-1.
The handbook’s policies include EVV standards and policy requirements for:
- Program providers.
- Financial Management Services Agencies.
- Consumer Directed Services employers.
- Payers, such as HHSC and managed care organizations.
For questions, email HHSC EVV Operations.
November 21st, 2021
EVV Portal and Training Updates for November 2021
Texas Medicaid and Healthcare Partnership made improvements to the EVV Portal and related training materials on Nov. 11.
For more information, access the November 2021 EVV Portal and Training Updates article on TMHP’s EVV webpage.
FYI- When you click on the link above for updates from HHSC, please be sure to scroll to the bottom and click on “accept” as this is a disclaimer page. You must do this 1st. I have received some comments that some providers get confused when they see this page on the EVV website first pop up and they think they are on the wrong page, or there is a problem with the website page, etc…
Email TMHP with questions about these updates.
November 18th, 2021
Revised EVV Policy Handbook Now Available
The Electronic Visit Verification Policy Handbook was revised.
The handbook’s policies are effective Nov. 1, 2021 and include EVV standards and policy requirements for:
- Program providers
- Financial Management Services Agencies
- Consumer Directed Services employers
- Payers such as HHSC and managed care organizations
The handbook replaces policies previously on the HHSC EVV webpage. See EVV Policy Handbook Revisions – November 2021 (PDF) for differences between previously published policies and the revised handbook.
The following computer-based training courses on the EVV Training page of the HHS Learning Portal now reflects the revised EVV Policy Handbook:
- Initial EVV Policy Training for CDS Employers
- EVV Policy Training for Program Providers and FMSAs
Use the applicable checklist within EVV Training Requirements Checklist (PDF) for EVV training requirements and completion options.
Email questions to HHSC EVV Operations.
November 17th, 2021
EVV Visit Maintenance Unlock Request Updates
HHSC published EVV Visit Maintenance Unlock Request spreadsheet updates.
These updates let the user request corrections to data element(s) on an EVV visit transaction(s) after the visit maintenance time frame has expired.
Program providers, Financial Management Services Agencies and Consumer Directed Services employers must use the request spreadsheets found on the EVV webpage.
The updates to the program provider and FMSA Request (Excel) include:
- New fields
- Added drop-down lists to applicable fields
- Updated and simplified field headers
- Revised instructions to:
- Reflect EVV policy updates
- List detailed steps and notes to complete the Request
The new Request for Consumer Directed Services employers (Excel) include:
- A new request spreadsheet for CDS employers who selected Option 1 on Form 1722, Employer’s Selection for EVV Responsibilities, to complete visit maintenance. This includes:
- Drop-down lists for applicable fields
- Sections for CDS employers and payers to complete
- Instructions reflect:
- EVV policy updates
- Detailed steps and notes to complete the request
Review the instructions on the spreadsheets for more information.
Email questions to your payer, either HHSC or a managed care organization
July 4th, 2021
EVV Visit Maintenance Policy Now Available
The Electronic Visit Verification Visit Maintenance Policy (PDF) is now available on the HHSC EVV webpage. The policy is effective July 1, 2021 and:
- Requires the program provider, Financial Management Services Agency or Consumer Directed Services employer to ensure each EVV visit transaction is complete, accurate and validated.
- Incorporates the Visit Maintenance: Last Visit Maintenance Date Policy.
- Incorporates the Visit Maintenance Unlock Request Policy.
- Includes the new visit maintenance time frame of 95 calendar days. (previously 60 calendar days) from the date of service delivery.
Email questions to HHSC EVV Operations at EVV@hhs.texas.gov.
July 4th, 2021
HHSC EVV Webpage Updates Now Available
The Texas Health and Human Services Commission updated and archived web sections and content, updated and added additional information related to the 21st Century Cures Act (Section 12006) and added new resources for the following Electronic Visit Verification webpages:
- EVV Home page,
- EVV Consumer Directed Services Option,
- EVV Cures Act,
- EVV Training and
- EVV Proprietary Systems.
Email questions to HHSC EVV Operations at EVV@hhs.texas.gov.
July 3rd, 2021
Revised EVV Visit Transaction Rejection Guide Now Available
The Electronic Visit Verification Visit Transaction Rejection Guide (PDF) was revised and is now available.
The guide provides step-by-step instructions for program providers and Financial Management Services Agencies to identify and correct issues that result in transaction rejections in the EVV system.
The guide is published on TMHP’s EVV Training webpage.
April 17th, 2021
EVV Policy Training for CDS Employers Now Available in Spanish
The computer-based training course, Initial EVV Policy Training for CDS Employers, is available in Spanish on the HHS Learning Portal.
To translate the HHS Learning Portal to Spanish, select Español from the drop-down menu in the upper left-hand corner of the webpage.
The policy training is tailored to the selection on Form 1722, Employer Selection for Electronic Visit Verification Responsibilities.
Registrants are not required to complete the Form 1722 Pre-Course Survey.
Follow the instructions throughout the course to complete and receive certification.
Email the HHSC EVV Mailbox for questions about EVV policy training.
March 16th, 2021
HHSC Publishes EVV Requirements of Signatures on Enrollment Documentation (IL 2021-13)
HHSC has published IL 2021-13, EVV Notification Requirement (PDF), replacing IL 2020-01.
The letter addresses revisions on instructing LIDDAs on the requirements of signatures on enrollment documentation.
It also addresses new activity requirements for HCS, TxHmL, CDS program providers and LIDDA service coordinators.
For questions, email HCS Policy or CDS.
March 10th, 2021
Temporary EVV Policies for the Feb. 2021 Severe Winter Weather
In response to the recent severe winter weather, HHSC issued Temporary EVV Policies for Severe Winter Weather (PDF).
The flexibilities are for dates of service from Feb. 10, 2021 through Feb. 24, 2021.
The flexibilities are for program providers, financial management services agencies and consumer directed services employers required to use EVV.
Email questions to the HHSC EVV Mailbox.
February 7th, 2021
EVV Refresher Training on Feb. 19
The Texas Health and Human Services Commission and Texas Medicaid & Healthcare Partnership are hosting an Electronic Visit Verification webinar.
This training is a refresher and covers topics for Home and Community-based Services program providers, Texas Home Living program providers and financial management services agencies who submit EVV claims for HCS and TxHmL EVV-required services.
The training is not required and is not a substitute for annual EVV training requirements.
Certificates of completion will not be issued.
Attendees will have the opportunity to submit questions throughout the training.
Both HHSC and TMHP will conduct a live question and answer session.
The registration link is below and provides details, such as agenda topics.
HCS/TxHmL EVV Refresher Training – Claims Submission/Claims Matching Policies & Best Practices to Avoid EVV Claim Mismatches
Friday Feb. 19
10 a.m. – Noon
Register for the webinar.
Reminder: Entering Schedules for EVV-Required Services
The Electronic Visit Verification system allows Home and Community-based Services, Texas Home Living program providers, CDS Employers and Financial Management Services Agencies to enter schedules for EVV-required services. This is not an HHSC requirement. Program Providers, FMSAs and CDS employers can choose to enter a schedule into the EVV system.
EVV is only required for the following services:
- Community First Choice Personal Assistance Services/Habilitation
- In-Home Day Habilitation in own home or family home settings
- In-Home Respite in own home or family home settings
Email hcspolicy@hhsc.state.tx.us or txhml@hhsc.state.tx.us with questions.
January 24th, 2021
EVV Portal and Training Updates for January
On Jan. 14, Texas Medicaid & Healthcare Partnership made improvements to the Electronic Visit Verification Portal by updating the EVV Reason Code Usage and Free Text Report and updated the related training materials.
Read the TMHP article EVV Portal Improvements and Training Updates for details.
Email TMHP with questions about these updates.
January 24th, 2021
HCS & TxHmL Best Practices to Avoid EVV Claim Mismatches for CFC PAS/HAB Services
HHSC has published Best Practices to Avoid Electronic Visit Verification Claim Mismatches for Home and Community-based Services and Texas Home Living (PDF) program providers and financial management services agencies.
The best practices help HCS and TxHmL providers avoid claim denials related to EVV.
The best practices are linked above and on the HHS EVV Training webpage in the Best Practices section.
Email questions about EVV policy to HHSC EVV.
January 18th, 2021
EVV Compliance Oversight Reviews Delayed for EVV Usage and Misuse of EVV Reason Codes
HHSC told managed care organizations to delay compliance oversight reviews for EVV Usage and Misuse of EVV Reason Codes. Evaluation of visit data collected during the grace period ensures the compliance measures continue to align with current EVV policy.
EVV Usage and Misuse of EVV Reason Codes reviews for the compliance grace period ended on Aug. 31, 2020 for:
- EVV visits with Sept. 1, 2019 to Aug. 31, 2020 dates of service.
- Program providers required to use EVV by state law before the Cures Act Implementation identified on pages 3 and 4 of the Programs and Services Required to Use EVV (PDF) document.
Next Steps
- HHSC will notify program providers 90 calendar days before reviews begin for EVV Usage and Misuse of EVV Reason Codes for EVV visits with dates of service on and after Sept. 1, 2020.
- HHSC and MCOs will continue reviews for EVV Landline Phone Verification and Required Free Text.
- Program providers can use the EVV Usage Report, and EVV Reason Code Usage and Free Text Report in the EVV Portal to track these compliance measures.
Program providers can contact their payer or email HHSC EVV with their questions or concerns.
January 10th, 2021
EVV Notification Requirement for HCS/TxHmL Program Providers
HHSC has published IL 2021-01 Electronic Visit Verification Notification Requirement (PDF).
The letter informs HCS and TxHmL program providers they are now required to use the EVV system for CFC PAS/HAB, in-home respite, and day habilitation provided in the home of an individual who has a residential location of “own/family home.”
Texas Government Code, §531.024172(c), requires that HHSC inform an individual who receives a service requiring the use of EVV that the individual is required to comply with the EVV system. HHSC has developed a form for providers to comply with this statute.
The Electronic Visit Verification Responsibilities and Additional Information form is included with the IL 2021-01 (PDF).
January 4th, 2021
EVV for HCS and TxHmL providers has gone live since January 1, 2021 (includes CDS and FMSA’s)
Resources for providers, including escalation processes, regarding EVV questions & concerns:
- HHSC EVV Operations and TMHP have developed two Contact Guides:
- To assist program providers and FMSAs identify and correct EVV visit transaction rejections, TMHP created the EVV Visit Transaction Rejection Guide (PDF).
- Email HHSC EVV Operations, Electronic_Visit_Verification@hhsc.state.tx.us, regarding:
- EVV Policy and Compliance Questions
- General EVV Inquiries and Complaints
- Good idea to CC your provider association, if you are a member (PPAT, PACSTX..)
- Email TMHP, EVV@tmhp.com, regarding TMHP issues and EVV vendor complaints/issues.
- Copy Evan Wilkerson on urgent TMHP or EVV vendor issues.
December 20th, 2020
Cures Act EVV:
Preparing for Jan. 1, 2021 Implementation
HHSC will require Electronic Visit Verification for all Medicaid personal care services beginning on Jan. 1, 2021. This requirement is mandated by the federal 21st Century Cures Act. If HHSC does not comply, Texas will lose federal funding for Medicaid services.
Beginning Jan. 1, 2021:
- Document all delivery visits for an EVV-required service in the EVV system. EVV-required services on the Programs, Services, and Service Delivery Options Required to Use EVV (PDF) document.
- An EVV-required service claim will be paid only if:
- The EVV visit transaction that supports the claim is accepted into the EVV Portal before claim submission.
- The claim receives an “EVV01 – EVV Match” result code in the EVV Portal after the claims matching process is performed.
Program providers and financial management services agencies must complete the following before Jan. 1, 2021, to avoid impacts to EVV claims payment:
- EVV system onboarding. This includes system setup and training.
- If an EVV vendor system is selected from the state vendor pool, the EVV vendor provides the training. Refer to the TMHP EVV Vendors webpage for more information about EVV vendors and their contact information.
- If an EVV proprietary system is selected, the program provider or FMSA handles system training.
- EVV training requirements outlined in the Cures Act EVV: Training Requirements Checklists (PDF).
- Document all visits for EVV-required services in the EVV system.
CDS employers must complete the following before Jan. 1, 2021, to avoid delays in payment to their CDS employees:
- Form 1722, Employers Selection for Electronic Visit Verification Responsibilities. Submit the signed form to their FMSA, which is the company that helps with CDS employee payroll.
- EVV system onboarding. CDS employers can contact their FMSA to complete onboarding and schedule training.
- EVV training requirements outlined in the Cures Act EVV: Training Requirements Checklists (PDF).
- Employees must start documenting all visits for EVV-required services in the EVV system.
HHSC is providing the following support to program providers, FMSAs, and CDS employers. This is to reduce impacts to claims payment and payment to CDS employees as they adjust to the new EVV requirements.
- If a visit is not captured through an electronic verification method, enter the visit manually into the EVV system and confirm acceptance into the EVV Portal to avoid claim denials. Instructions for manually entering a visit are posted in the following locations:
- DataLogic/Vesta EVV system.
- First Data/AuthentiCare EVV system in the “Custom Links” section.
- HHSC has published Best Practices to Avoid EVV Claim Mismatches (PDF) to help program providers and FMSAs ensure a claim is not denied for reasons related to EVV.
- HHSC has issued the 90 Day Visit Maintenance Temporary Policy (PDF). extending the time to complete visit maintenance for dates of service between Jan. 1, 2021 and March 31, 2021.
- An EVV compliance grace period will be applied for one year to all Cures Act EVV Expansion services with dates of service between Jan. 1, 2021 and Dec. 31, 2021 for the compliance measures listed in EVV Compliance Oversight Reviews Policy (PDF).
The EVV Contact Information Guides provide points of contact for EVV-related questions and issues:
- CDS Employer EVV Contact Information Guide (PDF)
- Program Provider and FMSA Contact Information Guide (PDF)
Visit the HHS EVV website for more information.
November 28, 2020
HCS and TxHmL CARE Service Authorization instructions for EVV
HCS and TxHmL are required to manually enter each individual’s service authorization in the EVV Vendor System.
Providers can find instructions here on how to find their service authorizations in CARE.
If additional assistance is needed after the service authorization is obtained, program providers can contact their EVV vendor for further instructions.
Existing EVV Users: Temporary EVV Policies for COVID-19 to End Dec. 31
HHSC is extending the Temporary EVV Policies for COVID-19 (PDF) through Dec. 31, 2020 for program providers currently required to use Electronic Visit Verification. HHSC will end the temporary policies after Dec. 31, 2020.
Program providers submitting EVV claims for dates of service on and after Jan. 1, 2021:
- Must ensure a matching EVV visit transaction is accepted in the EVV Portal before billing the claim, or the claim will be denied.
- Will no longer receive an EVV07 match code in the EVV Portal.
- Will no longer have 180 days to complete visit maintenance.
Reminder: HHSC extended the practice period for the Cures Act Expansion. Claims for EVV services included in the Cures Act Expansion, will be denied without a matching EVV visit transaction for dates of service on and after Jan. 1, 2021.
Best Practices for Temporary EVV Policies for COVID-19
Program providers should continue to follow the Best Practices for Temporary EVV Policies for COVID-19 (PDF) to avoid recoupments for claims submitted between March 21, 2020 and Dec. 31, 2020.
Contact your payer for questions or email HHSC EVV.
HCS and TxHmL Program Providers Required to Select an EVV Vendor | ||||||||
11/18/2020 | ||||||||
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Deadline Approaching Soon!!
Remember everyone: Effective Dec. 1, HHSC will require HCS and TxHmL program providers to use EVV for the following services:
- Community First Choice Personal Assistance Services/Habilitation (CFC PAS/HAB)
- In-Home Respite
- In-Home Day Habilitation (Own Home or Family Home only)
HCS and TxHmL program providers are required to select an EVV vendor and complete EVV training to meet the Dec.1 deadlines. The requirement to select an EVV vendor and complete training applies to all contracted HCS and TxHmL program providers.
Beginning Dec. 1, 2020, service claims for CFC PAS/HAB will be denied by the claims adjudication system and not paid by HHSC if the program provider has not onboarded with an EVV vendor.
Click here to read IL 20-07 (PDF) for more information about selecting an EVV vendor and completing training to be EVV-compliant by the Dec. 1 deadline.
Contact EVV if you have questions about EVV requirements.
Oct. 11th, 2020
EVV Revised Policies Effective Oct. 1
HHSC has revised the following electronic visit verification policies, effective Oct. 1. The information is for program providers and financial management services agencies. It is on the Policy section of the HHS EVV webpage.
The policy:
- Includes additional EVV claims match result codes
- Identifies exceptions to the claims matching process
Claims Submission Policy (PDF)
- The policy includes detailed information about the requirement to submit claims for EVV-required services to the appropriate HHSC claims management system.
- The EVV Billing Policy has been incorporated into the policy.
Email HHSC EVV with your questions.
Oct. 11th, 2020
Updated EVV Service Bill Codes Table Effective Oct. 1
The EVV Service Bill Codes Table is updated effective Oct. 1. The table is on the HHS EVV webpage in the Service Bill Codes Table section. See:
- Below for the major updates
- The Revision History in the table for a complete list of the changes
Program providers and FMSAs can refer to the table for the list of EVV-relevant services and bill code information to avoid EVV visit transaction rejections and EVV claim mismatches.
Units Matching
The updated table shows that during the EVV claims matching process for dates of service on and after Oct. 1, billable units on the EVV visit transaction will be matched to billed units on the claim for:
- EVV-relevant services delivered through the service responsibility option in Managed Care and fee-for-service Long-Term Care programs.
- Community First Choice Personal Assistance Services/Habilitation in the Community Living Assistance and Support Services program (Service Group 2, Service Code 10CFC T2026).
Home and Community-based Services and Texas Home Living Programs
- The table clarifies the EVV Requirements for In-Home Day Habilitation in the HCS Program when In-Home Day Habilitation and In-Home Respite services are provided in a member’s own home or family home setting.
- The “Claims Place of Service” column in the “CARE LTC FFS” tab only includes place of service code 12 (Home Location) because EVV is only required to capture services that need an in-home visit.
HHSC is issuing this guidance from CMS to Home and Community-based Services program providers. It clarifies electronic visit verification requirements for in-home day habilitation.
All service events occurring on or after Dec. 1, 2020, for an EVV-required service, must be captured in the EVV system and accepted into the EVV Aggregator.
EVV is not required for In-Home Day Habilitation provided to someone in a:
- Three or four-person home
- Host home
- Companion care residential setting
EVV is only required for the following services:
- Community First Choice Personal Assistance Services/Habilitation
- In-Home Day Habilitation in own home or family home settings
- In-Home Respite in own home or family home settings
See IL 20-07 Electronic Visit Verification in the HCS and TxHmL Program (PDF) for information about EVV requirements.
Additional Guidance on Day Habilitation Services
Program providers billing claims for In-Home Day Habilitation services requiring EVV will continue to use the current claims procedure code, T2020. The EVV Service Bill Codes Table lists this code on the HHS EVV website.
HHSC is developing separate bill codes for Out-of-Home Day Habilitation and will provide guidance before implementing the new codes.
Email hcspolicy@hhsc.state.tx.us with questions.
No EVV For In-Home DH: 3 & 4-bed Homes or Host Homes
August 20th, 2020
HHSC just informed the three IDD associations that it received clarification from CMS that EVV will not be required for in-home day habilitation delivered in a three- or four-bed home or host home. HHSC will send notice regarding this to all affected stakeholders. This does however mean that In-Home DH provided in an individual’s “Own Family Home” will still require staff to utilize EVV.
CURES Act EVV Training is Underway for HCS/TxHmL Providers
Program providers and FMSAs affected by the Cures Act EVV expansion must complete EVV policy and EVV Portal training before Dec. 1, 2020, and then annually. See the EVV Required Training Checklist (PDF) for more information.
To meet the training requirement, program providers and FMSAs attending these webinars must:
- Register for Session 1.
- Register for Session 2.
- Attend both sessions from start to finish.
To register, click the links below:
FMSAs
- Session 1 – June 2, 2020 – 8:30 a.m. to 12:30 p.m.
- Session 2 – June 3, 2020 – 8:30 a.m. to 12:30 p.m.
HCS/TxHmL
Additional Training Opportunities
Program providers and FMSAs can also meet training requirements by completing computer-based training online in the HHSC Learning Portal and TMHP Learning Management System. HHSC and TMHP are planning additional live training events this fall and will provide more information when available.
Email TMHP for questions about registration or the EVV Portal.
Email questions about EVV training requirements.
For more Cures Act information, visit the HHS EVV Cures Act webpage.
If you miss the EVV training dates, you may take them on the HHSC learning portal:
https://learningportal.dfps.state.tx.us/
Please go to HHSC’s page on Electronic Visit Verification for the latest information/ updates to EVV. Please see Training & Joint Training pages from HHSC as well!
https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/resources/electronic-visit-verification
Updated Timeline for Cures Act EVV Expansion
The updated timeline for expanding the Cures Act EVV requirement to all Medicaid personal care services is now available on the HHS Cures Act EVV website.
The timeline includes new information and resources about the EVV Practice Period beginning July 1, completing training requirements, and more.
This information is for Cures Act program providers and FMSAs (PDF) required to use Electronic Visit Verification by Jan. 1, 2021.
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Providers currently required to use EVV must continue to use EVV under state law and HHSC policy. See the Programs and Services Currently Required to Use Electronic Visit Verification (PDF)
For questions about EVV vendors, email evv@TMHP.com
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New EVV Proprietary System Onboarding Documents Available
TMHP has posted new information about the EVV proprietary system onboarding process on the TMHP EVV Proprietary Systems webpage.
The documents located in the Onboarding section provide an overview of the approval process that a program provider or FMSA must complete before using their own EVV proprietary system. For more information, refer to the article on the TMHP EVV website (PDF).
Resources
- Contact: Electronic_Visit_Verification@hhsc.state.tx.us
- Website: HHSC EVV Cures Act
Trainings Available:
EVV Policy Training (Provided by your payer)
- The HHSC EVV Policy computer-based training (CBT).
- The MCO Policy training. Contact your MCO for EVV Policy training opportunities.
EVV Aggregator and EVV Portal Training (Provided by TMHP)
There will also be instructor-led trainings (EVV Roadshow) in October. Find the schedule and register on the HHS Learning Portal.
Additional training resources are available on the HHSC EVV website and the TMHP EVV Provider Training webpage.
For questions about this alert, email Electronic_Visit_Verification@hhsc.state.tx.us.
Online, interactive EVV training courses are available
in the HHS Learning Portal and TMHP Learning Management System. Completing these courses help program providers meet EVV training requirements.
The HHS Learning Portal includes training about HHSC EVV Policy.
The TMHP Learning Management System includes training about:
- EVV Vendor Selection
- EVV Portal
- EVV Portal Standard Reports and Search Tools
- EVV Claims Submission and Billing
Termination of Waiver Services Due to Denial of Medicaid Eligibility
May 12th, 2023
Important Reminder: Denial of Medicaid Eligibility
HHSC has published IL2023-16 Termination of Waiver Services Due to Denial of Medicaid Eligibility.
On Dec. 29, 2022, Congress passed the 2023 Consolidated Appropriations Act, which separated continuous Medicaid coverage requirement from the Public Health Emergency declaration. The requirement for states to maintain continuous Medicaid coverage ended as of March 31, 2023. States may begin disenrolling members effective Apr. 1, 2023.
HHSC must conduct a full redetermination and allow members 30 days to respond to renewal packets or requests for information. If an individual enrolled in a waiver program is no longer eligible for Medicaid, the individual’s waiver program services will also end. This IL also includes information on how to help individuals prevent the loss of waiver services and how to monitor loss of Medicaid eligibility.
If you have questions about the termination of Medicaid eligibility, please call 2-1-1 or email update@hhs.texas.gov.
If you have questions about the termination of an individual’s CLASS, HCS, or TxHmL services, please call the IDD Program Eligibility and Support message line at (512) 438-2484.
If you have questions about the termination of an individual’s DBMD program services, please call the IDD Utilization Review message line at (512) 438-4896.
Infection Control Resources (2023 Update)
May 2nd, 2023
Infection Control Resources from HHSC
- Infection Prevention and Control Measures for Common Infections in LTC Facilities (PDF)
- Infection Control Basics & PPE Training for Essential Caregivers (PDF)
- Helping Individuals with Intellectual Disabilities and Related Conditions Prevent the Spread of COVID-19 (PDF)
- Long-term Care COVID-19 Vaccination Options (PDF)
Resources Created by HHSC
- Evidence-Based Best Practices: Infection Control is a guide for developing a facility-wide system for infection prevention and control.
- Quality Monitoring Program Immunizations web page includes information for developing a system for immunizations, as well as the current CDC guidelines for common vaccine-preventable diseases.
Center for Disease Control and Prevention (CDC)
- Infection Prevention and Control Assessment Tool for Long-term Care Facilities (ICAR) can be used by nursing facilities to evaluate their Infection Prevention and Control programs and practices.
- Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19 Pandemic) provides strategies for preventing the spread of COVID-19, as well as the latest testing and treatment recommendations.
- Nursing Homes and Assisted Living (Long-term Care Facilities) is a website for clinical professionals, residents and their families. Resources include a number of fact sheets, guidelines and toolkits that address infection control and prevention.
- Core Elements of Antibiotic Stewardship for Nursing Homes provides nursing facilities with resources for developing an effective antibiotic stewardship program.
- Influenza (Flu) is a comprehensive resource for influenza-related information.
- Hand Hygiene in Healthcare Settings provides healthcare workers and their patients with helpful information, including hand hygiene guidelines, self-assessment tools and other educational resources.
- Carbapenem-Resistant Enterobacteriaceae (CRE) Control and Prevention Toolkit will help facilities develop interventions to prevent infections caused by CRE.
Statewide Program for Infection Control & Epidemiology (SPICE)
- Competency for Proficient Infection Preventionists can be used to document the ongoing competency of the facility’s Infection Prevention and Control coordinator/Infection Preventionist.
- Environmental Rounds Worksheet can be used to monitor environmental cleaning and infection prevention practices throughout the facility.
- Hand Hygiene Audit Tool can be used by the Infection Preventionist to monitor compliance with the facility’s hand hygiene policies and procedures.
- Hand Hygiene Competency Validation Tool can be used by the Infection Preventionist to document individual employee’s competency with hand hygiene protocols.
World Health Organization
- WHO Guidelines on Hand Hygiene in Health Care 2009 provides health care workers with evidence-based recommendations for hand hygiene in healthcare settings.
- Five Moments for Hand Hygiene is a graphic representation of the WHO Guidelines for Hand Hygiene in Health Care.
Agency For Healthcare Research & Quality
A Unit Guide To Infection Prevention for Long-Term Care Staff
National Association of County & City Health Officials (NACCHO)
Infection Prevention and Control Resource Library (Provides Best Practices, Tools, Teaching Materials, and specific information just for COVID-19)
Revision To Billing Requirements
May 1st, 2023
HHSC Publishes Revision 23-2 of the HCS and TxHmL Program Billing Requirements
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:
- Home and Community-based Services Program Billing Requirements (PDF)
- Texas Home Living Program Billing Requirements (PDF)
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:
- Home and Community-based Services Program Billing Requirements (PDF)
- Texas Home Living Program Billing Requirements (PDF)
- Community First Choice Billing Requirements for HCS and TxHmL Program Providers (PDF)
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:
Joint Training From HHSC For Providers
Joint Training Page Available for HCS and TxHmL Program Providers
The HCS and TxHmL programs now have a Joint Training Opportunities page where providers can register for upcoming classes. Class size will be limited to maximize participation, but classes will be offered regularly. Providers should check the page often for updates. There will be recordings of special presentations available for viewing on-demand later.
Missed a COVID-19 training? Many COVID-19 presentations for long-term care providers are recorded and are available 24/7. Please be sure to select the most appropriate recording for your program. Note that recordings are accurate as of the date of presentation and that updated guidance may be available.
Visit the recording library at https://www.gotostage.com/channel/covid-19webinarsforltc.
May 1st, 2023
May 2023 HCS/TxHmL Provider Training Opportunities
Hurricane and Flooding Readiness for ICFs
Wednesday, May 3
10 a.m.–noon
Register here for webinar.
Infection Control in LTC
Thursday, May 4
6 p.m.–8 p.m.
Register here for webinar.
Individualized Skills and Socialization Basic Program Overview
Monday, May 8
11 a.m.–noon
Register here for webinar.
Hurricane and Flooding Readiness for HCS and TxHmL Providers
Wednesday, May 10
10–11:30 a.m.
Register here for webinar.
Nursing Scope of Practice in Long-Term Care Communities
Thursday, May 18
10–11:30 a.m.
Register here for webinar.
Hurricane and Flooding Readiness for HCS and TxHmL Providers
Thursday, May 18
3–4:30 p.m.
Register here for webinar.
Individualized Skills and Socialization Basic Program Overview
Monday, May 22
11 a.m.–noon
Register here for webinar.
Hurricane and Flooding Readiness for ICFs
Wednesday, May 31
2–4 p.m.
Register here for webinar.
**Writing Acceptable Plans of Correction of HCS and TxHML (course description)Texas Department of Family and Protective Services
Tuesday, May 30, 20239:00 AM – 4:00 PM
2017 N Frazier, Suite C
Room:65
Conroe, TX 77301
(24 MAX) (Live session) Registration
April 2023 HCS/TxHmL Provider Training Opportunities
Most Cited Deficiencies for HCS & TxHmL Providers
Wednesday, April 12
11:30 a.m.–12:30 p.m.
Register here for webinar
Individualized Skills and Socialization Basic Program Overview
Wednesday, April 12
4–5 p.m.
Register here for webinar
Writing Acceptable Plans of Correction of HCS and TxHmL
Thursday, April 20
9 a.m.–4 p.m.
Marshall, TX
Register here for in-person class
Individualized Skills and Socialization Program Basic Overview (1 hour) (course description)
Friday, April 28, 20233:00 PM – 4:00 PM
February 2023 HCS/TxHmL Provider Training Opportunities
Infection Control Basics for HCS and TxHmL Program Providers (course description)
Wednesday, February 8, 2023 11:30 AM – 12:30 PM
Administrative Penalties and Related Processes in HCS & TxHmL Settings (course description)
Tuesday, February 28, 20231:30 PM – 2:30 PM
Dec. 2022 HCS/TxHmL Provider Training Opportunities
Emergency Preparedness 101 for HCS and TxHmL Providers
Tuesday, Dec. 1311:30 a.m.–12:30 p.m.
HCS/TxHmL Program Provider Responsibilities in Death Reviews and Provider Investigating Reports
Wednesday, Dec. 211–2 p.m.
Writing Acceptable Plans of Correction for HCS and TxHmLThursday, Dec. 29
9 a.m.–4 p.m.Nacogdoches, Texas
Register here for in-person class
Oct./Nov. 2022 HCS/TxHmL Provider Training Opportunities
Top 10 Most Cited Deficiencies for HCS and TxHmL Providers (course description)
Wednesday, October 5, 20221:30 PM – 2:30 PM
Hurricane and Flooding Readiness for HCS/TxHmL (course description)
Wednesday, October 12, 20221:30 PM – 2:30 PM
Infection Control Basics for HCS and TxHmL Program Providers (course description)
Wednesday, October 19, 20222:00 PM – 3:00 PM
Emergency Preparedness 101 for HCS Program Providers (course description)
Tuesday, November 1, 20221:00 PM – 2:00 PM
July 2022 HCS/TxHmL Provider Training Opportunities
Long-term Care Regulation staff and program providers are invited to attend the following trainings hosted in July:
Writing Acceptable Plans of Correction for HCS and TxHmL
Wednesday, July 6
10:30 a.m.–12:30 p.m.
Register for the webinar.
Writing Acceptable Plans of Correction for HCS and TxHmL
Wednesday, July 6
10:30 a.m.–12:30 p.m.
Register for the webinar.
Hurricane and Flooding Readiness for HCS and TxHmL
Tuesday, July 12
1–2:45 p.m.
Register for the webinar.
Hurricane and Flooding Readiness for HCS and TxHmL
Tuesday, July 12
1:30–2:45 p.m.
Register for the webinar.
Administrative Penalties and Related Processes for HCS and TxHmL
Wednesday, July 20
1:30–2:45 p.m.
Register for the webinar.
Administrative Penalties and Related Processes for HCS and TxHmL
Wednesday, July 20
1:30–2:45 p.m.
Register for the webinar.
Infection Control Basics for HCS and TxHmL
Thursday, July 28
1:30–3 p.m.
Register for the webinar.
Additional classes may be added, and all available training opportunities can be found on the following websites:
July 5th, 2022
Nursing in HCS and TxHmL Settings -Recorded Session: April 5th, 2022
This three-hour webinar covers requirements for the provision and delegation of nursing care in HCS and TxHmL settings. A Texas Board of Nursing representative will be a guest presenter. The most frequently cited deficiencies related to these requirements will be noted during the training. No CEs are offered for this webinar. However, a certificate of attendance will be provided.
**You can still watch the recording from this session, click on the registration link below.
From April 5, 2022
11 a.m. – 2 p.m.
Register here for the webinar.
Registration is limited. A recording will be available after the presentation for those unable to attend. Contact LTCR Policy with questions.
COVID-19 Update to Temporary Change in HCS and TxHmL Policy for Service Providers of DH, Respite and CFC PAS/HAB
May 1st, 2023
COVID-19 Update to Temporary Change to HCS and TxHmL Policy for Respite, CFC PAS/HAB Service Provider
In March 2020, HHSC implemented a temporary policy change for respite and Community First Choice Personal Assistance Services/Habilitation provided in the Home and Community-based Services and Texas Home Living waiver programs. This change allows service providers of respite and CFC PAS/HAB to live in the same home as the person receiving these services.
This change has given greater access to needed services for people living in their own home or family’s home. A person’s spouse or the person’s parent, if the person is under 18, is not allowed to be a paid service provider of these services in accordance with the HCS, TxHmL and CFC Billing Requirements.
This temporary policy change is effective March 27, 2020, through Aug. 31, 2023. HHSC will provide guidance if anything changes.
Program providers must complete the required background checks for all service providers. They must follow:
- The Texas Administrative Code, Title 26, Part 1, Chapter 263 and Chapter 262.
- HCS and TxHmL Rules, Section 9.177 (n) and (o), and Section 9.579 (r) and (s).
- The HCS Program Billing Requirements and the TxHmL Program Billing Requirements Section 3400 for service provider qualifications and the CFC Billing Requirements for HCS and TxHmL Program Providers.
October 4th, 2022
COVID-19: HHSC Publishes In-Home Day Habilitation Information for Program Providers (Replaces IL 2022-48)
IL 2022-51 is posted on the HHS webpage for Home and Community-based Services, Texas Home Living, local intellectual and developmental disability authority, and financial management services agency program providers.
HHSC is temporarily waiving certain requirements in Section 3710, 4381.3, 4381.7(6) and 4381.7(7) of the HCS Billing Guidelines and TxHmL Guidelines. This is due to COVID-19 and provides access to needed day habilitation services.
HHSC has published a revision to this guidance in IL 2022-51 In-Home Day Habilitation Information for Program Providers for COVID-19 (PDF). This replaces IL 2022-48.
It extends the temporary guidance through October 31st, 2022, unless the COVID-19 public health emergency ends sooner. HHSC will provide guidance if there are any changes.
Email questions to HCS Policy.
May 30, 2022
COVID-19 Update to Temporary Change for Service Providers of Respite and CFC PAS/HAB
In March 2020, HHSC implemented a temporary policy change for respite and Community First Choice Personal Assistance Services/Habilitation. This change allows service providers of respite and CFC PAS/HAB to live in the same home as the person receiving Home and Community-based Services or Texas Home Living program services.
This change has given access to needed services for people living in their own or family’s home. A person’s spouse or a child or teenager’s parent still cannot be a paid service provider of these services due to guidelines in HCS, TxHmL and CFC handbooks located under Long-term Care Waiver Programs.
This temporary policy change is effective March 27, 2020 through October 31st, 2022, unless the COVID-19 public health emergency ends sooner. HHSC will provide guidance if anything changes. Program providers must complete the required background checks for all service providers. They must follow:
- The Texas Administrative Code, Title 40, Part 1, Subchapter D and N.
- HCS and TxHmL Rules, Section 9.177 (n) and (o), and Section 9.579 (r) and (s).
- HCS and TxHmL Billing Guidelines Section 3400 for service provider qualifications.
FYI- Don’t forget that currently (Due to COVID-19) HHSC has said if you need to add on more CFC PAS/HAB units on the IPC, you are not required to request SC to update the CFC PAS/HAB assessment. The provider needs only complete an IPC revision and IP update.
ISS Program Basic Overview Webinar
April 27th, 2023
HHSC Long-term Care Regulation will be providing recurring one-hour webinars for Individualized Skills and Socialization providers. These webinars will cover the basics of a license application, and an overview of the survey process.
Additional topics will include reporting abuse, neglect, exploitation or incidents to HHSC. All sessions are duplicates and offer multiple opportunities to facilitate provider attendance.
Friday, April 28
3–4 p.m.
Click here to register.
Monday, May 8
11 a.m.–noon
Click here to register.
Monday, May 22
11 a.m.–noon
Click here to register.
In addition, see following webinar with handout
TMHP Portal Town Hall Webinars And FAQ’s
April 17th, 2023
HCS and TxHmL Town Hall Webinars and FAQs
May & June Save the Dates For Town Hall Webinar Meetings
The webinar will be held on the following dates. We encourage Providers and FMSAs to invite staff who use the LTC Online Portal for HCS and TxHmL programs.
May 2023
- Wednesday, May 10, from 10 a.m.–noon
Register for the webinar.
June 2023
- Wednesday, June 14, from 10 a.m.–noon
Register for the webinar.
Standing Meeting Agenda
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Trending Issues — discuss trending issues and solutions to increase successful processing of forms.
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Training and Information Sharing — provide relevant training and updates.
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Questions and Answers — HCS/TxHmL Providers and FMSAs will have the opportunity to ask questions* regarding LTC Online Portal for HCS and TxHmL.
*To comply with HIPAA requirements, questions that include any identifying information for a specific individual will not be allowed during the monthly meetings.
Providers and FMSAs are encouraged to submit questions that they would like addressed during the webinar as part of the registration process.
April 14th, 2023
March Webinar 2023
- March 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
- March 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Joint Training Provider Opportunities
- Trending Issue Support Volume 18
- Appendix A and Dashboard YouTube Videos
- Updated Quick Reference Guide
- Suspension Discussion and Training
- Placeholder/Admin Locations
February Webinar 2023
- February 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
- February 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- IPC Template and Location Code Field
- Cost Reporting Training
- Claims Adjustment follow-up
January Webinar 2023
- January 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
- January 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
- Enhancements to Individual Plan of Care (IPC) revisions and corrections, Individual Movement (IMT) correction forms have now been implemented.
- Trending Issue Support Volume 14 and 15 are now published.
- YouTube videos on the TMHP Remittance and Status (R&S) has now been published.
January 16th, 2023
Helpful Information: From TMHP Portal Town Hall Meeting on 1/11/23
-A representative from one of the LIDDAs (Alamo Area Council of Governments) relayed the following information:
- If an individual moves from one LIDDA to another (LIDDA to LIDDA transfer) and they are going to new HCS or TxHmL provider, the old LIDDA has to do INT form 1st and then the new LIDDA has to do the transfer to the new provider. These things must happen in this order, or it will hold things up in your transfer.
- One of the major problems the LIDDA’s have is that the LOCATION code is being changed by the system (a glitch of some sort in TMHP) and then it is greyed out by the system so they can’t put anything in that spot where location code goes. They can’t edit it to correct it. This has caused many of the delays in transfers and this is why alot of providers might be thinking the LIDDA is causing the delay. However, that may not be the case because of this issue. Good news: Enhancement to allow the LIDDA to type in location code instead of grey out barrier. This is happening Friday Jan. the 13th. This should provide a resolution to this “glitch” in the system. Hopefully, it will allow a lot of transfers to go through. This problem has been happening since April of 2022 for LIDDA’s.
- FYI-HHSC sent out a letter to LiDDAS, that they should not hold up on transfers if the location code is not correct. They can then contact HHSC about correcting the location code after the fact.
-In some situations, if the LIDDA itself is not changing during the transfer (transfer from one provider to another, but LIDDA the same), then the provider needs to make the changes on the IMT form before the -LIDDA can submit. They have to complete the process in that order before the transfer can be submitted. Meaning the previous form must be done before the new form should be completed.
-One of the HCS providers shared the following information: Somewhat related to location codes. She was closing a couple of location codes after the home was no longer open. Noticing that the drop-down list is out of sync. She would put in the address of the new location and go to close the old location code and the drop-down link showed a different address for the location being closed out than it should. It is like it is out of sync. This fix happening this Friday should also fix that for the provider. Basically using right code but the wrong address is showing up in the dropdown menu’s. Referring to PLU system.
-If providers are experiencing any delays with LIDDA not submitting any forms they are required to submitted. Please try to resolve that by escalating that to LIDDA director, so HHSC says they want you to then send an email to interestlistpreenroll_liddahelp@hhs.texas.gov. then they can reach out to them directly.
–To escalate tickets: Email. LTCOPS-Escalations@TMHP.com to escalate tickets
-Another provider noted the following issue: When they migrated to TMHP, somehow their contract address was now incorrect. The provider’s company name was no longer associated with the right contract #. It is not something the provider did on their side. So far, they have had no luck in changing that address to the correct address for their contract #. Provider information update. They will need to check it on the provider system data to find out. Contract and Administration and Monitoring will have to help with the correction of the error. This is also the case if providers have questions about a contract’s begin and end date, or when it expires, etc.. Go to the contract manager. HHSC acknowledges that there has been alot of turnover in this department. (Don’t I know it, lol.) Information provided by Kaliope Schmidt was to do the following: Go to iddwaivercontractenrollment@hhsc.state.tx.us and cc Kaliopi.schmidt@hhs.texas.gov
–One Provider had a Transfer since May of 2022 that hasn’t gone through because the old provider’s address is showing on the location since transferring, so it does not match the contract of the new provider. Hopefully, the fix will come from the Friday the 13th, 2023 enhancement.
–Client assignment question: In the CARE system, this was done differently than in THMP so has caused a domino effect. i.e. Individual on temp discharge, would be re-assign to a different temp discharge location code. The local authority wanted her back into rotation. ……. We can’t view who is assigned to what location on what date, so couldn’t figure out how to move people sometimes. People at the help desk don’t even know how to look up people’s locations and assignments. What can we do?
To do that in the portal for now until June 2023, when they will have an enhancement out to correct this issue, providers must use the form status inquiry page (FSI) you can search for the consumer’s forms by imputing their Identifier (Medicaid or CARE #) and put in with search criteria. Leave the form blank but put in the date range or a little bit longer time if needed and search that. In the list should receive list of forms for the consumer for your organization. The effective date on the forms, if you click it, the system will show the list by effective date and which code has the latest effective date, and then that form as the latest location code. But won’t help unless the form is completed already. Location availability information is limited. The provider has to keep trying to look up everything in a fashion that seems long and very backward. It is the opposite of what the provider needs. It ends up being the longest way to look if up. The provider asked if they would create something in their June enhancement, that shows the moves of a person, hoping to build the function to search the function by location, what client is with them.
-If on temp discharge is the individual still assigned a code from the facility or a new code form (IMT suspension purpose code form)? Because the provider currently has to wait for the suspension form to finish the process so it is considered complete before they can do anything. How long does that usually take? Ask CARE people to get back to you.
-Another provider said they can’t do IMF form til the Residential component is changed but can’t change the residential component until IMF changed. Moving from 1 location to the other inside the same agency. Moving from HH/CC to RSS. So, when they try to change the residential type, it won’t let her progress from there in TMHP. Provider needs to submit IPC revision to change residential type. Then at the same time on that revision form, then the location code is updated for you to update IMF automatically. Don’t need to do the IMT, just the IPC revision form to change the residential type and location code. That changes the residential component type, submit IPC revision or transfer if that is the case.
-How do you know what claims to pay when you get your overpayment letter? To request a list, please contact the THMP-LTC Help desk at 1-800-626-4177 or 1-800-626-5436 (Option #1 then Option #7). The provider will need to provide a secure email for them to send the list. Should get within 24 hrs. Can also go to your Tex Med connect and remittance status screens.
HHSC asked providers to limit ISS questions at this time, but here is one that came up during the session:
-In-Home ISS come March 1st, 2023-does the provider need to submit documentation like BCBA documentation or medical/physician’s order of need, before it is entered into TMHP billing? Anything the provider needs to be prepared for? They have to go back and find out about it. Don’t know now.
Other Important Contacts:
Issues that go to UR (Utilization Review): • 8578 ID/RC form with purpose code 3 or 4 on the LTC Online Portal • Renewal or revision IPCs
Utilization Review (UR)
512-438-5055 email: deskURLONIPC@hhs.texas.gov
Issues that go to PES (Program Enrollment Services) • 8578 ID/RC with a purpose code 2 forms * initial or transfer IPCs forms • Suspensions • 3615 Continuation of Suspension forms • 3616 Request for Termination forms • Individual Movement (IMT) forms for LA Reassignments
Program Eligibility and Support (PES)
512-438-2484
enrollmenttransferdischargeinfo@hhs.texas.gov
Did You Miss The Last HCS & TxHmL Town Hall Meeting?
April 14th, 2023
April 12, 2023 town hall meeting
- April topics included:
- Using the Provider Location Update (PLU) Form for moves/updates
- Entering Individualized Skills and Socialization in TMHP
- Highlighting Individualized Skills and Socialization Available Resources
- Questions and Answers – HCS/TxHmL Providers and FMSAs will have the opportunity to ask questions* regarding the LTC Online Portal for HCS and TxHmL.
You can register for the recorded session at: https://register.gotowebinar.com/register/91533672855255893
The next meeting is May 10, 2023. We will keep you posted on registration for this webinar.
Next session they will discuss the “Enrollment Process” and Location Code Issues
Some highlights during the April 13th, 2023 Town Hall Session:
Use the Frequently Asked Questions document:
Frequently Asked Questions Home and Community-based Services (HCS)
Texas Home Living (TxHmL) Waiver Programs
2022 Cost Reporting:
➢WHERE: 2022 Cost Report Units of Service Information for HCS and TxHmL Programs
➢HOW: 2022 Cost Report Units of Service Tool Information for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Programs
➢WHO: Contact PFD-LTSS@hhs.texas.gov or (737) 867-7817, if there are questions after reviewing the above notifications
▪Refer to the HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 19 notification for updates including avoiding overbilling for service components limited to 1 unit per day, valid IMT suspension reasons for temporary discharge and billable units on IPC form accommodation for leap year.
❑ BEST PRACTICE: Download and reconcile R&S Reports on a weekly basis, as a claim is reported only once in the Non-Pending section of the R&S Report, after it is finalized.
Purpose of PLU Form (Provider Location Update)
3) To End location: •Used when the location does not have any residents and needs to be closed. •Ensure all individuals have been assigned to a new location before ending a location. If a service location is ended by the provider, it cannot be reopened. •The provider must add the ended location as a new location to reopen it.
Avoiding delays in billing when submitting forms for transferred clients
BEST PRACTICE: Review the data auto-populated on the subsequent form (especially the Program Provider section) to ensure that the correct provider is displayed.
Common Location Submission Issues
b)In the event you are still not able to change the effective date, then, you can reach out to UR if this was related to a renewal/ revision. Or reach out to PES if it was related to a transfer.
2. Handling PLU forms that are in ‘Pending Dads Review’ status. •Just like any other forms in this status, HHSC will need additional documentation.
For PLU, supplemental documentation must be submitted by email to Survey Operations at HCSFourPersonResidenceRequests@hhs.Texas.gov
3. Location Capacity issues with submitted forms:
•This will prevent the forms from being stuck for a long time till the verification is complete.
For information on Provider Training, Webinars, Resources, and more
see:
•Texas Health and Human Services Individualized Skills and Socialization website
•Send HCS/TxHmL/DBMD Policy Individualized Skills and Socialization
Questions to: HCSPolicy@hhs.Texas.gov , TxHmLPolicy@hhs.Texas.gov ,or DBMDPolicy@hhs.Texas.gov
•Send Licensure Policy and Rules Questions to:
LTCRPolicy@hhs.Texas.gov
Things to know before billing ISS:
1) You will be authorized for 1,560 hours (max) during an IPC year.
2) Can only bill up to six hours per calendar day.
3) Can only bill five days per calendar day. (Although you can trade out weekend days for equal amount of weekdays, i.e. Mon, Tues, Weds. Sat and Sun.)
4) Cannot date span on claims.
5) Must use HCPCS code H2014 and bill per hour.
6) Use the bill code crosswalk to see the codes and modifiers needed for the particular Individualized Skills and Socialization service.
7) Rate information can be found at this website Long term Services & Supports |Provider Finance Department (texas.gov) Select the appropriate Service from the left side menu.
ISS Units
•Individual Skills and Socialization is an hourly unit, max 1560
•260 DH days= 1560 ISS hrs
•1560 (max) covers the extra day for Leap Year
As of January 1, 2023, you will automatically get Individualized Skills and Socialization
authorization if you were already getting day habilitation authorization.
•This information can be verified on the MESAV.
•These units for individualized skills and socialization will not be visible on the current
IPC form nor on the dashboard until a revision or renewal IPC is entered.
You will first need to submit a Revision IPC to end Day Hab.) Once the revision is in a ‘Processed/Complete’ status, then the Transfer IPC can be submitted.
Tips for data entry
•Make changes on IPC/Cost tab
Prorating
205 X 6 = 1230
TMHP Training Resources For HCS/TxHmL Providers (Videos, FAQ’s, Quick Check Guides, CBT training)
April 11th, 2023
**Please also check the HCS/TxHmL joint training website from HHSC, for periodic related webinars.
Training Resources
(Videos, FAQ’s, Quick Check Guides, CBT training)
It is highly recommended that program providers, LIDDAs, and FMSAs create a TMHP Learning Management System (LMS) account at learn.tmhp.com to access current training related to the LTC Online Portal and claims submissions. New TMHP LMS users can access the Learning Management System (LMS) Registration and Navigation Job Aid for Providers located on the LMS homepage or email TMHP Training Support for help creating an LMS account or navigating the LMS.
Suggested training resources include:
- HCS and TxHmL Waiver Programs Frequently Asked Questions
- Long-Term Care (LTC) Online Portal Basics Computer-based Training (CBT)
- TexMedConnect for Long-Term Care (LTC) Providers CBT
- Remittance and Status (R&S) Reports for LTC Providers Quick Reference Guide (QRG)
- Claim Appeals for Medicaid CBT
- TMHP Claims Video
- TMHP Account Setup for HCS and TxHmL Waiver Programs QRG
- Long-Term Care (LTC) User Guide for Online Portal Basics, General Information, and Program Resources
- Long-Term Care (LTC) User Guide for TexMedConnect
For more information, email tmhptrainingsupport@tmhp.com
HCS & TxHmL TMHP YouTube Video Playlist
Reminder of New HCBS Rules (HCS & TxHmL): TAC Title 26, Part I Ch. 262 & 263
April 4th, 2023
New HCBS Rules (HCS and TxHmL)
These new HCS rules have been added as TAC Title 26, Part 1, Chapter 263.
Texas Home Living HCBS regulations for compliance requirements is the following TAC title 26 part I Chapter 262
HCS/TxHmL Resources: ISS Provider in San Antonio
March 30th, 2023
I wanted to share the website for one of the ISS providers in the San Antonio area as they do also offer competitive employment for individuals and have employment assistance (EA) and supported employment (SE). Hope this is a good resource from some HCS/TxHmL providers in their area.
https://www.texasfoundationofhope.org/
(210) 265-3351
Office Hours:
Monday – Friday 9:00 AM to 5:00 PM
HCS TAC 9.174 (23) Service Delivery: On-Site Residential Expectations Including Hot Water Temps & Locks On Bedroom Doors
March 30th, 2023
Review of this important section in 9.174 Service Delivery
9.174 (23) (concerning HH/CC, RSS, SL on-site expectations including locks on bedrooms and hot water temps in the home)
(23) ensure that, for an individual receiving host home/companion care, residential support, or supervised living:
(A) the individual lives in a home that is a typical residence within the community;
(B) the residence, neighborhood, and community meet the needs and choices of the individual and provide an environment that ensures the health, safety, comfort, and welfare of the individual;
(C) there is a sufficient supply of hot water at sinks and in bathing facilities to meet the needs of individuals;
(D) the temperature of the hot water at sinks and bathing facilities does not exceed 120 degrees Fahrenheit unless the program provider, in accordance with subsection (i) of this section, conducts a competency-based skills assessment evidencing that all individuals in the residence can independently regulate the temperature of the hot water from the sinks and bathing facilities; (see hot water assessment form from HHSC)
(E) unless contraindications are documented with justification by the service planning team, the individual lives near family and friends and needed or desired community resources consistent with the individual’s choice, if possible;
(F) the individual or LAR is involved in planning the individual’s residential relocation, except in the case of an emergency;
(G) unless contraindications are documented with justification by the service planning team, the individual has a door lock on the inside of the individual’s bedroom door, if requested by the individual or LAR; and
(H) the door lock installed in accordance with subparagraph (G) of this paragraph:
(i) is a single-action lock;
(ii) can be unlocked with a key from the outside of the door by the program provider; and
(iii) is not purchased and installed at the individual’s or LAR’s expense;
ISS Service Delivery Logs -Update
March 30th, 2023
Service Delivery Logs for Individualized Skills and Socialization
As of March 14th, 2023, information from the HHSC ISS SDL website page:
Form 8615, On-site and Off-site Individualized Skills and Socialization Service Delivery Log, and Form 8616, In-Home Individualized Skills and Socialization Service Delivery Log, are no longer mandatory to document a service claim of on-site, off-site, or in-home individualized skills and socialization.
A program provider may develop their own service delivery logs or use an electronic health record system to document individualized skills and socialization. All elements from Form 8615 and Form 8616 must be included in any documentation developed.
For each service event the service delivery log must include the following elements:
- Individual’s name
- Name of the individualized skills and socialization provider
- Individualized skills and socialization Provider License Number
- Date of service
- Time in and time out for each service event
- Location
- Description of billable activities
- Name and signature of service provider
For off-site service delivery logs, in addition to the information above for each service event, the elements that must be documented include:
- Individual’s level of need (LON)
- Ratio or approved enhanced staff rate
- Number of individuals being served by the service provider during the service event
- Name and address of community location(s) visited during the off-site service event
- Name and signature of the service provider
For in-home service delivery logs, in addition to the information for each service event, the elements that must be documented include:
- Staff ID as assigned by the program provider (meaning the HCS/TxHmL program provider)
HHSC will update Form 8615 and Form 8616 to provide Spanish-language versions. Any submission of forms containing information that is not in English will need to comply with 26 TAC §263.7.
For providers who use Form 8615 and Form 8616, HHSC has provided clarification below:
Form 8616 and Form 8615 are only required to document service events for individuals in the HCS and TxHmL Programs. (Does not include DBMD program)
In the off-site section of the form:
- “Ratio” refers to the ratio for the individual as required by 26 TAC §263.2017 (HCS) or 26 TAC §262.917 (TxHmL).
- “Staff” would equal one.
- “Individuals” refers to the total number of individuals or other persons receiving services assigned to a service provider during a service event. This does not include any identifying information. *Persons outside of the HCS and TxHmL Programs, receiving a similar service, must be included in the number of individuals for the delivery of off-site individualized skills and socialization.
Form 8615 and Form 8616 were developed to document a service event for on-site, off-site, or in-home individualized skills and socialization. Program providers may request additional information or documentation from an individualized skills and socialization provider to obtain updates on the progress or lack of progress towards an individual’s goals.
The days of the week included on Form 8615 and Form 8616 may be altered if an individual receives individualized skills and socialization on a Sunday or Saturday. The program provider must ensure that an individual does not exceed the service limit of five days per calendar week (Sunday–Saturday).
Each service event must have an exact time in and time out and all documented elements. The total amount of time providing the service each day cannot be combined into one service event for that date.
If a program provider chooses to complete Form 8615 or Form 8616 electronically, it must be in compliance with 40 TAC §49.305(j) related to a contractor using electronic records.
For questions about this alert or the service delivery logs for individualized skills and socialization, email HCSPolicy@hhs.texas.gov.
March 1st, 2023
ISS Service Delivery Logs (SDL’s) & Electronic Health Record (EHR) systems
February 21st, 2023
Service Delivery Logs Finally Available for Individualized Socialization Skills Services
INSTRUCTIONS: Updated: 2/2023
Purpose
Form 8615 is used by Texas Health and Human Services Commission (HHSC) staff, as well as Home and Community-based Services (HCS) and Texas Home Living Service (TxHmL) Waiver program providers to document a service event for on-site and off-site individualized skills and socialization.
Procedure
When to Prepare
Form 8615 must be completed within 14 calendar days after the activity being documented is provided.
Form Retention
The program provider must maintain a copy of the completed Form 8615 in the individual’s record.
General Instructions
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Form 8615 must be used for only one individual.
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Form 8615 may be used for multiple billable service events. Each billable service event must have a begin and end time.
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Form 8615 is considered a Medicaid document used for Medicaid purposes. By using this form, you understand it is your responsibility to record accurate information, as this information may be subject to a court of law. Failure to record accurate information or deliberate falsification of documentation is strictly prohibited.
Detailed Instructions
Individual Name — Enter the individual’s name.
Place of Service(s) — Enter the address at which the billable activity occurred.
Level of Need — Enter the individual’s level of need.
Name of Individualized Skills and Socialization Provider — Enter the name of the entity.
Individualized Skills and Socialization Provider License Number — Enter the license number of the individualized skills and socialization provider.
Date and Days of the Week — Enter the date (month, day, year) when the billable activity occurred.
Time In — Enter the time when the billable activity started.
Time Out — Enter the time when the billable activity ended.
Name of Service Provider — The printed name of the service provider who provided the service event for on-site or off-site individualized skills and socialization.
Service Provider Signature — At least one service provider who provided the service event for on-site or off-site individualized skills and socialization must sign the form. If more than two service events occur in a calendar day, the service provider must complete a new Form 8615.
Initial all areas in which you assisted the person — Initial the box that corresponds to activities provided by the service provider. The services initialed must justify amount of time spent providing services. A minimum of one activity must be marked for a billable service claim to have occurred.
Community Locations Visited and Special Events or Occurrences — This field is required to identify the location(s) for off-site individualized skills and socialization and may be used to document special events or occurrences. If providing written documentation, enter the date on which the billable activity occurred and the staff initials.
Initials — Enter the initials of the service provider(s) providing billable activities to the individual.
Questions
To inquire about Form 8615 or instructions, email hcspolicy@hhs.texas.gov.
TMHP: Where Do HCS/TxHmL Providers Go To Find The Information To Complete Their Cost Reports For 2022?
HHSC’s Response to Some Of The Questions Concerning Cost Reports for 2022:
The HCS/TxHmL Units of Service Look-up tool was created at the providers’ request to assist them in completing the 2022 cost report. Providers have questioned whether it captures all that is needed for the cost report and if HHSC is responsible for ensuring there is an appropriate report page for providers to collect this information in TMHP and/or Texas Med Connect.
HHSC has stated that Providers may rely on their own billing records to complete their required reports in accordance with the Title 1 of the Texas Administrative Code (1 TAC) and cost report instructions, etc. The provider must certify that the information included in the cost report is accurate. As a reference, 1 TAC Section 355.102(c) states:
Accurate cost reporting is the responsibility of the contracted provider. The contracted provider is responsible for including in the cost report all costs incurred, based on an accrual method of accounting, which are reasonable and necessary, in accordance with allowable and unallowable cost guidelines in this section and in §355.103 of this title, revenue reporting guidelines in §355.104 of this title (relating to Revenues), cost report instructions, and applicable program rules. Reporting all allowable costs on the cost report is the responsibility of the contracted provider. The Texas Health and Human Services Commission (HHSC) is not responsible for the contracted provider’s failure to report allowable costs; however, in an effort to collect reliable, accurate, and verifiable financial and statistical data, HHSC is responsible for providing cost report training, general and/or specific cost report instructions, and technical assistance to providers. Furthermore, if unreported and/or understated allowable costs are discovered during the course of an audit desk review or field audit, those allowable costs will be included on the cost report or brought to the attention of the provider to correct by submitting an amended cost report.
Regarding concerns about the data provided in HHSC’s units of service look-up tool, information letter 2023-12 clarifies:
HHSC will be updating the record of paid units of service before beginning the financial examination of the 2022 cost reports. This timing will allow cost reports to be revised based on any paid claims adjudicated after the 2022 cost report was submitted. HHSC PFD’s Cost Report Review Unit (CRRU) financial examiners will work individually with the provider and cost report preparer if there are material variances between the units reported and the updated paid claims data.
Regarding concerns about the unit totals and not reflecting units that have not been paid, information letter 2023-12 clarifies:
Providers must report, on an accrual basis, paid units of service delivered during their 2022 cost reporting period in Step 5 on the cost report. Providers should report units of service for each waiver service by the level of need delivered during their cost reporting period and paid by the time the cost report is submitted. Any units of service delivered during the cost reporting period, but not paid by the time the cost report is submitted, should be reported as a non-reimbursed unit. HCS and TxHmL providers should report all allowable costs incurred during their cost reporting period for paid and non-reimbursed units of service.
Regarding concerns about additional training or a webinar:
HHSC is incorporating training related to accessing and using the units of service look-up tool in upcoming cost report trainings and is working on publishing recorded instructions to assist providers with using the tool. A Gov Delivery will be published when this information is made available.
HHSC encourages any provider who has questions about the tool to contact HHSC Provider Finance at PFD-LTSS@hhs.texas.gov for assistance.
Regarding requests for cost report extension:
HHSC is not granting cost report extension at this time outside of the 15-day extension established in accordance with 1 TAC Section 355.111.
Remember providers to submit 2022 cost reports prior to May 1st, 2023. Cost reports are due April 30, 2023.
The lookup tool will include any units paid through the Client Assignment and Registration (CARE) and Texas Medicaid & Healthcare Partnership (TMHP) claims systems during the cost reporting period.
Please refer to Information Letter 2023-12 for more information on how to obtain the lookup tool and report units of service on the 2022 cost report.
Please refer to our Cost Reporting Training webpage for the 2022 Cost Report Unit of Service (UOS) Tool Webinar demonstration on how to obtain the lookup tool and report units of service on the 2022 cost report.
If you have questions after reviewing the Information Letter, please contact PFD-LTSS@hhs.texas.gov or (737) 867-7817.
Heightened Scrutiny: Process For ISS
March 29th, 2023
Heightened Scrutiny Process For ISS (Individualized Skills and Socialization)
Individualized skills and socialization has replaced day habilitation in these programs: HCS, TxHmL & DBMD. Individualized skills and socialization will include an on-site component and an off-site component.
The heightened scrutiny process will be required if a setting in which on-site individualized skills and socialization is provided:
(1) is located in a building in which a state supported living center or a certified intermediate care facility for individuals with an intellectual disability or related conditions (ICF/IID) operated by a LIDDA is located but is distinct from the state supported living center or the certified ICF/IID operated by a LIDDA;
(2) is located in a building that is on the grounds of or immediately adjacent to a state supported living center or a certified ICF/IID operated by a LIDDA;
(3) is located in a building in which a licensed private ICF/IID, a hospital, a nursing facility, or other institution is located but is distinct from the ICF/IID, hospital, nursing facility, or other institution;
(4) is located in a building that is on the grounds of or immediately adjacent to a hospital, a nursing facility, or other institution except for a licensed private ICF/IID; or
(5) has the effect of isolating individuals from the broader community of persons not receiving Medicaid HCBS.
If heightened scrutiny is required, a provider must complete the heightened scrutiny process and receive written approval from HHSC before submitting an application to become licensed as a day activity and health services facility with a special designation for individualized skills and socialization.
Read more about the heightened scrutiny process for individualized skills and socialization in Information Letter 22-53, Requirements for Providers Seeking to Deliver New Individualized Skills and Socialization Services (PDF).
Questions
If you have questions about the heightened scrutiny process or whether it applies to you, email MCS_Heightened_Scrutiny_Review@hhs.texas.gov.
ISS Updates & New Rules (HCS/TxHmL)
March 28th, 2023
Host Home Companion Care Providers Concerning ISS & PHE Flexibilities For In-Home ISS
Clarification Concerning Information Letter No. 2023-10 (Replaces IL 2023-06) from February 2023
In-Home Individualized Skills and Socialization Information for Program Providers for COVID-19 PHE
In response to COVID-19 and to provide access to day habilitation services, the Health and Human Services Commission (HHSC) temporarily waived certain requirements in Sections 3710, 4381.3, 4381.7(6) and 4381.7(7) of the HCS Billing Requirements and the TxHmL Billing Requirements. Until the end of the COVID-19 PHE, this flexibility will continue as part of in-home individualized skills and socialization.
Effective May 12, 2023, these flexibilities will no longer be in effect:
The flexibility has allowed HCS and TxHmL program providers to provide in-home individualized skills and socialization to an individual in the individual’s residence, including those residing in their own homes or family homes, without having the required justification outlined below. Program providers and LIDDAs need to have transition plans ready for individuals who receive in-home individualized skills and socialization prior to this end date (before May 12th, 2023).
Beginning May 12th, 2023:
in order to receive in-home individualized skills and socialization, individuals must meet all requirements outlined in the HCS and TxHmL Program Rules, the HCS Billing Requirements, and the TxHmL Billing Requirements, which include:
• A physician has documented that the individual’s medical condition justifies the provision of in-home individualized skills and socialization; or
• A licensed professional or behavioral support service provider has documented that the individual’s behavioral issues justify the provision of in-home individualized skills and socialization; or
• The individual is 55 years of age or older and requests to receive in-home individualized skills and socialization.
In addition, after May 11, 2023, a service provider of host home/companion care will not be permitted to provide in-home individualized skills and socialization to the individual to whom they provide host home/companion care services.
Clarification & Answer to Question From Some of Our Readers:
This letter indicates that HHSC does not appear to prevent a host home provider from becoming an ISS provider, nor does it prevent that licensed ISS provider from providing on-site and/or off-site services to their own individuals living with them. In other words, it would appear they can be a HH/CC provider and licensed ISS provider at the same time and they can provide ISS services to their own individuals they are serving as HH/CC providers. They can not provide their own in-home ISS (anymore) as an HH/CC provider as of May 12th, 2023. The only ISS they can provide after May 11th, is if they are a licensed on-site and/or off-site provider.
March 1st, 2023
Reminder Must Be Licensed As ISS Provider To Bill As Of March 1st, 2023
For HCS/TxHmL Providers, you can’t bill for On-site &/or Off-site ISS as of today March 1st, 2023, if you send someone to an ISS location or have staff providing Off-site services (previously Community DH), if they are not listed as a licensed ISS program.
The directories may be accessed at: https://www.hhs.texas.gov/providers/long-term-care-providers/day-activity-health-services-dahs to find out if the ISS program is licensed.
**You can bill for In-Home ISS as persons providing In-Home ISS do not have to be licensed! No justification is needed for In-Home through May 11th, 2023 I believe. I believe HH/CC providers can still provide In-Home (This was part of the PHE exception prior to March 1st) up through May 11th, 2023, but I am still unclear and will inquire and update everyone when I get some kind of definitive answer.
Previous DH providers & New ISS Provider applicants: If you do not have a temporary ISS license by March 1, 2023, you may not provide or bill HCS, TxHmL, or DBMD providers for on- and off-site ISS services until the temporary license is received. HCS/TxHmL, DBMD Providers who have individuals attending an ISS program may not send persons to the program until they confirm that the operator of the program has received the license. There are no exceptions.
February 21st, 2023
More ISS Training
Very Important: Surveys of ISS Providers With Temporary Licenses
In case this information was overlooked by new ISS providers:
- Once HHSC issues a temporary license, HHSC may conduct a survey at any time.
- HHSC may conduct a survey of any licensed Individualized Skills and Socialization Providers prior to March 1, 2023.
- i.e. if HHSC issues a temporary license on Feb. 21, 2023, HHSC may conduct an initial survey on Feb. 27, 2023.
- HHSC conducts unannounced surveys of ISS Providers.
- For on-site ISS providers, the address on the license must match the address for service provision.
- ISS providers must allow HHSC surveyors access to the on-site location and off-site activity locations.
Please refer to Texas Administrative Code Title 26, Chapter 559 for more info on the LTCR survey process.
February 10th, 2023
How Do I Find A Licensed ISS Provider?
HHSC has now posted directories on the DAHS webpage to help people find a licensed ISS Provider.
The directories may be accessed at: https://www.hhs.texas.gov/providers/long-term-care-providers/day-activity-health-services-dahs
Please note the following:
- There are 2 directories: DAHS with ISS and DAHS-ISS Only.
- The DAHS with ISS Directory is intended to reflect entities licensed as just a DAHS, and entities licensed as DAHS with ISS.
- At this time, this particular directory lists all entities as just having a DAHS license. This is because the commission has yet to approve any DAHS with ISS licenses. The process for approving a DAHS with ISS application takes longer than that of a provider applying as an ISS-only entity. According to HHSC, the entity must undergo an LSC and Health survey before a license is issued to a DAHS with ISS entity. Once these have been approved, they will be listed in this directory as DAHS with ISS.
- Entities listed in the DAHS – ISS Only Directory, currently reflect a 6-month license. This is because these licenses are considered ‘temporary’ at this time. Once the health survey is conducted the entities will receive a one, two or three-year license.
February 5th, 2023
HHSC LTCR Updates the ISS FAQ’s
HHSC Long-term Care Regulation updated the Individualized Skills and Socialization frequently asked questions document on Feb. 01, 2023.
January 27th, 2023
FYI- somehow I missed this alert back in November for Licensed ISS providers. Please be sure to log in and set up your account.
PL 22-32 letter issued 11/28/22 to ISS providers that was sent out concerning Blackboard Connect Emergency System
The purpose of this letter was to inform providers of the emergency communication system called Blackboard Connect, how it will be used, and your responsibility in signing up for the system if you are an ISS provider. This system will be used to send emergency and outreach notifications through email, phone, voice and text if available.
The rules require program providers to assign a designee to enroll in and respond to requests through the system. The designee should be someone who is associated with the licensed building or someone who is responsible for communicating emergency communications. However, you may also have other designees, such as corporate headquarters staff, sign up.
Blackboard Connect sign-up process:
Go to this link and click “Sign Me Up!”
If you have any questions, please contact the Policy and Rules Section by email at LTCRPolicy@hhs.texas.gov or call (512) 438-3161.
Rember, this also applies to HCS, TxHmL and ICF providers among other services.
January 16th, 2023
- The ‘new’ IPC referenced in IL 2022-03 will most likely not be ready until March. They did not have answers as to what providers should do in the interim or even how service logs should be revised until new ones are available. (The letter does indicate that those individuals receiving DH at the time of the switch to ISS (March 1st, 2023) will initially roll over automatically to ISS ).
- After Feb. 28th this would apply to all current clients as far as IPC units are concerned. Persons who don’t have any Day Hab units/days on their plan as of Feb. 28th, 2023 and want ISS hours, will have to do a new PDP and request IPC hours. Providers will have a new IPC form, with ISS on it, before March 1st, 2023.
- To date, no provider has been issued an ISS license.
- Providers can confirm that an entity has an ISS license by checking the DAHS directory on the DAHS webpage: https://www.hhs.texas.gov/providers/long-term-care-providers/day-activity-health-services-dahs
ISS FAQs and Upcoming Webinars:
On January 26, 2023, from 9:00 to 10:30 HHSC will conduct its quarterly LTC webinar which will focus on ISS. To register for the webinar, go to: https://register.gotowebinar.com/register/5204373791714060639
January 12th, 2023
Information Letter No. 2023-03 Individualized Skills and Socialization Automatic Service Authorizations
Effective January 1, 2023, individualized skills and socialization became an available service in the HCS and TxHmL Programs. For the time period of January 1, 2023 to February 28, 2023 both day habilitation and individualized skills and socialization will be allowable program services.
Day habilitation will no longer be a Medicaid-billable service in the HCS or TxHmL Programs for dates of service beginning March 1, 2023, and ongoing.
On January 9, 2023, HHSC will automatically add units of individualized skills and socialization for all individuals with day habilitation (including individuals receiving in-home day habilitation through the COVID-19 flexibility) currently authorized on their individual plan of care (IPC). The units will be available for billing immediately for the provision of on-site, off-site, or in-home individualized skills and socialization and will be visible to program providers in the Medicaid Eligibility Service Authorization Verification (MESAV). The added units will be authorized beginning January 1, 2023 through the end of the individual’s current IPC period. For individuals with an IPC period that must be renewed between January 1, 2023 – April 30, 2023, the added units will be authorized until December 31, 2023.
These units for individualized skills and socialization will not be visible to program providers or service coordinators on the IPC in the Long-term Care Online Portal (LTCOP) on the Texas Medicaid & Healthcare Partnership (TMHP) website nor on the dashboard until a revision or renewal IPC is entered. This automatic service authorization will give service coordinators additional time to meet with the individual’s service planning team (SPT) to update the individual’s person-directed plan (PDP) and for program providers to update the individual’s implementation plan (IP) as this new service takes effect. HHSC is implementing this process to minimize disruption to an individual’s desired services.
Service Plan Revisions
At the individual’s next service planning team meeting to complete a revision or renewal IPC (whichever occurs first) for individuals receiving individualized skills and socialization, service coordinators should update the individual’s PDP to reflect the new individualized skills and socialization service. During the service planning team meeting, any new goals related to the provision of on-site and off-site individualized skills and socialization should be discussed and documented in the new action plan. Until the PDP is updated, the individual’s current day habilitation goals, frequency, and duration should be followed for the individualized skills and socialization service.
Following the update to the PDP, the IPC and IP must be updated in accordance with applicable HCS or TxHmL Program rules with the appropriate units of individualized skills and socialization. HHSC will update the IPC and IP form to add individualized skills and socialization by March 1, 2023.
All individual’s PDPs, IPCs, and IPs must be updated with the appropriate units of individualized skills and socialization in accordance with applicable HCS or TxHmL Program rules by December 31, 2023.
For new enrollees and current enrollees who are not currently receiving day habilitation, individualized skills and socialization will need to be added, once the IPC and IP form have been updated, to the individual’s service plan because units will not be auto-authorized for these individuals. Day habilitation can be added and delivered until February 28, 2023.
To read more, please click on link below, for Information Letter 2023-03 related to ISS automatic service authorizations and EVV
January 3rd, 2023
Easier Format For ISS Licensing Rules effective Jan. 1, 2023
The link below provides a format that is easier to read and understand the newly adopted licensing rules rather than those when published as adopted in the Texas Register
Effective Jan. 1, 2023, HHSC adopts new Individualized Skills and Socialization rules for providers who want to deliver individualized skills and socialization services. New rules provide guidance regarding:
- applying for an Individualized Skills and Socialization license;
- provider requirements; and
- HHSC survey and enforcement actions.
Read the new rules in Title 26 of the Texas Administrative Code, Chapter 559, Subchapter H.
HHSC also published Provider Letter 2023-01 New Regulatory Rules for Long-term Care Regulation (LTCR) Individualized Skills and Socialization Services. This PL provides guidance to Individualized Skills and Socialization providers about the new rules.
Read PL 2023-01.
December 23rd, 2022
NEW RULES FOR ISS & ISS LICENSE
HHSC Adds Individualized Skills and Socialization to Email and Text Updates
HHSC added an option to the HHSC email and text update GovDelivery system that subscribers can select to receive updates related to the Individualized Skills and Socialization services program. Users can select to receive Individualized Skills and Socialization program alerts from the “Provider Alerts” drop-down menu.
To sign up for updates, select this link Texas Health and Human Services Commission (govdelivery.com).
For questions about Individualized Skills and Socialization, please email LTCRPolicy@hhs.texas.
November 28th, 2022
Webinar for New Licensing Process Nov. 30th, 2022 Extended to 2 hrs
All providers interested in the new licensing process for the Day Activity Health Services Individualized Skills and Socialization program are invited to a 2-hour webinar on Nov. 30. Originally it was a 1 hr session but has now been extended to have enough time for questions and explanations.
HHSC Long-Term Regulation staff will discuss how to navigate TULIP, the licensing system, explain the license application process and provide an overview of the survey process. There will also be a Q&A session as time allows.
Register for the webinar: Licensing Process Webinar
November 19th, 2022
DAHS ISS Licensing Application Available!
On Dec. 1, 2022, HHSC will launch the Day Activity Health Services (DAHS) Individualized Skills and Socialization License Application in the Texas Unified Licensure Information Portal (TULIP).
Link to TULIP: https://txhhs.force.com/TULIP/s/
Email TULIP_Support@hhsc.state.tx.us with questions related to TULIP functionality or if you have issues gaining access.
Email LTC_NF_DAHS_Licensing@hhs.texas.gov with questions related to the DAHS Individualized Skills and Socialization licensing application
October 13th, 2022
Licensing Application Process For ISS:
October 2nd, 2022
Register for Individualized Skills and Socialization Provider Portal Trainings
Individualized Skills and Socialization Provider applicants are required to complete HHSC Individualized Skills and Socialization Provider Trainings. Below are two computer-based trainings, which will assist Individualized Skills and Socialization Providers with applying for a license and preparing for an inspection.
- Prelicensure Training for Individualized Skills and Socialization Providers
This training was designed for providers who wish to offer individualized skills and socialization services. Prior to surveys or inspection, an entity must submit an application for a Day Activity and Health Services license. Information about the requirements to obtain a license will be shared. Register for the training. - Preparing for an Inspection
This training was designed to assist Individualized Skills and Socialization Providers to prepare for an inspection. In this course, information about the inspection process and licensure rules will be shared. Register for the training.
September 24th, 2022
HHSC Moved The Individualized Skills and Socialization Webpage
The Individualized Skills and Socialization webpage moved from the Resources webpage to the main Long-term Care Providers webpage. This was done so its location is consistent with other Long-term Care Regulation programs and is easier to find.
Individualized Skills and Socialization can be found under the “Community-based Programs” heading.
August 23rd, 2022
No Public Hearing on ISS Licensing Rules
Comments must be submitted no later than 31 days after the date the rules were published in the Texas Register; i.e., 31 days after August 12, 2022.. Comments must be (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered before 5:00 p.m. on the last working day of the comment period; or (3) emailed before midnight on the last day of the comment period. If the last day to submit comments falls on a holiday, comments must be postmarked, shipped, or emailed before midnight on the following business day to be accepted. When emailing comments, please indicate “Comments on Proposed Rule 22R050” in the subject line.
Public Hearing on ISS Program Rules
HHSC will conduct a public hearing on the proposed HCS, TxHmL and DBMD ISS program rules on September 7, 2022 from 8:00 am. until Noon. To register for the virtual hearing, go to: https://attendee.gotowebinar.com/register/927810115195515152
For a copy of the proposed ISS license rules or go to: https://www.hhs.texas.gov/regulations/policies-rules/health-human-services-rulemaking/comment-proposed-draft-rules
August 13th, 2022
Texas HHSC has developed the Individualized Skills and Socialization Provider Portal, an online source of information for providers of individualized skills and socialization.
The Individualized Skills and Socialization Provider Portal will allow providers to:
- Complete and review trainings on the Individualized Skills and Socialization service.
- Find and review provider letters and other information and releases related to Individualized Skills Socialization.
- Link to rules and other services related to Individualized Skills and Socialization.
Provider Communications
- PL 2021-42 – This Provider Letter offers a brief introduction to the new individualized skills and socialization service and what providers can expect as HHSC implements the service.
- Individualized Skills and Socialization Services webinar – This helpful webinar provides an introduction and overview to Individualized Skills and Socialization
- Individualized Skills and Socialization FAQs – revised April 26, 2022
- July 2022 – Individualized Skills and Socialization Provider Webinar – This webinar covers the service description, ratio requirements, and licensing information based on HHSC’s draft individualized skills and socialization rules.
August 6th, 2022
See Draft/Proposed Rules for ISS in HCS and TxHmL below:
Proposed ISS Rules (Main portion of rules start on page 13-52)
- The anticipated adoption date is October, 2022 with an effective date of November 2022. These dates also apply to the proposed rules for the DBMD waiver program.
- Very few changes were made from comments HHSC received during the informal comment period earlier this year. Though we had been apprised of such before this positing, know that any comments you submitted during the informal comment period will need to be resubmitted.
- Carefully review the introduction to the HCS and TxHmL rules on pages 1 -4, including the sections on Issues and Alternatives and Stakeholder Involvement on page 3.
- Carefully review the preamble to the rules before reading the actual rules and pay attention to the sections on Impact to Small Businesses.
- The proposed HCS and TxHmL rules are included in one document. To help you navigate the document, the following is offered:
Info Concerning Medicaid HCBS Settings Compliance Requirements Including CMS Toolkit
March 26th, 2023
HHSC published PL 2023-06 Compliance with New HCBS Settings Rules
HHSC Long-term Care Regulation published Provider Letter 2023-06 regarding Compliance with New HCBS Settings Rules on March 24, 2023. This letter explains how LTCR surveyors will assess HCS providers for compliance with the new HCBS settings requirements.
March 15th, 2023
The Center for Medicaid and CHIP Services (CMCS) is sharing this toolkit with State Medicaid Agencies, Operating Agencies, and other stakeholders a Home and Community-Based Settings Toolkit to assist states to develop Home and Community-Based 1915(c) waiver and 1915(i) SPA amendment or renewal application(s) to comply with new requirements.
Texas State Transition Plan for CMS’s HCBS Compliance Requirements (2022 update)
These requirements were noted in the recently published Home and Community-Based Settings (HCBS) regulations. HHSC is amending TAC rules to add requirements for all settings in the HCS program, including 3-person and 4-person group homes and host home/companion care settings, to comply with HCBS settings requirements at 42 CFR §441.301(c)(4)(i)-(v).
These new HCS rules have been added as TAC Title 26, Part 1, Chapter 263.
Texas Home Living HCBS regulations for compliance requirements is the following TAC title 26 part I Chapter 262
I would pay attention, in particular to the following information in the toolkit: Info on residential & non-residential settings, Q&A for HCBS, Transition Plan toolkit, and the info on Heightened Scrutiny and the Review process for it, as well as person-centered requirements.
Handy Dandy List of Items In The Toolkit:
- SMDL: Home and Community-Based Settings Regulation – Implementation Timeline Extension and Revised Frequently Asked Questions – July 14, 2020
- March 2019 Updated Frequently Asked Questions on Heightened Scrutiny Provisions
- July 2019 CIB: Heightened Scrutiny Review of Newly Constructed Presumptively Institutional Settings
- All State Call Slides: FAQs on Heightened Scrutiny – March 2019
- FAQs concerning Medicaid Beneficiaries in Home and Community-Based Settings who Exhibit Unsafe Wandering or Exit-Seeking Behavior
- A summary of the regulatory requirements of fully compliant HCB settings and those settings that are excluded.
- Schematic drawings of the heightened scrutiny process as a part of the regular waiver life cycle and the HCBS 1915(c) compliance flowchart.
- Additional technical guidance on regulatory language regarding settings that isolate.
- Exploratory questions that may assist states in the assessment of:
- Questions and Answers Regarding Home and Community-Based Settings
- Statewide Transition Plan Toolkit for Alignment with HCB Settings Regulation Requirements Suggestions for alternative approaches and considerations for states as they prepare and submit Statewide Transition Plans for the new federal requirements for residential and non-residential home and community-based settings. The regulatory requirements can be found at 42 CFR 441.301(c)(4)(5) and 441.710(a)(1)(2).
- Frequently Asked Questions Regarding the Heightened Scrutiny Review Process and Other Home and Community-Based Settings Information
- Frequently Asked Questions on Planned Construction and Person-Centered Planning Requirements
Bills Submitted During Texas’s 88th Legislative Session
March 20th, 2023
88th Legislative Session in Texas!
Here Are A Few House Bills Submitted That May Affect Long-Term Care & Other Services For Persons With Disabilities
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HB 54: Personal needs allowance for certain Medicaid recipients who are residents of long-term care facilities.
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HB 144: Possible Exemption from ad valorem taxation of the total appraised value of the residence homestead of an unpaid caregiver of an individual.
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HB 166: The appointment of an educational representative for certain students with disabilities.
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HB 245: Community attendants under the community attendant services program.
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HB 568: Education and training for peace officers on interacting with persons with Alzheimer’s disease and other dementias.
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HB 653: Guardianships of the person of wards with profound intellectual disabilities who are minors or were minors when their guardianship proceedings commenced.
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HB 1430: Establishing a minimum wage for certain personal attendants under Medicaid and other programs administered by HHSC (One can only hope this means an increase in funding for wages!)
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HB 1593: Infection prevention and control programs and other measures for communicable diseases at certain long-term care facilities.
See more info on House Bills and Senate Bills in the PDF links below.
*Note: Each bill provides a link to the text of the bill. After clicking on the link, click on ‘text’. Under ‘Text’ you will find the bill as filed and various versions of the bill as it makes its way through the committee process and moves from one chamber to the other. Bills highlighted in yellow are deemed ‘priority’ bills.
1-Day Live Training- Austin, Tx- Introduction To ISS (Individualized Skills & Socialization) April 3rd, 2023
Individualized Skills and Socialization Joint Training Opportunities
For: Applicants For ISS Licensure and New ISS Providers
HHSC Joint Provider Trainings will host a 1-day live training (Austin, Tx) that will cover the licensing process for the Individualized Skills and Socialization Program, as well as an overview of the rules, survey process, and reporting requirements for allegations of abuse, neglect, and exploitation.
Introduction to Individualized Skills and Socialization Program (course description)
701 W. 51st Street
Room: Public Hearing Room
Austin, TX 78751
(150 MAX)
1915(c) Waiver Interest Lists: Find By Legislative Districts
March 5th, 2023
Thanks to our friends at ARC for posting this in one of their recent newsletters
1915(c) Waiver Interest Lists by Legislative District
Find below maps produced by The Arc of Texas showing how many Texans on Medicaid waiver interest lists live within each State House, State Senate, and Congressional district. The Medicaid waivers being tracked are all CLASS, DBMD, HVC, MDCP, STAR+ PLUS, and TXHML.
The darker the hue of the district, the more people there are on any interest list in that district.
Each district’s label indicated the current incumbent in that district.
Clicking on each district with show more detailed information.
Letter IL 2023-09: Host Home Provider’s Who Are Immediate Family Members & New CMS Rules For HCS
February 27th, 2023
Letter IL 2023-09 discusses that Sections 263.502 and 263.503 (a)(1)(A) and (b) through (m) of the new Chapter 263 CMS rules do not apply to HH/CC providers in which the HH/CC provider is an immediate family member of the person receiving HH services. See page 1, 2nd paragraph of the IL for the definition of an immediate family member. Sections 263.502 and 23.503 (a)(1)(A) and (b) through (m) will however, apply if a HH/CC provider does not meet the definition of an immediate family member
Under Chapter 263, Subchapter F related to Provider Owned or Controlled Residential Settings, in particular Sections 263.501, 263.510 and 263.503. The rules under these sections address the following: requirements related to HCBS settings (Section 263.501); requirements as to what providers must ensure in the delivery of services, such as privacy in bedrooms, an operable bedroom door lock, access to food, choice of roommates, etc. (Section 263.502); and requirements related to residential lease agreements (Section 263.503).
Do You Know How Millin Billing Pro Can Help Providers With TMHP Billing & EVV? Check Out These Videos
February 23rd, 2023
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.
HCBS Settings Rules Adopted for HCS, TxHmL & TAS (Transition Assistance Services)
February 25th, 2023
- Only the rule provisions to which changes were made are included in the links above. I believe HHSC will post the complete set soon.
- You are urged to read the preamble to the rules, in particular HHSC’s responses to comments received from stakeholders, before reading the rules.
- See pages 74 through 81 in the HCS rules for the adopted rules governing Residential Settings and Residential Agreements.
PHE (Public Health Emergency) & New ISS Services
February 22nd, 2023
I know providers have really been concerned about the period of time between March 1st and May 11th while the PHE has been extended, as to whether or not this will include ISS services for In-Home ISS.
HHSC stated it would release a notice soon stating that beginning March 1, 2023 in-home ISS can be done without the justification (medical or behavioral justification or anyone 55 years of age and older should they request such) for such that will be required in the rules, through May 11th. After May 11th, however, this will not be permitted anymore and the justifications for in-home ISS must be in place.
***Remember medical and behavioral justifications will require medical recommendations or orders from physician and/or behavioral support professional recommendations (i.e. psychologist, bcba)
In-Home ISS in Host Home Companion Care (HH/CC) Settings: Update
February 22nd, 2023
In-Home ISS in HH/CC Settings: If persons receiving HH/CC services receive in-home ISS only, the provider does not have to be licensed. If the person receiving HH/CC services engages in community activities (known as off-site ISS), then the provider of the off-site ISS must be a licensed ISS provider.
Modifications to CMS Regs HCBS Settings Rules: Access To Food, Locks On Individual’s Doors & More
February 21st, 2023
Update on Who Qualifies To Assess The Need For A Modification
According to HHSC (and the proposed rules that will now be under Chapter 263) modifications to the door lock requirement must be based on a documented, assessed need and brought to the SPT for review and documentation in one’s PDP
As to whom determines the assessed need, HHSC stated at recent training sessions in Lake Jackson and Austin I believe, that a licensed professional, defining such as a doctor, RN, behavioral health provider, or other therapist providing such determination is within the scope of their practice.
February 14, 2023
Protocol For Modifications to AccessTo Food, Locks on Individual’s Doors & Other CMS Regs HCBS Settings Rules
Please see the alert letter below for complete information discussed in this post:
“In 2014, CMS issued federal regulations for settings where Medicaid home and community-based services (HCBS) are provided. All settings where Medicaid HCBS are delivered must meet federal requirements by March 17, 2023.
HHSC is finalizing updates to the HCS Program rules at 26 TAC §263.502. The rules are expected to be adopted in early 2023 and will include the detailed requirements outlined below.
The federal regulations require that all individuals residing in a provider-owned or controlled setting must ensure certain requirements are met. These requirements include:
● Individual privacy in the bedroom;
● Choice not to share a bedroom;
● Choice of roommate if sharing a bedroom;
● A lock is installed on the bedroom door;
● Individual can furnish and decorate their bedroom;
● Individual has control over their schedule and activities that are not part of an implementation plan;
● Individual has access to food at any time;
● Individual has the ability to have visitors of their choosing at any time;
If a program provider becomes aware that a modification to one of these requirements must be implemented due to a specific assessed need of an individual, the program provider must notify the service coordinator as soon as possible. The program provider must provide the service coordinator with the following information:
● A description of the specific and individualized assessed need that justifies the modification;
● A description of the positive interventions and supports that were tried but did not work;
● A description of the less intrusive methods of meeting the need that were tried but did not work;
● A description of the condition that is directly proportionate to the specific assessed need;
● A description of how data will be routinely collected and reviewed to measure the ongoing effectiveness of the modification;
● The established time limits for periodic reviews to determine if the modification is still necessary or can be terminated;
● The individual’s or legally authorized representative’s (LAR’s) signature evidencing informed consent to the modification; and
● The program provider’s assurance that the modification will cause no harm to the individual.
If the service coordinator receives a notification from the program provider of a required modification(s), the service coordinator must convene a service planning team (SPT) meeting to update the person-directed plan (PDP) with the information above.
If the SPT agrees to the modification(s) and updates the PDP, then the program provider may implement the modification(s).
**Note that a family member/LAR’s request or preference to not comply with one of the requirements is not considered an individualized assessed need that justifies a modification to the federal requirement.”
Link to PowerPoint Handout From Austin Training on February 10th, 2023 for information discussed on this subject and other current issues (residential agreements, ISS, etc…)
Repeal of HCS Rules under Title 40, Chapter 9 / Movement to Title 26, Chapter 565
February 14th, 2023
Repeal of HCS Rules under Title 40, Chapter 9 / Movement to Title 26, Chapter 565
An additional concern from HCS program providers involves their ability to comply with the regulations without financial support from HHSC. Program providers expressed that both existing requirements that will transfer to new Title 26 and new requirements added to improve health and safety create an undue financial burden given the current reimbursement rate structure within the Medicaid HCS waiver program. Program providers and advocates also expressed a desire for interpretive guidance to ensure accurate implementation from both a provider and surveyor perspective.
HHSC worked closely with HCS program providers and advocacy groups while creating these rules to attempt to mitigate their concerns regarding cost of implementation and clarity of rules language. HHSC also agreed to develop interpretive guidance once rules are adopted to ensure consistent application from providers and surveyors. During the year-long workgroup process, HCS program providers, advocacy groups, and HHSC staff crafted health and safety language that all parties agreed would meet the needs of the individuals who receive HCS waiver program services.
In March 2021 through February 2022, HHSC met with HCS providers associations, including PPAT, PACTX, and Texas Council for Community Centers; advocacy groups, including Disability Rights Texas and Every Child; and HHSC program staff. This workgroup focused on creating clear and concise rule language dedicated to the health and safety of the individuals who receive HCS waiver program services. HHSC held monthly workgroup meetings to review existing HCS regulations and create revised HCS regulations, with the focus on health and safety. Workgroup participants provided feedback both during and between meetings by providing feedback on proposed language. The workgroup received the complete draft regulatory language in February 2022 and provided input prior to beginning the formal rulemaking process.”
- Target date for publication in the Texas Register: February, 2023.
- Target date for adoption: May 2023.
- See pages 1-3 for Background Information.
- See pages 4 – 8 for Preamble to repeal of rules under Chapter 9.
- See page 9 for Preamble to the proposed new rules which provides a high-level summary of changes.
- See pages 16 – 106 for proposed new rules.
- See pages 73 – 74 for Residential Requirements, including provisions related to locks on bedroom doors. These proposed rules contradict the proposed HCBS settings rules under Chapter 263 regarding locks. [Though confirmation is being sought, it was reported that at the ISS and HCBS training HHSC conducted in Austin last Friday, HHSC stated the rules under Chapter 263 (which are still not adopted) will take precedence.
- See page 78 for provisions related to the new requirement for conducting quarterly on-site visits in HHs.
- See bottom of page 81 for requirements related to Finances and Rent.
PAT: Provider Applicant Test-Update 2023
February 10th, 2023
From HHSC’s PAT FAQ’s as of Jan. 1st, 2023
“Frequently Asked Questions for Providers Applicant Training (PAT) for HCS/TXHML”
-When is the Provider Applicant Training (PAT) Online available?
This training is now available online. The PAT training is the first step for applicants to obtain a contract with HHSC. Please do not submit your application without the PAT certificate that reflects a passing score of 85% or above.
-Who can take the training?
Applicants listed on Form 3681, Section 8.a and 8.b must complete the online PAT training. The Program Manager listed must complete the training and pass the test with an 85% or above.
See Texas Administrative Code Title 40, Chapter 49, Rule §49.204.
-How can I access the HHS Learning Portal?
• HHS Learning Portal (texas.gov).
• Set up your new account. You will need to confirm your new account through the email address used.
• Find and select the Medicaid Long Term Services and Support Training under “Course Categories.”
• Select the Provider Applicant Training (PAT) link. Select “Enroll me” to access the Training and get access to the “Welcome” page.
The training is compiled in four different steps.
Step 1. Important to know Before you Get Started
Fill out the Provider Applicant Training (PAT) Information form. This form must be completed to access the introduction and the training modules.
Step 2. Training Modules
Complete each module must be completed to advance to the next module.
Step 3. Evaluation and Certificates
Complete the mandatory survey
Step 4. Provider Competency Exam
Download, and save your exam certificate upon completion. Submit the certificate along with your completed application
IMPORTANT: You must take the PAT before you can apply to be an HCS Provider!!!. You must pass the Test by 85 % If you fail the test, you can’t retake the test for a period of 6 months, so please study the TAC before and pay careful attention to the PAT modules before answering test questions.
Note: If you do not pass on your first attempt, please DO NOT apply.
Important: Re-evaluation of Medicaid Eligibility!!
March 2nd, 2023
Unwinding of Continuous Medicaid Coverage: HHSC will stagger Medicaid Eligibility Determinations, separating into 3 groups. IDD will be in the last group, meaning that packets will be sent in June with persons having 30 days to reply. More information can be found at: https://www.hhs.texas.gov/services/health/coronavirus-covid-19/coronavirus-covid-19-provider-information/end-continuous-medicaid-coverage-ambassador-toolkit
February 9th, 2023
The Biden administration plans to end the state of Public Health Emergency (PHE), due to the pandemic. Many are warning that the shift will have major implications for people with disabilities that go far beyond COVID-19.
Under the public health emergency, which has been in place since 2020, states have been eligible for extra federal funding for Medicaid in exchange for agreeing not to drop most beneficiaries from the program. The federal government has also given HCS providers added flexibilities during this time.
Currently, it appears that President Biden plans to extend the public health emergency to May 11, at which point it will end.
Once the PHE is over, it will trigger a widespread effort by Medicaid programs across the country to re-evaluate each beneficiary (in this case, meaning individuals in our IDD programs) to determine whether or not they remain eligible. Many are worried that quite a few persons with developmental disabilities could inadvertently or accidently be dropped from the program, even if they still qualify. In addition, if they lose Medicaid eligibility even temporarily due to this issue, it will make it much harder to reverse the decision in a timely fashion. This would affect providers in receiving funds for their services provided to individuals. It would also mean that these individuals would not be able to obtain HCS services possibly anymore as they would not qualify for the waiver and they would not be able to receive their medical care and medications through Medicaid.
I can’t stress enough, that people with disabilities and their families (or specific Medicaid contact person) make sure they respond to any mail or email from their Medicaid office, that their address is up to date at HHSC & Medicaid as well as being in compliance with the financial eligibility rules under Medicaid as well. Be sure to fill out any annual Medicaid Status Reports on time as well.
If an IDD provider (HCS, TxHmL, etc..) is the contact person for Medicaid please have all available persons that are appropriate assist with this process to ensure your individuals do not lose their Medicaid. ( i.e. case managers/care coordinators, program managers, financial dept. staff, etc.)
States can start the redetermination process as soon as this month and can terminate Medicaid coverage for individuals as early as April 1. Across the country, the process is expected to be complete no later than May 2024.
TMHP’s 1915(c) Waiver YouTube Training Videos Website: PEMS (Program Enrollment Management Systems) & More
February 9th, 2023
Where can you find helpful Training Videos on the PEMS process? Check out the TMHP page with their Youtube videos for PEMS.
In addition, you will find information on removing TPI’s and a Video series on running and utilizing your R&S Reports
1915 (c) waiver page at TMHP For YouTube Training Videos
Specific link to R&S Report Video Series
Specific link to Removal of TPI From Forms Video
HCS & TxHmL Webinars & FAQ’s (Recordings)
For Previously Recorded Webinars & FAQ’s
February 5th, 2023
IDD and PI Quarterly Webinar with HHSC LTCR Recording Available
The January 26 recording of the Intellectual and Developmental Disability (IDD) Programs and Provider Investigations (PI) Quarterly Webinar with Long-term Care Regulation (LTCR) is available.
Listen to the webinar recording.
Read the IDD and PI Webinar (PDF).
Any questions or requests for transcripts may be emailed to LTCR Policy.
November 1st, 2022
HCS & TxHmL Updates Provider Webinar from Oct. 13
For: HCS/TxHmL program providers, LIDDA’s, and other interested parties
This webinar will provide information on the following:
- Substantial changes are being made to the HCS and TxHmL Program rules.
- IL 2022-49, assessments of HCS three-person residences, four-person residences and host home/companion care settings for compliance with the federal HCS settings rules.
HCS and TxHmL Program Updates Provider Webinar
Oct. 13
1–3 p.m.
September 25th, 2022
TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar
Medicaid and CHIP Services (MCS) will begin hosting monthly meetings for Providers and Financial Management Services Agencies (FMSAs) who use the Long-Term Care (LTC) Online Portal for the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver programs.
Texas Medicaid & Healthcare Partnership (TMHP) and Health and Human Services Commission (HHSC) staff from the following departments will be available to provide information and answer questions:
- Program Eligibility and Support (PES).
- Utilization Review (UR).
- Provider Claims Services (PCS).
- Contract Administration & Provider Monitoring (CAPM).
- Local Procedure Development and Support (LPDS).
Save the Dates
The webinars will be held on the following dates. We encourage Providers and FMSAs to invite staff who use the LTC Online Portal for HCS and TxHmL programs.
- October 2022: Wednesday, Oct. 5, 1–2 p.m. Register for the webinar.
- November 2022: Wednesday, Nov. 9, 10–11 a.m. Register for the webinar.
- December 2022: Thursday, Dec. 8, 1–2 p.m. Register for the webinar.
Standing Meeting Agenda
- Trending issues – discuss trending issues and solutions to increase successful processing of forms.
- Updates on LTC Online Portal for HCS and TxHmL – provide relevant updates.
- Questions and Answers – HCS and TxHmL Providers and FMSAs will have the opportunity to ask questions* regarding LTC Online Portal for HCS and TxHmL.
*To comply with HIPAA requirements, questions that include any identifying information for a specific individual will not be allowed during the monthly meetings.
Email Questions to TxHmL Policy.
September 25th, 2022
HCS and TxHmL Updates Provider Webinar
HHSC will host the HCS and TxHmL Services Program Updates Provider Webinar on Oct. 13 for HCS and TxHmL program providers, local intellectual and developmental disability authorities, and other interested parties.
This webinar — offered on Thursday, Oct. 13, from 1–3 p.m. — will provide information on the substantive changes made to the HCS and TxHmL Program rules. Both webinars will provide the same information, so program providers and LIDDAs can register for the time that works best for them.
Email questions about the webinar to your program policy inbox:
September 12th, 2022
Updated HCS and TxHmL Waiver Programs FAQ Document Now Available- Sept. 2022
The Home and Community-based Services and Texas Home Living Waiver Programs Frequently Asked Questions document has been updated.
July 15th, 2022
HCS and TxHmL Webinar Recorded From July 14th, 2022
Webinar topic includes:
- Forms Submission and Processing in TMHP LTCOP
HCS and TxHmL Webinar
July 14, 2022
2:30 – 4 p.m.
Click link below to register to watch recording of this session.
Register for the webinar
Email questions about the webinar to your program policy mailbox:
July 13th, 2022
IDD and PI Quarterly Webinars
May 5th, 2022
HCS and TxHmL FAQ Updates Available May 9 and May 23
The Home and Community-based Services and Texas Home Living Waiver Programs Frequently Asked Questions document has been updated.
HCS-TxHmL-FAQ-TMHP-TexasMedConnect
Updated HCS and TxHmL COVID-19 FAQ
May 6th, 2022
Read the revised Updated COVID-19 FAQs for HCS and TxHmL Providers (PDF).
September 1st, 2022
HHSC has revised the Updated HCS and TxHmL COVID-19 FAQ (PDF)
August 15th, 2021
HCS and TxHmL Webinar Recording Available
” WSC Transition into HHSC LTCR”
(From August 10th, 2021)
Long-term Care Regulation hosted a webinar for HCS and TxHmL program providers to discuss upcoming HHSC organizational changes, introduce LTCR survey operations leadership, and answer questions about the Waiver Survey and Certification unit’s transition into LTCR survey operations.
A recording of August 10, 2021, HCS and TxHmL Transformation Webinar with HHSC Long-Term Care Regulation is available for those who could not attend.
Read the HCS and TxHmL Transformation Webinar (PDF).
Listen to the webinar recording here.
.
May 23rd, 2021
June Infection Control Basics for HCS and TxHmL Providers Webinars
This webinar will review basic infection control concepts such as hand hygiene, standard and transmission-based precautions, and steps to prevent the spread of infectious disease.
Registration for each class is limited to 50 participants.
June 3
10 – 11:30 a.m.
Register for the June 3 webinar.
June 10
10 – 11:30 am
Register for the June 10 webinar.
June 17
10 – 11:30 a.m.
Register for the June 17 webinar.
June 24
10 – 11:30 a.m.
Register for the June 24 webinar.
.March 16th, 2021 Updated
Updated COVID-19 Frequently Asked Questions for HCS and TxHmL Providers
HHSC has published an updated Frequently Asked Questions about COVID-19 for Home and Community-based Services and Texas Home Living providers.
Read the Updated COVID-19 FAQs for HCS and TxHmL Providers (PDF).
March 19 Recording of Clarification of Administrative Penalties and Related Processes Webinar Available
A recording of the March 19, 2021 Clarification of Administrative Penalties and Related Processes for HCS and TxHmL Providers webinar is available for those unable to attend.
Listen to the webinar recording here.
March 4 Recording of Writing Acceptable Plans of Correction Webinar Available
A recording of the March 4, 2021 Writing Acceptable Plans of Correction webinar for HCS and TxHmL program providers is available for those unable to attend.
Listen to the webinar recording here.
Feb 25. HCS & TxHmL Provider Responsibilities: Death Notifications & Investigation Reports Webinar
This webinar will provide information about program provider responsibilities for reporting abuse, neglect and exploitation and providing notifications of death.
Feb. 25
1-3 p.m.
Register for the webinar.
Jan. 5 Recording Webinar Available – HCS and TxHmL Changes to Survey Process and Hold Harmless Period Overview
A recording of the Jan. 5, 2021, HCS and TxHmL Changes to Survey Process and Hold Harmless Period Overview webinar is available for those unable to attend.
Listen to the webinar recording here.
Jan. 7 Recording of HCS and TxHmL Administrative Penalties and Amelioration Available
A recording of the Jan. 7, 2021 HCS and TxHmL Administrative Penalties and Amelioration webinar is available for those unable to attend.
Listen to the webinar recording here.
DSHS Video on Long-term Care Facilities COVID-19 Infection Prevention and Control Now Available
The Department of State Health Services has published a recorded training for long-term care providers on COVID-19 precautions to take and how to accomplish them.
Proposed HCS and TxHmL Billing Requirements
February 5th, 2023
Proposed HCS and TxHmL Billing Requirements
Home and Community-based Services and Texas Home Living stakeholders can now comment on the proposed revisions to the HCS and TxHmL Billing Requirements by Feb. 14.
The proposed billing requirement revisions and a summary of changes are located on the Long-term Care Providers webpage and are outlined below:
HCS
HCS Billing Requirements Draft Revision 23-2 (MS Word)
HCS Billing Requirements Draft Revision 23-2 Summary of Changes (PDF)
TxHmL
TxHmL Billing Requirements Draft Revision 23-2 (MS Word)
TxHmL Billing Requirements Draft Revision 23-2 Summary of Changes (PDF)
Email stakeholder comments to TxHmL Policy.
LTC Provider Bulletin Now Available
February 5th, 2023
LTC Provider Bulletin Now Available
The February 2022 Long-Term Care (LTC) Provider Bulletin has been published on the LTC homepage on TMHP.com.
Visit the TMHP LTC homepage regularly for news, reminders, training opportunities, and other important program updates.
For questions, see the LTC Provider Resources Guide under Reference Material.
IMT and IPC Form Enhancements Pertaining To Location Code Issues in TMHP Now Available!
January 5th, 2023
IMT and IPC Form Enhancements and IBI Guide Updates Now Available
From HHSC:
“On January 13, 2023, a text box replaced the location code drop-down box on the following Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Individual Movement (IMT) and Individual Plan of Care (IPC) form fields:
- IPC transfers (3608/8582) field 39a: Receiving Program Provider Location Code
- IMT (all-purpose codes) field 18: Location Code
- IMT Individual Update fields 122: Current Location Code and 123: New Individual Location Code
- IMT LA Reassignment field 111: New Location Code
The information that is entered manually will be validated upon submission to ensure that the location code is valid for the provider. This enhancement will improve overall system performance.”
***Should be a huge help to getting those transfers through that many have had pending at the LIDDA’s!
The following item-by-item (IBI) guides have been updated to reflect enhancements:
For further information, contact the TMHP LTC Help Desk at 800-626-4117. Select option 1 and then option 7.
ARC Free Resource: Advocacy Toolkit
January 31st, 2023
Advocacy Toolkit from our friends at the ARC of Texas
https://www.thearcoftexas.org/wp-content/uploads/Advocacy-Toolkit.pdf
Twogether Consulting Webinars
February 2023
Common Nursing Violations: Prevention & Correction
February 23rd, 2023 10 AM-12:00 PM
(ICF/IID)
The HCS/TxHmL Interpretive Guidance Booklet: Nursing Focus
February 27th, 2023 11AM-12:30 PM
(HCS/TxHmL)
March 2023
Abuse, Neglect & Exploitation: Definitions, Signs & Symptoms, Reporting
March 2nd, 2023 11 AM-12:30 PM
(HCS/TxHmL)
(This session is for employees, contractors, volunteers, and more)
The CRA (Client’s Responsible Adult) & Their Responsibilities To The Nurse
March 8th, 2023 10 AM-11:30 AM
(HCS/TxHmL & ICF)
RN Delegation: Important Things To Remember
(This session does not cover SB1857/HRC 161 or HH/CC Exemptions)
March 9th, 2023 10 AM-11:30 AM
(HCS/TxHmL & ICF)
Billing Requirement Changes In HCS-2023 Update
March 29th, 2023 10AM-12:30PM
To Be Determined At A Later Date
Abuse, Neglect & Exploitation Allegation Follow-Up Requirements: (HCS/TxHmL Providers)
(This session is for: Administrative Staff, Program Managers, Case Managers/Care Coordinators, Nurses, and Quality Assurance Staff)
Abuse, Neglect & Exploitation Allegation Follow-Up Requirements: (ICF/IID Providers)
(This session is for: Administrators, QIDPs, House Managers, Nurses, and Quality Assurance Staff)
Please Continue To Check The Website For More Trainings
Pre-recorded sessions are available for purchase!
To Purchase these Pre-Recorded Trainings:
Go to www.twogetherconsulting.com
Or
Contact us at Javasbja@gmail.com at Meghanjones.tx@gmail.com
Currently, we have the following pre-recorded sessions:
ICF/IID Pre-Recorded Webinar Sessions
QIDP In The ICF Program (3 Part Series)
Nurse In The ICF Program (3 Part Series)
HCSTxHmL Pre-Recorded Webinar Sessions
Expectations of The Nurse: HCS/TxHmL
(includes: Delegation, CNA Training, Billable Services & Documentation as well) (4 Part Series)
Care Coordination (5 Part Series)
CARE COORDINATION (5 Part Series)
Part I
“Roles & Responsibilities: The LIDDA Vs. The Provider (For HCS/TxHmL providers)
Contact us at info@twogetherconsulting.com to purchase this training and the handouts.
Part II Pre-recorded sessions available for purchase!
“Important Parts of The TAC In Relation To The HCS Handbook” (For HCS/TxHmL providers)
Part III Pre-recorded sessions available for purchase!
For HCS & TxHML Providers
“Developing The IP Using Person-Centered Practices” This is part 3 of 5 of our Care Coordination series.
Part IV Pre-recorded sessions are available for purchase!
“ICAP/IDRC/LON” Webinar This is part 3 of 5 of our Care Coordination series.
Part V Pre-recorded sessions are available for purchase!
(Billable Services- HCS) This session is split up into 2 parts! Each section is 2 to 2.5 hrs long
General Billable Services (Day 1) & then Adaptive Aids/Minor Home Mods/Dental (Day 2)
Contact us at info@twogetherconsulting.com to purchase this training and the handouts.
Migration of In-Home DH to In-Home ISS Update
January 27th, 2023
As of 1/27/23, there have been no new alert letters concerning the extension of temporarily waiving certain requirements for In-Home DH due to the Public Health Emergency, past January 31st, 2023. This was the date we were given in Letter No. 2022-55.
My understanding is providers would receive notice at least 30 days prior to ending the PHE. I am assuming at this time that the PHE will extend through Feb. 28th, 2023. In-Home DH billing will discontinue in TMHP as of March 1st, 2023, so the last day to bill In-Home DH will be Feb. 28th, 2023. At this point, we move to In-Home ISS services. However, if the PHE does not end, I am unclear yet if In-Home ISS will allow for continuing to waive certain requirements temporarily due to the PHE. I believe that due to the fact the allowance for anyone to qualify for In-Home DH during the PHE is not part of the In-Home ISS rules/ISS rules, that an addendum would have to be put in place to cover In-Home ISS due to PHE. Not sure that will happen, so I would plan to be ready by March 1st.
Otherwise, come March 1st, 2023 all individuals wishing to receive In-Home ISS services will have to qualify in the following way:
In-home ISS must be provided in the individual’s residence.
Billing Requirements Section 49102.3
Requirement for Justification by a Licensed Professional or to be 55 Years or Age or Older
Revision 23-1; Effective January 1, 2023
An individual may receive in-home individualized skills and socialization only if:
(a) a physician has documented that the individual’s medical condition justifies the provision of in-home individualized skills and socialization; or
(b) a licensed professional or behavioral supports service provider listed in Section 4240(2), Qualified Service Provider, has documented that the individual’s behavioral issues justify the provision of in-home individualized skills and socialization; or
(c) the individual is 55 years of age or older and requests to receive in-home individualized skills and socialization.
In addition, EVV will need to occur for In-Home ISS services.
Qualifications for Service providers of In-Home ISS are as follows (they don’t need to be licensed)
49102.8 Qualified Service Provider
Revision 23-1; Effective January 1, 2023
In addition to meeting the requirements in Section 3400, Qualified Service Provider, a qualified service provider of the in-home individualized skills and socialization service component;
- (a) must have: (1) one of the following:
- (A) a high school diploma or a certificate recognized by a state as the equivalent of a high school diploma; or
- (B) documentation of a proficiency evaluation of experience and competence to perform the job tasks that includes:
-
- (i) a written competency-based assessment of the ability to document service delivery and observations of the individuals to be served; and
- (ii) at least three written personal references from persons not related by blood that indicate the ability to provide a safe, healthy environment for the individuals being served; and
(b) must not be the individual’s host home/companion care service provider
November 21, 2022
Letter No. 2022-55 (Replaces IL 2022-54)
This information letter (IL) replacesd IL 2022-54 In-Home Day Habilitation Information for Program Providers for COVID-19, previously released on October 31, 2022, to extend the temporary guidance through January 31, 2023, unless the COVID public health emergency ends sooner. HHSC will provide guidance if anything changes.
In response to COVID-19 and to provide access to needed day habilitation services, the Health and Human Services Commission (HHSC) is temporarily waiving certain requirements in Sections 4381.3, 3710, 4381.7(6) and 4381.7(7) of the HCS Billing Guidelines and the TxHmL Billing Guidelines.
Effective March 13, 2020, through January 31, 2023 unless the COVID PHE ends sooner:
● HCS or TxHmL program providers may provide day habilitation to an individual in the individual’s permanent or temporary residence without having the justification required by Section 4381.3. This includes individuals residing in their own homes or family homes.
For more info, please click on the information letter.
HHSC Form 4719 Required for Fire Drills for ISS Providers
January 27th, 2023
HHSC Form Required for Fire Drills for ISS Providers
Click on link below
* Some providers have noted that this form seems a bit inappropriate for ISS providers as the form has locations that seem more appropriate for a “home” setting, as opposed to maybe a “building” used by a licensed ISS provider, but it does have a box for “other” locations.
Blackboard Connect Emergency System (HCS, TxHmL, ICF, & DAHS-ISS Providers)
January 26th, 2023
FYI- somehow I missed this alert back in November for Licensed ISS providers. Please be sure to log in and set up your account.
PL 22-32 letter issued 11/28/22 to ISS providers that was sent out concerning Blackboard Connect Emergency System
(This applies to HCS, TxHmL, ICF, & DAHS-ISS Providers among other services)
The purpose of this letter was to inform providers of the emergency communication system called Blackboard Connect, how it will be used, and your responsibility in signing up for the system if you are an ISS provider. This system will be used to send emergency and outreach notifications through email, phone, voice and text if available.
The rules require program providers to assign a designee to enroll in and respond to requests through the system. The designee should be someone who is associated with the licensed building or someone who is responsible for communicating emergency communications. However, you may also have other designees, such as corporate headquarters staff, sign up.
Blackboard Connect sign-up process:
Go to this link and click “Sign Me Up!”
If you have any questions, please contact the Policy and Rules Section by email at LTCRPolicy@hhs.texas.gov or call (512) 438-3161.
STATEWIDE TRANSITION PLAN: HCBS
January 16th, 2023
Statewide Transition Plan
CMS requires states to submit a transition plan describing the state’s planned initiatives and activities for achieving compliance with the federal HCBS Settings Rule. HHSC has received initial approval of its transition plan and has updated the plan to include additional information required for CMS to grant final approval.
This version of the STP includes new information about site-specific assessments, ongoing monitoring and oversight, non-disability specific setting options, communications with beneficiaries regarding provider choice, and notification of provider non-compliance.
HHSC will submit a final Statewide Transition Plan (STP) to the Centers for Medicare and Medicaid Services (CMS). The STP is posted for public comment. All states must obtain final approval of their STP from CMS to comply with the federal Home and Community-Based Services Settings (HCBS) Rule. The STP describes HHSC’s activities and planned initiatives for meeting the requirements of the HCBS Settings Rule.
HHSC invites members of the public, including HCBS recipients and their families, providers and other stakeholders, to submit comments on the STP. Comments will be accepted until 11:59 pm on Feb. 13, 2023.
Access the STP and instructions for submitting public comments here.
Written comments, requests to review comments or both may be sent by U.S. mail, overnight mail, special delivery mail, hand delivery, fax, or email.
Email: Medicaid_HCBS@hhs.texas.gov
Fax:
Attention: Rachel Neely, Office of Policy at 512-438-5835
U.S. Mail:
Texas Health and Human Services Commission
Attention: Rachel Neely, Office of Policy
John H. Winters Complex
701 W 51st Street
Mail Code H-600
Austin, TX 78751
Overnight mail, special delivery mail, or hand delivery:
Texas Health and Human Services Commission
Attention: Rachel Neely, Office of Policy
John H. Winters Complex
701 W 51st Street
Mail Code H-600
Austin, TX 78751
Phone number for package delivery: 512-438-4297
When Will HCS New Rules and Status of Statewide Transition Plan (STP) Be Adopted?
January 16th, 2023
Adoption Date of HCS Rules and Status of Statewide Transition Plan (STP):
gave HHSC preliminary approval of its STP on 12/21/2022. The STP will be posted for public comment this Friday (Jan. 20th, 2023).
It is unclear when the HCS rules will be adopted.
See graph of draft rules below (pages 12-17 for HCS). Includes CLASS, TxHML, MDCP, and DMDB programs as well.
Appendix A: Home and Community-Based Services (HCBS) Settings Statewide Transition Plan
HCS/TxHML: /TMHP Recoupment, Due To Overpayment
January 15th, 2023
TMHP Recoupment Letters
December 12th, 2022
Avoiding HCS and TxHmL Overpayment of Services
Effective Jan. 2, 2023, Texas Medicaid and Healthcare Partnership (TMHP) will perform monthly calculations on services for the Individual Plan of Care that overlaps the May 1, 2022 implementation of the new process for submitting Home and Community-based Services and Texas Home Living forms and claims.
On a quarterly basis, TMHP will calculate all services that have been paid through Client Assignment and Registration System and TMHP and will recoup services that exceed the authorized IPC amount.
On-Site Assessments of HCS Group Homes & Certain HH Settings From CMS
Help With The New Residential Agreements
-An individual’s bedroom door is lockable by the individual, with only appropriate staff having keys to doors.
– An individual has access to food at any time.
Initial Critical Incident Management Services (CIMS) User Account Email
Have You Signed Up For CIMS (Critical Incident Management System)Yet?
Initial CIMS User Account Email
On Monday, Aug. 29, FEI Systems sent another mass email to Critical Incident Management System (CIMS) users who have not logged into CIMS. It will provide your user ID and temporary password. The temporary password in the email will expire after seven days.
This applies to:
- Community Living Assistance and Support Services providers and case management agencies
- Deaf Blind with Multiple Disabilities providers
- Home and Community-based Services providers
- Texas Home Living providers
- Local intellectual and developmental disability authorities
Please do not delay logging into your organization’s CIMS account. The account creation email will come from FEI Systems.
Providers are required to begin entering critical incidents into CIMS by Nov. 1. HHSC strongly encourages providers to become familiar with the system as soon as possible.
AAIDD Texas Chapter: Link To Follow Bills During The Texas 88th Legislative Session
January 12th, 2022
From our good friends at the Texas Chapter of AAIDD, some important info about the Texas 88th Legislative Session
Dion White, Center for Life Resources
AAIDD Texas Chapter Board Member
“Texas is home to more than 500,000 adults and children with intellectual and developmental disabilities (IDD). This legislative session will be very important to address specific changes happening within the IDD systems of care across the State.
Our system of care specific to IDD is currently undergoing changes in its service delivery system. One aspect of this change deals with a transition of IDD long term services and supports going from a traditional Medicaid model to a managed care model. Currently there are plans to pilot test this transition starting in September 2023. This is major change because it may impact the monitoring role of targeted case management. Through targeted case management, services are monitored to insure continuity over time. Currently the IDD local authorities are providing the TCM service.
As Texas continues to grow there is a concern if the entire system of care across the State will grow to meet the increased need of services. Many providers are also dealing with staffing shortages across the State which is making the situation much more difficult. There is a possibility this will be addressed either directly or indirectly during this session.
During this session there will be a-lot of discussion on addressing the IDD population in regard to the new programs starting such as Individualized Skills and Socialization services. The session started on January 10 and will end on May 29th. I encourage all stakeholders to follow legislation specific to IDD services and supports and contact your designated legislator with any concerns you may have. “
A good resource to follow bills online can be found at this link, https://capitol.texas.gov.
Employment Assistance & Supported Employment Training Options From HHSC
Employment Assistance & Supported Employment Training Options From HHSC
January 12th, 2022
“HHSC is pleased to announce the delivery of in-person Employment First / Employment Services training for the first time since 2019. This free one-day training opportunity has proven to be a very valuable opportunity to various levels of staff involved in the support of individuals who set the goal of competitive and integrated employment in the community. Various staff from the Local Authority, along with private providers in the area, as well as stakeholder groups will benefit from this training.
With the very high turnover rates the last several years, this training provides the opportunity to garner a basic understanding of Employment First, Employment Services, Benefits and Work Incentives, Job Coaching, Employment Readiness Skills, and Employer Relationships. Service Coordinators will benefit tremendously from this training as they serve as the first line in service planning. Additionally, a myriad of staff such as social workers, employment support staff, direct service staff, case managers, Qualified Intellectual Disability Professionals (QIDP), management staff and many others have found this training valuable. In short, anyone who has a role in supporting an individual directly or indirectly will benefit from the training.
This training will be offered at numerous locations in the state from February thru August 2023. We are pleased to advise that the first two events will be in Houston on February 7th and 8th. Each day will cover the same training, thus only one day should be chosen when registering.
Training will be held at the Harris Center 9401 Southwest Freeway, Houston, Texas 77074 in Conference Room 104, 9am to 4pm. Each event will have a max attendance limit of 70 people. Thus, moving quickly to register will be important. Please help us in getting the word out to your staff as well as sharing with others outside of your organization who can benefit. Registration is easy. Registrants can use one of the two links below based on the best date for the registrant.”
Thank you and we look forward to seeing everyone on February 7th or February 8th!
August 1st, 2021
Live HHSC Training Workshop!
HHSC is announcing a free, one-day Employment First / Employment Services Training event to be offered in six cities from September 2021 thru December 2021. Employment promotes a more independent living setting and creates independence for a person in many ways. This training is another tool to increase the Employment First focus and provide better tools for providers to improve hands-on skills and increase job opportunities for people with intellectual and developmental disabilities.
Training includes:
· Overview of Texas Employment First Policy
· Employment services in Medicaid waivers
· Basic facts on Social Security Administration disability benefits
· Basic facts on developing an employment profile and vocational assessment
· Building connections and working with families
· Development of soft skills and job-readiness skills
· Basic overview of applications and tablets for use as job coaches
· Building and maintaining strong employer relationships
The training is specifically designed for any staff member who has a role in supporting people who set employment goals or people with direct, hands-on roles such as service coordinators, employment specialists, direct care staff, day habilitation staff, job coaches, supervisors and others who support individuals as they pursue competitive and integrated employment.
Registration Links for each event as follows:
*September 8, 2021 – Lubbock – MGM Elegante (801 Avenue Q, Lubbock, TX 79401)
*September 29, 2021 – Austin – Norris Conference Center (2525 W Anderson Ln #365, Austin, TX 78757)
*October 13, 2021 – McAllen – Cambria Hotel McAllen Convention Center (701 South Ware Road, McAllen, TX, 78501)
*November 4, 2021 – San Antonio – Norris Conference Center (618 Northwest Loop 410 STE 207, San Antonio, TX 78216)
*November 17, 2021 – Corpus Christi – Region 2 Education Center (209 N Water St, Corpus Christi, TX 78401)
*December 1, 2021 – El Paso – Region 19 Education Center, (6611 Boeing Dr., El Paso, TX 79925)
Each event is limited to a maximum of 45 registrants. HHSC highly encourages everyone to register early to make certain a space is reserved. HHSC will also offer a waiting list after they reach the maximum capacity for any event, which will be identified to anyone attempting to register once a given event is full. Those on the waiting list will be contacted in the order received if they are notified of a cancellation.
June 28th, 2021
There are two Home and Community-based Services and Texas Home Living trainings in this series:
The web-based trainings cover employment services provided through HCS and TxHmL, information about the payer of first resort for employment assistance, and the basics of providing these services. They are designed to enhance staff knowledge about providing quality employment services to people enrolled in the waivers.
Each training has a corresponding quiz.
The Direct Service Workers web-based training provides information about employment services and how direct service workers can support people achieve their employment goals. The training covers federal and state initiatives related to employment for people with disabilities and touches on issues related to people who work and receive SSI or SSDI benefits. The training has a corresponding quiz.
Public Health Emergency (PHE) Renewed
January 11th, 2023
RENEWAL OF DETERMINATION THAT A PUBLIC HEALTH EMERGENCY EXISTS
“As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19) pandemic, on this date and after consultation with public health officials as necessary, I, Xavier Becerra, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective January 11, 2023, the January 31, 2020, determination by former Secretary Alex M. Azar II, that he previously renewed on April 21, 2020, July 23, 2020, October 2, 2020, and January 7, 2021, and that I renewed on April 15, 2021, July 19, 2021, October 15, 2021, January 14, 2022, April 12, 2022, July 15, 2022, and October 13, 2022, that a public health emergency exists and has existed since January 27, 2020, nationwide.”
From the HHSC ASPR website page, this is the alert concerning continuing PHE. At this time we have no further information on how long this will be ongoing.
ISS Rates
January 11th, 2023
Revised Information Letter (IL) 2023-01 related to ISS Payment Rates (replaces IL 2022-56):
HHSC has published Revised Information Letter (IL) 2023-01, which replaces 2022-56 related to payment rates for Individualized Skills and Socialization Services, effective January 1, 2023.
HHSC has also approved payment rates for the Individualized Skills and Socialization in the Deaf Blind with Multiple Disabilities waiver (DBMD), Home and Community-based Services waiver (HCS), and Texas Home Living waiver (TxHmL) programs, effective January 1, 2023.
- The revised Individualized Skills and Socialization payment rates for these programs can be accessed on the Provider Finance Department Long-term Services & Supports webpage.
- The Long-term care HHSC Bill code Crosswalks which is used to match the Texas Long-term Care (LTC) Local Codes (i.e., bill codes) to the National Standard Procedure Codes (e.g., procedure, item, revenue codes) and claim payment for services is available on the HHSC Long-term Care Bill Code Crosswalk page.
Contact PFD-LTSS@hhs.texas.gov or (737) 867-7817 if you have questions.
December 06, 2022
Last Friday HHSC posted the ISS rates which may be viewed at the link below.
- The on and off-site ISS rates are effective January 1, 2023. It appears to be unlikely any of the licenses for ISS will be approved by that time.
- The current in and out-of home DH rates will remain effective through February 28, 2023.
- ACRE will not be available for the ISS service.
- This is because the current DH rate is a daily rate; the ISS rate is an hourly rate.
- Restructuring this component of ACRE will necessitate additional funds which HHSC will be requesting from the 88th Texas Legislature. Unfortunately, once received access to funds will not be available until September 1, 2023 and which providers choosing to participate in ACRE can request during the July, 2023 enrollment period.
- Though the ISS rules have yet to be adopted (hopefully by no later than December 16th), the proposed rules allow persons with a medical or behavioral justification to receive in-home ISS.
- proposed rules also state that if requested, a person who is 55 or older may also receive in-home ISS.
- The provider of the in-home ISS service does not need to be a licensed ISS provider.
- Note: As proposed, the rules do not address whether persons with the aforementioned justification or request can also participate in community activities and bill for off-site ISS. Though assumed this will not be permitted, we are still waiting for a response.
- The off-site rates allow for two levels of enhanced staffing. Though the proposed rules did not call for two levels of enhanced staffing, the adopted rules will.
- The adopted rules will also change the ratios at least for the ‘LON 1 and LON 5 without enhanced staffing’ category.
September 27th, 2022
Please see the newly proposed ISS (Individualized Skills & Socialization) rates. The proposed rates would be effective January 1st, 2023, if accepted, at the following link: https://pfd.hhs.texas.gov/sites/rad/files/documents/2023/01-01-2023-pmnt-rates-individualized-skills-socialization-%20srvcs.pdf
The recording can be accessed on-demand after the hearing at https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings.
Trainings Initiatives: From HHSC
January 10th, 2023
Below are just some of the trainings offered by HHSC on their “Trainings Initiative” page. Some live and some via webinar.
For more information, please go to: https://www.hhs.texas.gov/providers/provider-training/training-initiatives
SSI/SSDI Benefits Overview
The SSI/SSDI Benefits Overview web-based training provides a basic foundation for understanding Supplemental Security Income and Supplemental Security Disability Insurance and provides contact information for people who can help you further understand these programs. The training has a corresponding quiz.
Employment First
The Employment First web-based training covers Texas’ new Employment First policy. The training has a corresponding quiz.
Visit the HHS Employment First website.
HCS and TxHmL
There are two Home and Community-based Services and Texas Home Living trainings in this series:
The web-based trainings cover employment services provided through HCS and TxHmL, information about the payer of first resort for employment assistance, and the basics of providing these services. They are designed to enhance staff knowledge about providing quality employment services to people enrolled in the waivers.
Each training has a corresponding quiz.
Direct Service Workers
The Direct Service Workers web-based training provides information about employment services and how direct service workers can support people achieve their employment goals. The training covers federal and state initiatives related to employment for people with disabilities and touches on issues related to people who work and receive SSI or SSDI benefits. The training has a corresponding quiz.
STATUS OF HCS RATES!
Status of HCS Rates as of Jan. 1st, 2023 (includes new ISS rates)
HCS Rates Jan. 1st, 2023 including ISS services
Status of HCS Rates as of June 3rd 2022
Provider Rate Updates for HCS and TxHmL Providers
In early May, HHSC identified missing or incorrect rate keys for some Home and Community-based Services and Texas Home Living providers.
On May 11–12, HHSC completed updates to rate keys for these HCS and TxHmL providers based on rates published on the Provider Finance website.
After confirming rates with Provider Finance and paid claims on the R&S Report, contact the TMHP LTC Help Desk at 800-626-4117, Option 1, then Option 7, if you have additional questions.
https://pfd.hhs.texas.gov/sites/rad/files/documents/long-term-svcs/2022/2022-hcs-awards.pdf
Status of HCS Rates as of January 17th, 2022
HCS and TxHmL Day Habilitation Rates, Respite Rates and Other Concerns
- The Public Health Emergency (PHE) was renewed until April 16, 2022, and
- Clarification: The HCS & TxHmL rates posted on HHSC’s webpage listed as Effective March 1, 2022 to Current. are a bit confusing
Please contact the Rate Analysis Department’s Customer Information Center at (512) 424-6637 or by email at RAD-LTSS@hhsc.state.tx.us should you have any questions regarding the information in this document.
Free Provider Resource Webinar Series
Free Webinars!!
January 2023 Webinars
Core-VA Solutions “Virtual Healthcare Assistants For LTC Programs”
Virtual Healthcare Assistants Services and Training for Long-Term Care Programs, including HCS, TxHmL, and ICF
Free Webinar Series Hosted By: Twogether Consulting (1/10/22 from noon-1pm)
Pre-Registration is required, click on the “Registration” button below to attend this free webinar and complete pre-survey questions!!
REGISTRATION
or Visit our website: www.twogetherconsulting.com and click on the Free Webinar calendar
Twogether Consulting is happy to have Brittney Russo-COO (Chief Operations Officer) from Core-VA Solutions to discuss her company’s “virtual assistant” services.
Core-VA Solutions provides virtual assistance for any type of long-term healthcare setting, whether it be for a small medical office or therapy office or HCS provider. All of our virtual assistants have a degree in nursing and/or health-related fields.
Core-VA is able to serve clients all over Texas and beyond. Some of the clients these virtual assistants work with are those in HCS, TxHmL, and also other IDD programs. This includes assisting with EVV and TMHP billing. Brittney’s team is able to provide appropriate training to her staff to cater to some of your specific needs, including persons with experience in the HCS/TxHmL programs providing some of that training and the IT solutions which they can learn to use using IT fundamentals here to learn for this. They have “virtual assistants” versed in the use of quite a few electronic health records software such as Taskmaster Pro, Focus, and other EHR and billing software. This is a wonderful resource for HCS/TxHmL providers for sure! This is especially true for some of you, who are brand-new HCS/TxHmL providers. Core-VA serves many different clients in other lines of Long-Term Health Services, but it is so nice to have help from a virtual assistant who understands the world of HCS/TxHmL!
-Core-VA team Solutions is part of our free webinar series for the month of January 2023! Click on their postcard below for more information. Services are available at $10/hr and no contracts.
core va post card
“Core-VA Solutions aims to positively change how your long-term healthcare facility operates with our virtual assistants with degrees in nursing and/or health-related fields. We understand that you may currently waste precious time and money completing tedious tasks such as medical reception, appointment scheduling, insurance authorization, receiving and submitting medical information, and so much more. Instead of hiring expensive employees to complete these much-needed tasks, hire our affordable virtual assistants instead, as we can provide you with the same level of service, at a fraction of the price. All you have to do is let us know how we can help, and our team will find the perfect assistant match for your facility!”
“Support & Empowerment Program For Persons With IDD & Their Caregivers”
Twogether Consulting is happy to have Diana Chavarria from AACOG discuss an amazing program offered via a grant from TCDD (Texas Council For Developmental Disabilities). This is a wonderful resource for IDD providers, Caregivers of persons with IDD and persons with IDD. Dianne is part of our free webinar series for the month of January 2023!
Free Webinar Series Hosted By: Twogether Consulting (1/17/22 from noon-1pm)
Pre-Registration is required, click on the “Registration” button below to attend this free webinar and complete pre-survey questions!!
REGISTRATION
or Visit our website: www.twogetherconsulting.com and click on the Free Webinar calendar
The Program Provides Support & Empowerment For Individuals and Their Caregivers Concerning The Following:
-General Health and Aging
-Aging With Specific Syndromes (i.e. Down Syndrome)
-Nutrition & Physical Fitness
-Financial Wellness
-Benefits and Employment
-Planning For The Future
-Mental Wellness
-Coping With A Diagnosis
-Crisis Management
Some Of Our Previously Recorded Free Webinars of Interest
Here is a link to a short, introductory video about the HRST: https://hrstonline.com/video/index.php?id=410335893
Topic: Health Risk Screening Tool
HRST (Health Risk Screening Tool) is an assessment tool that can identify & detect health risks in vulnerable populations. This tool and other services offered by HRS are based on person-centered practices. Here is a little more information about HRS from their website. The Health Risk Screening Tool (HRST) identifies and tracks health risks in vulnerable populations, making it possible to design a plan tailored to meet the unique health and safety needs of each individual in the least restrictive setting. The instrument can objectively justify resources allocated both financially and in service intensity. Used by Case Managers, supervisors, and direct support professionals. HRS also helps the provider to comply with CMS Rules and assist with Person-Centered planning and continuity of care. It is field-tested, reliable, and user-friendly
“Health Risk Screening, Inc.’s roots began in 1992. Along with training courses, webinars, and materials, HRS is the sole developer, producer, and distributor of the web-based Health Risk Screening Tool (HRST). The HRST is the most widely used and validated health risk screening instrument for people with intellectual and developmental disabilities.
HRS was established on the principles of person-centered practices. Our founder, Karen Green McGowan was a pioneer in the early formative days of the person-centered movement.. Our focus is on developing tools and training for the person-centered support of vulnerable populations. Through the education of government agencies and service providers, we have helped improve people’s lives. Along with training courses, webinars and materials, HRS is the sole developer and distributor of the web-based Health Risk Screening Tool (HRST). The HRST is the most widely used and validated health risk screening instrument for people with disabilities.”
For more information, please contact Hillary Gaytan at: Phone: 727.754.9539 Email: hilary@hrstonline.com
You can also go to their website: www.hrstonline.com
Check out this great page they have devoted to COVID-19 Resources: https://hrstonline.com/covid-19-resources/
Guest presenter:
Patrick Lane (PCT Mentor & Trainer)
From: HRS
Date: Thursday -November 12th, 2020 (Session ended)
Time: 11am-12pm (Central Time)
Cost: Free!!!
Where: See recorded link below:
https://attendee.gotowebinar.com/recording/1049673375643527182
Topic: Person-Centered Services
Patrick will be talking about some of the Person-Centered Services offered at HRS including software that helps the provider develop Person-Centered Descriptions. These can be used as a resource for making annual plans Person-Centered by using these same person-centered skills practiced in PCT sessions.
“Person-Centered Planning Training is designed to help you approach support from a more holistic angle, with person-centered practices that respect the autonomy of those with intellectual and developmental disabilities while providing them with the highest possible level of care.”
Improve The Quality of Life
- Balancing personal choice with personal responsibility by establishing and maintaining things that are important to the person with things that are important for the person
- Being integrated in one’s community so that the person is known and respected for her or his contributions.
- Being respectfully communicated with as a person, using language consistent with being a typical adult as opposed to using clinical or system language
- Receiving support that is consistent so that new staff and others know and respect the person’s values and choices, as well as how others can help the person.
- Being matches with staff, housemates, or others that the person making life more enjoyable.
You can contact Patrick at: patrick@hrstonline.com For more info about HRS PCT services, please see the following link: https://hrstonline.com/person-centered-services/
Guest presenter:
Steve Cardie
From: Abundant Health
Date: Tuesday -November 17th, 2020 (Session ended)
Time: Noon-12:45 pm (Central Time)
Cost: Free!!!
Where: See link to the recorded session below:
https://attendee.gotowebinar.com/recording/5931551182568587528
Topic: Cellular Blood Pressure Monitoring System (Free To Medicare Patients!)
“Our new Cellular Blood Pressure Monitor System connects automatically to cell towers and transmits your patient’s information directly to your practice. This device makes it simple for seniors who tend to be more technology challenged to utilize Medicare’s RPM program without the difficulty of connecting to cell phones or the internet. No passwords, no Bluetooth, no internet connections required.
The rapid advance of medical device design plus an enormous upgrade in telecommunications makes Remote Patient Monitoring (RPM) suddenly possible for virtually everyone. Anywhere. In November 2018 CMS officially approved three new billing codes for Remote Patient Monitoring (RPM). The telehealth industry experts agree that this is the biggest financial incentive to date in the history of digital medicine.”
Register for the webinar at https://attendee.gotowebinar.com/register/3642654945259750160
Letter From Twogether Consulting To Providers-January 2023 Update
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Starting Jan. 2023: New HCS& TxHmL Provider Application Process
January 2nd, 2023
Effective January 2023, the open enrollment application process to get a provisional contract to provide Home and Community-based Services (HCS) and Texas Home Living (TxHmL) services will change.
- You must be enrolled as a Texas Medicaid provider through the Texas Medicaid & Healthcare Partnership (TMHP) Provider Enrollment System (PEMS) before applying.
2. To apply, you must complete the Provider Applicant Training (PAT). The PAT is now available on the HHS Learning Portal. Do not take the PAT if you aren’t applying for an HCS and TxHmL waiver contract.
- You must get a score of 85% or higher to pass the exam. Lower scores will not be accepted.
- After completing the PAT, you can apply using Form 5873 Waiver and Community-based Programs and Services. Your PAT exam certificate must be included with your application packet. Do not apply without a PAT exam certificate showing your passing score.
PAT FAQ’s. Please read before taking the PAT!
You must pass this test by 85% and if you fail the 1st x will have to wait 6 months to retake it!
Mail Your Application to the Waiver Program Enrollment Team
Send to this address:
HHSC
Contract Administration and Provider Monitoring
Mail Code W-359 P.O. Box 149030
Austin, TX 78714-9030
Applicants can also submit applications by email: IDDWaiverContractEnrollment@hhsc.state.tx.us or fax: 512-206-3916.
More resources can be found on the HHSC website, including guidance on how to apply and manage your contracts. If you have any questions about the application process, please email us.
Expedited PPE Delivery for Long-Term Care Providers
January 2nd, 2023
HHSC published an alert on Dec. 21, 2022, informing long-term care providers that expedited delivery is available for a limited time for personal protective equipment through the Texas Division of Emergency Management.
This resource is available to all long-term care providers, including:
- Nursing Facilities
- Assisted Living Facilities
- Intermediate Care Facilities
- Home and Community-based Services
- Home and Community Support Services Agencies, including Community Living Assistance and Support Services, Deaf Blind with Multiple Disabilities, and Medically Dependent Children Program
- Texas Home Living
- Prescribed Pediatric Extended Care Centers
- Hospice
- Day Activity Health Services
Long-term care providers who have a current need for these specific resources can submit requests by visiting star.tdem.texas.gov and selecting the “Expedited PPE” button. The generic passcode for the inventory listed above is: 112518.
Items are available on a first-come, first-served basis. This system is only to be used on a one-time basis for expedited PPE only. If a provider needs these resources, please include the amount needed in your request.
HCS & ICF Emergency & Disaster Preparation Updates
January 1st, 2023
LTC Winter and Extreme Freezing Weather Preparedness
HHSC encourages long-term care facilities and agencies to review and update emergency plans for freezing temperatures and snow. Emergency plans for extreme weather should include the provider’s plan to address:
- Power loss
- Water and food needs
- Communication to families and staff
- Staffing shortages
- Sheltering in place and evacuation as applicable
Providers must follow emergency preparedness rules and their own internal emergency preparedness policies and procedures.
Facilities with generators should perform any maintenance or needed testing while the weather is mild. This will ensure the equipment functions in case of extreme cold or power loss.
It is important to review building integrity and identify any areas that may need repair, reinforcement or weatherproofing. Multi-story buildings should review any other needed measures should evacuation be required and have a plan in place for how to move residents around or out of the building if there is a loss of power.
Preparing for disaster is the most important step in protecting our most fragile Texans and reducing the risk for loss of life.
May 26th, 2022
Guidance related to Emergency Preparedness- Exercise Exemption based on A Facility’s Activation of their Emergency Plan *** Revised to provide additional guidance and clarifications due to the ongoing COVID-19 public health emergency (PHE) REVISED 05.26.2022 ***
Memorandum Summary
• Emergency Preparedness Training and Testing Program Exemption -CMS regulations for Emergency Preparedness (EP) require facilities to conduct exercises to test the facility’s EP plan to ensure that it works and that staff are trained appropriately about their roles and the facility’s processes. During or after an actual emergency, the regulations allow for a one-year exemption from the requirement that the facility perform testing exercises.
• This worksheet presents guidance for surveyors, as well as providers and suppliers, with assessing a facility’s compliance with the EP requirements, in light of many of the response activities associated with the COVID-19 Public Health Emergency (PHE).
• As the PHE continues, many facilities continue to operate under their respective activated emergency plans. Therefore, CMS is providing additional guidance related to the exercise requirements (full-scale/functional drills and exercises) for inpatient and outpatient providers/suppliers.
• This exemption only applies to the next required full-scale exercise (not the exercise of choice), based on the facility’s 12-month exercise cycle. The cycle is determined by the facility (e.g. calendar, fiscal or another 12-month timeframe).
***All revisions are in red on this letter from CMS, click the link below for the complete document.
September 13th, 2021
Very Important Updates on Emergency & Disaster Preparedness During the Pandemic
Resources Listed Are From CMS & HHSC
See Info For ICF Facilities Below
Life Safety: Updated Guidance for Emergency Preparedness-Appendix Z of the State Operations Manual (SOM)
Emergency Preparedness Participant Workbook
Interim Guidance for General Population Disaster Shelters During the COVID-19 Pandemic
Screening Tool For COVID-19 During Pandemic For Arrival At General Population Shelters
Out-of-Hospital Do-Not-Resuscitate Order (From DSHS)
Out-of-Hospital Do-Not-Resuscitate Order
Out-of-Hospital Do-Not-Resuscitate (OOH DNR) order.
Both the English and Spanish versions can be downloaded on the EMS and Trauma Systems website, along with “Frequently Asked Questions About OOH DNR,” also in both languages.
For questions related to OOH DNR orders, email EMSInfo@dshs.texas.gov.
“Moving Forward Together” 2022 Conference for ICF Surveyors and Providers- Dec. 1st, 2022
“Moving Forward Together” 2022 Conference for ICF Surveyors and Providers- Dec. 1st, 2022
Dec. 1 ICF Conference Recordings Available
The “Moving Forward Together” Intermediate Care Facilities Conference session recordings from Dec. 1 are available for viewing. Note that a certificate of completion will be generated upon completion, but no professional CE awards are available.
Listen to the ICF session recordings.
Email questions to LTCR Joint Training.
ICF COVID-19 Response & COVID-19 FAQs Retired By HHSC-Dec. 13th, 2022
December 18th, 2022
HHSC Long-term Care (LTC) Regulation has retired the COVID-19 Response for ICF for Individuals with an Intellectual Disability or Related Conditions Response Plan and the ICF Frequently Asked Questions documents, effective Dec. 13, 2022.
Facilities can obtain guidance along with resources for infection prevention, control measures, and Personal Protective Equipment (PPE) through the Infection Prevention and Control Measures for Common Infections in LTC Facilities (PDF) and Infection Control Basics & Personal Protective Equipment for Essential Caregivers (PDF) documents published by HHSC.
These resources can also be found on the ICF Provider Portal page.
Program providers may reach out to LTCR Policy with questions at LTCRPolicy@hhs.texas.gov.
ICF/IID Updates
December 15th, 2022
ICF Resources
These resources can also be found on the ICF Provider Portal page.
September 25th, 2022
HHSC Publishes Updated Guidance on the Amelioration of Administrative Penalties for ALF, ICF/IID, and NF Providers
HHSC Long-term Care Regulation has published Provider Letter 2022-24 – Amelioration of Administrative Penalties (replaces PL 2013-18).
The letter provides guidelines to assisted living facilities,
intermediate care facilities for individuals with an intellectual
disability or related conditions, and nursing facilities about
the amelioration of administrative penalties assessed for state licensure
violations.
Read the provider letter details.
June 12th, 2022
ICF COVID-19 Vaccination Reporting Emergency Rules Expired June 6!!
Emergency rules for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions that require COVID-19 vaccination reporting expired June 6.
This means that effective June 7, ICFs no longer have to report COVID-19 vaccination data for staff and individuals to HHSC.
The following rules expired June 6:
- 26 TAC §551.48 – ICF/IID Provider COVID-19 Vaccination Data Reporting Requirement.
Here is a copy of the previous rule that expired:
551.48.ICF/IID Provider COVID-19 Vaccination Data Reporting Requirement.
(a) An intermediate care facility administrator and one additional designee must enroll in an emergency communication system in accordance with instructions from Texas Health and Human Services Commission (HHSC).
(b) An intermediate care facility must respond to requests for information received through the emergency communication system in the format established by HHSC.
(c) Within 24 hours of becoming aware of a staff or resident’s COVID-19 vaccination, an intermediate care facility must accurately report COVID-19 vaccination data for staff and individuals in the format established by HHSC.
(d) Subsection (c) of this section does not apply to state supported living centers.
The agency certifies that legal counsel has reviewed the emergency adoption and found it to be within the state agency’s legal authority to adopt.
Filed with the Office of the Secretary of State on August 10, 2021.
Email questions to LTCR Policy.
April 29th, 2022
ICF Visitation Rules Update
An alert went out to remind providers that all visitation must be allowed. Essential caregiver and end-of-life visits must be allowed for all individuals with any COVID-19 status. A facility may be cited if visitation is not allowed.
Review ICF/IID visitation rules from April 4th, 2022, for additional information.
April 10th, 2022
COVID-19 ICF Mitigation, Response Rule Revised Effective April 6
HHSC Long-term Care Regulation has published a revised Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions COVID-19 Mitigation and Response Emergency Rule. It is effective April 6, 2022.
The revised rule:
- Removes the requirements to have plans for obtaining and maintaining a two-week supply of full PPE.
- Clarifies that a facility does not have to provide the name of the person who tested positive for COVID-19 when reporting to CII.
April 10th, 2022
HHSC Publishes Description of Key Changes to 26 TAC 551, ICF/IID (PL 2022-07)
HHSC has published Provider Letter 2022-07, Description of Key Changes to 26 TAC 551, Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions, for ICF/IID providers. This letter describes the key changes to Title 26 of the Texas Administrative Code, Chapter 551, that were effective on Feb. 24.
Throughout the rule, HHSC updated citations, agency names, and terminology; corrected minor grammatical and punctuation errors; and revised sentence structures to make the chapter easier to read. In addition, the following items are addressed in this letter:
– New Requirements for Infection Prevention and Control Policies and Procedures
-HHSC included a state rule that refers to each Centers for Medicare & Medicaid Services (CMS) Condition of Participation (CoP). Additions to 26 TAC 551 include • Governing Body • Client Protections • Facility Staffing • Active Treatment • Client Behavior and Facility Practices • Health Care Services • Physical Environment • Emergency Preparedness • Dietetic Services.
– transition from paper applications to the use of the online licensure portal, called the Texas Unified Licensure Information Portal (TULIP) (Disclose information when applying for “relocation” and application information must be submitted through portal in “TULIP” system)
-Now require evaluation of the emergency preparedness and response plan at least every two years, instead of annually.
-ANE & Incident definitions
-Administrative penalties for each visit are limited to the cap amount, regardless of the number or duration of violations as of Sept. 1st, 2021
****If you have any questions about this letter, please contact the Policy and Rules Section by email at LTCRPolicy@hhs.texas.gov or call (512) 438-3161
April 6th, 2022
COVID Screening in ICF’s
ICF COVID-19 Mitigation and Provider Response emergency rules require an intermediate care facility must screen individuals according to HHSC guidance
.ICFs must screen individuals:
•upon admission or readmission to the facility; and
•at least once a day.
ICFs must screen each employee or contractor for the following criteria (listed below) before entering the facility at the start of their shift.
•Staff screenings must be documented in a log kept at the facility entrance and must include the name of each person screened, the date and time of the evaluation, and the results of the evaluation.
**Staff who meet any of the criteria must not be permitted to enter the facility.
As per ICF/IID Expansion of Reopening Visitation Emergency rules, ICFs are required to screen all visitors for signs or symptoms of COVID-19.
*Visitor screenings must be documented in a log kept at the entrance to the facility, which must include the name of each person screened, the date and time of the screening, and the results of the screening. The visitor screening log may contain protected health information and must be protected in accordance with applicable state and federal law .
*A visitor may not participate in a visit if the visitor has signs and symptoms of COVID-19 or active COVID-19 infection.
Screening Criteria:
•fever, defined as a temperature of 100.4 Fahrenheit and above, or
signs or symptoms of a respiratory infection, such as cough, shortness of breath, or sore throat;
•other signs or symptoms of COVID-19, including
-chills,
-new or worsening cough,
-shortness of breath or difficulty breathing,
-fatigue,
-muscle or body aches,
-headache,
-new loss of taste or smell,
-sore throat,
-congestion or runny nose,
-nausea or vomiting,
-or diarrhea;
•any other signs and symptoms as outlined by the CDC in Symptoms or Coronavirus at cdc.gov;
•contact in the last 14 days with someone who has a confirmed diagnosis of COVID-19, is under investigation for COVID-19, or is ill with a respiratory illness, regardless of whether the person is fully vaccinated, unless the person is entering the facility to provide critical assistance; or
•testing positive for COVID-19 in the last 10 days.
April 6th, 2022
Reporting Confirmed Case of COVID-19 in ICF/IID
A facility must notify the Texas Health and Human Services Commission (HHSC) Complaint and Incident Intake of COVID-19 activity as described below.
(1) A facility must notify HHSC of the first confirmed case of COVID-19 in staff or individuals, and the first confirmed case of COVID-19 after a facility has been without cases for 14 days or more, at HHSC Complaint and Incident Intake (CII) through TULIP, or by calling 1-800-458-9858, within 24 hours of the positive confirmation.
(2) A facility must submit a Form 3613-A Provider Investigation Report, minus the name of the person who tested positive for COVID-19, to HHSC Complaint and Incident Intake, through TULIP, by email at ciiprovider@hhs.texas.gov, or by fax at 877-438-5827, within five working days from the day a confirmed case is reported to CII.
April 6th, 2022
COVID-19 Mitigation and Response Emergency Rule Updated
HHSC Long-term Care Regulation has published a revised Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions COVID-19 Mitigation and Response Emergency Rule.
It became effective April 6, 2022.
The revised rule:
•Points to guidance from the Texas Department of State Health Services and HHSC rather than the CDC.
•Removes the requirements to have plans for obtaining and maintaining a two-week supply of full PPE.
•Removes the requirement to have spaces to don and doff PPE
•Clarifies that a facility does not have to provide the name of the person who tested positive for COVID-19 when reporting to CII.
February 27th, 2022
HHSC Adopts Revised ICF/IID Rules – Effective Feb. 24th, 2022
HHSC Long-term Care Regulation has adopted updates to the Intermediate Care Facilities for Individuals with an Intellectual Disability (ICF/IID) or Related Conditions program rules. The revised rules are in the Texas Administrative Code Title 26, Chapter 551. They are effective Feb. 24, 2022.
Key changes to the rule are to:
- Implement House Bill 1848 from the 86th Legislature, Regular Session, 2019 which requires new infection control policies and procedures in long-term living facilities.
- Implement House Bill 3720 from the 87th Legislature, Regular Session, 2021 which limits the total amount of an administrative penalty assessed against an ICF/IID.
- Reintegrate the conditions of participation from the Code of Federal Regulations.
- Corrects legacy agency terms, update rule citations, and edit for clarity and consistency.
COVID-19 ICF/IID Webinar Recording from Feb. 14 Available
A recording of the Feb. 14 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions COVID-19 Q&A with HHSC Long-term Care Regulation and DSHS is available for those who could not attend.
There have been changes made to the PowerPoint based on the information provided by DSHS during the webinar.
Listen to the webinar recording.
Email LTCR Policy for the transcript.
February. 20th, 2022
Mar. 07 ICF COVID-19 Webinar with HHSC LTCR
Long-term Care Regulation and the Department of State Health Services will provide the latest information on the COVID-19 pandemic and take live questions from participants in this intermediate care facilities provider webinar.
Provider attendance is critical to staying current with COVID-19 requirements and guidance. ICF/IID providers are strongly encouraged to attend all COVID-19 webinars with LTCR and DSHS.
Those using Internet Explorer may have difficulties registering for the webinar. If so, try using another browser, such as Google Chrome or Microsoft Edge.
March 7, 2022
11 a.m.–12 p.m.
Register for the COVID-19 Webinar.
February 13th, 2022
HHSC is not currently assessing compliance with CMS’s Omnibus COVID-19 Health Care Staff Vaccination rules, published in the Federal Register on November 5, 2021.
ICF COVID-19 Vaccination Data Reporting and Emergency Communication System – Feb 7
HHSC Long-term Care Regulation has published a revised ICF/IID Provider COVID-19 Vaccination Data Reporting Rule (PDF). It became effective February 7, 2022 and includes Emergency Communication System Enrollment for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions providers.
The rule requires ICF/IIDs to:
- Report COVID-19 vaccine data within 24 hours
- Enroll in an emergency communication system
January 7th, 2022
ICF COVID-19 Response Plan and FAQ Updated – Jan. 7
Document Version Date Change Comments
Version 3.5 1/5/2022 Changes to pages 6, 31, 38, 39, 40, 51, 72 71, and Changes made to reflect the most updated CDC guidance.
Version 3.4 12/07/2021 Changes to pages 15, 16, 25, 26, 31, 35 Edited to include revised ICF COVID-19 Provider Response Mitigation Rules for ICFs/IID
For changes made previous to 12/07/2021, please read the Table of Changes starting with page 7 of 19 of the Response Plan.
Update your Infection Control Policies and other related policies accordingly.
HHSC has revised the ICF COVID-19 Response Plan and Frequently Asked Questions document in response to the most recent CDC guidance.
November 21st, 2021
HHSC Publishes PL 2021-38 Medicaid Bed Reallocation
HHSC published Provider Letter 2021-38 Medicaid Bed Reallocation which explains the process to request reallocated ICF/IID Medicaid beds from HHSC. This letter replaces Provider Letter 2019-21.
November 4th, 2021
Updated ICF/IID COVID-19 FAQ and COVID-19 Response Plan Revised
HHSC has revised the Frequently Asked Questions for ICF/IIDs about COVID-19 (PDF) and the ICF/IID COVID-19 Response Plan (PDF) in response to the revised COVID-19 Expansion of Reopening Visitation for ICF Providers rules.
October 24th, 2021
New PL 2021-21 COVID-19 – Expansion of Reopening Visitation for ICF Providers
Super important!!!!
HHSC has published Provider Letter 2021-21, COVID-19 Response – Expansion of Reopening Visitation (PDF) for ICF/IID providers. This letter replaces Provider Letter 2021-10. This letter describes the criteria for expanded visitation as well as address changes in response to Executive Order No. GA-38(link is external) and updated CDC guidance.
Updated COVID-19 Expansion of Reopening Visitation Emergency Rules for ICF Providers
HHSC Long-term Care Regulation has published revised COVID-19 Expansion of Reopening Visitation Emergency Rules for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID) or Related Conditions (PDF). The rules address changes in response to Executive Order No. GA-38 (PDF)(link is external) and updated CDC guidance.The rules became effective on October 20, 2021.
September 15th, 2021
HHSC Publishes Amended Statutory Cap Regarding Administrative Penalties for ICFs: (PL 21-34)
HHSC published Provider Letter 21-34 Amended Statutory Cap Regarding Administrative Penalties for Intermediate Care Facilities. PL 21-34 notifies providers of changes to how HHSC determines and imposes administrative penalties based on changes made by House Bill 3720 (87th Legislature, Regular Session, 2021).
September 5th, 2021
Guidance for Providers Regarding Entry into LTC Facilities (PL 2021-33)
HHSC Long-term Care Regulation has published Provider Letter 2021-33, Authority to Enter Long-term Care Facilities (PDF), for ALF, HCS, ICF/IID and NF providers. This letter reminds providers that they must allow persons providing critical assistance and providers of essential services to enter the facility if they pass the facility’s COVID-19 screening.
September 5th, 2021
ICF/IID Leave During COVID-19 Rule Reinstated
HHSC has published IL 2021-42 ICF/IID Services During COVID-19 (PDF), which replaces IL 2020-43.
A resident must be discharged from the Intermediate Care Facility for Individuals with an Intellectual Disability or Related Conditions, with or without a contract to hold the resident’s placement in accordance with 26 TAC Section 261.227(j), if the resident is absent from the ICF/IID for one full day or more and the absence is not during leave described in 26 TAC Section 261.226.
August 1st, 2021
HHSC Publishes Updated COVID-19 Response Plan and Frequently Asked Questions for ICF Providers
HHSC Long-term Care Regulation updated the ICF COVID-19 Response Plan and FAQ document on July 29, 2021.
Read the updated ICF COVID-19 Response Plan (PDF).
Read the updated ICF FAQs (PDF).
March 24th, 2021
HHSC Adopts New Expansion of Reopening Visitation Emergency Rules for ICF Providers!!!
HHSC has adopted new Expansion of Reopening Visitation (PDF) emergency rules that establish criteria for expanded indoor and outdoor visitation as well as essential caregiver visits. These rules are effective March 24, 2021.
HHSC Publishes COVID-19 Response – Expansion of Reopening Visitation for ICF Providers (PL 2021-10)
HHSC has published Provider Letter 2021-10, COVID-19 Response – Expansion of Reopening Visitation (PDF) for ICF/IID providers. This letter replaces Provider Letter 2020-43. This letter describes the criteria for expanded indoor and outdoor visitation as well as essential caregiver visits.
March 22nd, 2021
ICF COVID-19 March 22 Webinar Recording Available
A recording of the March 22, 2021, ICF/IID COVID-19 Q&A with HHSC LTC Regulation and DSHS is available for those who could not attend.
Listen to the COVID-19 Q&A recording.
March 11th, 2021
Recording of ICF COVID-19 March 8 Provider Webinar Available
A recording of the March 8, 2021 ICF/IID COVID-19 Q&A with HHSC LTC Regulation and DSHS is available for those who could not attend.
Listen to the COVID-19 Q&A recording.
February 8th, 2021
Draft ICF/IID Rule Changes
- Draft ICF/IID Rule Changes- See link: https://documentcloud.adobe.com/link/track?uri=urn:aaid:scds:US:cf5ea154-04b4-4c75-8aec-7e230c3cfda0
- High Level Summary of Proposed Changes See link: https://documentcloud.adobe.com/link/track?uri=urn:aaid:scds:US:2aa689d6-3018-4ab9-8d75-04578f4c922d
February 7th, 2021
Feb. 8- ICF/IID Provider Bed Hold Payments Webinar &
Reminder to Provide Letter to Families
IL 2020-43, ICF/IID Services During COVID-19 directed program providers to give a copy of the letter attached to that IL to each resident who was:
- Absent from an ICF/IID
- Not on leave
- Was not discharged from the ICF/IID
If you have not provided the letter to residents who meet that criteria, do so immediately. It was to be complete by Oct. 5, 2020. You must assist residents in deciding to do only one of the following:
- Return to the facility.
- Continue to be absent from the facility, be discharged, but enter into an agreement with the ICF/IID to hold your place at the facility.
- Continue to be absent from the facility and be discharged.
HHSC Medicaid and CHIP Services will issue instructions to providers about entering COVID-19 therapeutic leave for days a resident was away from an ICF/IID to reduce the risk of COVID-19 transmission. Register for the following webinar to review the emergency rules authorizing this leave and the instructions for entering it.
ICF/IID Provider Bed Hold Payments Webinar
Friday, Feb. 5
9:30-11 a.m.
Register for the Bed Hold Payment Webinar.
The emergency rule authorizing payment for COVID-19 therapeutic leave (PDF) is effective Jan. 29, 2021.
January 19th, 2021
HHSC Updates the ICF COVID-19 Response Plan and FAQ Document
Please be sure to update your infection control and other related policies based on the updated Response Plan!!!
Let us know if we can help. We will be working on some of these addendums in the next few weeks.
HHSC Long-term Care Regulation updated the ICF COVID-19 Response Plan and FAQ document on Jan. 12, 2021.
Read the updated ICF COVID-19 Response Plan (PDF).
Read the updated ICF FAQs (PDF).
Jan. 25 ICF Provider COVID-19 Webinar with HHSC LTC Regulation
Long-term Care Regulation and the Department of State Health Services provide the latest information on the COVID-19 pandemic and take live questions from participants in this ICF provider webinar. Provider attendance is critical to staying current with COVID-19 requirements and guidance.
ICF/IID providers are strongly encouraged to attend this and all biweekly COVID-19 webinars with LTCR and DSHS.
Those using Internet Explorer may have difficulties registering for the webinar. Please try another browser such as Google Chrome or Microsoft Edge.
ICF Provider Webinar
Jan. 25, 2021
11 a.m. – 12:30 p.m.
Register for the COVID-19 Webinar.
Recording of ICF COVID-19 Jan. 11 Provider Webinar Available
A recording of the January 11, 2021 ICF/IID COVID-19 Q&A with HHSC LTC Regulation and DSHS is available for those who could not attend.
Listen to the COVID-19 Q&A recording.
January 10th, 2021
Informal Comments on Draft Rules for ICF/IID or Related Conditions
HHSC is accepting informal comments from stakeholders on the following draft rules, which are now posted on the HHS Rulemaking page. The comment period ends Jan. 19, 2021.
This project implements two bills from the 86th Legislature, Regular Session, 2019. House Bill (H.B.) 1848 contains required elements for infection prevention and control. H.B. 3803 limits the daily amount of an administrative penalty assessed against an ICF/IID. The project will also update rule references and agency names, amend rules to align with Centers for Medicare & Medicaid Services conditions of participation in the ICF/IID program, and edit the rules for clarity and consistency.
HHSC Publishes Revised Reporting Guidance for Long-Term Care Providers
(PL 20-37)
HHSC has published a revised version of Provider Letter 20-37, Reporting Guidance for Long-Term Care Providers (PDF). The revision includes information for ALF and ICF providers offering point-of-care testing for COVID-19 and clarifies reporting requirements for NF providers.
November 22nd, 2020
November 30 ICF Provider COVID-19 Webinar with HHSC LTC Regulation
LTCR and DSHS provide the latest information on the COVID-19 pandemic and take live questions from participants in this ICF provider webinar. Provider attendance is critical to staying current with COVID-19 requirements and guidance.
ICF/IID providers are strongly encouraged to attend this and all biweekly COVID-19 webinars with HHSC Long-term Care Regulation and the Department of State Health Services.
Those using Internet Explorer may have difficulties registering for the webinar. Please try another browser such as Google Chrome or Microsoft Edge.
ICF Provider Webinar
November 30, 2020
11 a.m. – 12:30 p.m.
Register for the COVID-19 webinar.
Recording of November 16 ICF COVID-19 Q&A Provider Webinar Available
A recording of the November 16, 2020 ICF/IID COVID-19 Q&A with HHSC LTC Regulation and DSHS is available for those who could not attend.
View the COVID-19 Q&A recording.
10/16/20
Important Information!
LTCR FORM 2195: Expansion of Reopening Visitation Status Attestation and Letter PL 20-43 (for ICF Only)
Note: to receive an approved general visitation designation, a small ICF/IID that cannot provide separate areas, units, wings, halls, or buildings for individuals who are COVID-19 positive, COVID-19 negative or unknown COVID-19 status, based on the status of the entire facility, must:
- have no facility-acquired COVID-19 cases in individuals for at least 14 consecutive days; and
- have no COVID-19 cases in staff.
An ICF/IID must provide instructional signage throughout the facility and proper visitor education regarding
- signs and symptoms of COVID-19;
- infection control precautions; and
- other applicable facility practices (e.g., the use of facemasks or other appropriate PPE, specified entries and exits, routes to designated visitation areas, and hand hygiene).
An ICF/IID that does not meet the criteria for a visitation designation must permit closed window visits and end-of-life visits for individuals regardless of their COVID-19 status, as well as essential caregiver visits for individuals with COVID-19 negative or unknown COVID-19 status.
Such an ICF/IID must also develop and implement a plan to meet the visitation criteria and submit the plan to the regional director in the Long-term Care Regulation (LTCR) region where the ICF/IID is located within five days of submitting the new 2195 Expansion of Reopening Visitation Status Attestation Form,
or
within five days of receiving notification from HHSC that the ICF/IID was not approved for general visitation designation.
LTCR Form 2195
Each ICF/IID must submit LTCR Form 2195 to the Regional Director in the LTCR region where the facility is located and must provide information about whether the ICF/IID meets or does not meet the criteria for expanded general visitation.
Each ICF/IID must submit a completed form 2195 to the Regional Director no later than October 31, 2020.
An ICF/IID that does not meet the visitation designation criteria must attest that it:
- is permitting closed window visits, end of life visits, and essential caregiver visits;
- will develop and implement a plan to meet the visitation designation criteria as defined in 26 TAC §551.47; and
- has included the plan with the form or will submit the plan within five business days of submitting the form.
To seek a designation for general visitation, an ICF/IID must complete LTCR Form 2195, Expansion of Reopening Visitation Status Attestation, to notify LTCR that the ICF/IID seeks a designation as a visitation facility.
The form must be emailed to the LTCR regional director in the LTCR region where the facility is located. Any applicable pictures and facility maps must also be included with LTCR Form 2195.
The LTCR regional director or designee will review the form within three working days of submission and notify the ICF/IID whether it has received been approved for a visitation designation.
An ICF/IID with previous approval for visitation does not have to submit LTCR Form 2195 or other documentation unless the previous visitation approval has been withdrawn, rescinded, or canceled, or was for only indoor or outdoor visitation instead of both indoor and outdoor visitation.
If approved, the ICF/IID must allow outdoor visits, indoor plexiglass visits, open window visits, and vehicle parades in accordance with the applicable emergency rule. HHSC LTCR can conduct an on-site visit to confirm an ICF/IID’s compliance with the requirements. If HHSC determines that the ICF/IID does not meet the requirements for the designation as a visitation facility, the ICF/IID must immediately stop all visitation except a closed window visit, end-of-life visit, and visits by persons providing critical assistance, including designated essential caregivers.
If, at any time after a visitation designation is approved by HHSC, the ICF/IID experiences an outbreak of COVID-19, the ICF/IID must notify the Regional Director in the LTCR Region where it is located that the ICF/IID no longer meets visitation criteria, and the ICF/IID must immediately stop all visitation, except a closed window visit, end-of-life visit, or visits by persons providing critical assistance, including essential caregivers.
The ICF/IID can submit a new request for designation when it meets all visitation criteria.
Under Section 37.10 of the Texas Penal Code, a person commits a criminal offense if he or she makes a false entry in a governmental record; makes, presents, or uses any record or document with knowledge of its falsity and intent that it be taken as a genuine governmental record; or makes, presents, or uses a governmental record with knowledge of its falsity. In addition, making a false statement on the attestation form can result in the imposition of an administrative penalty as described in Texas Health and Safety Code, Chapter 252, section 252.065(a)
Contact Information for Submitting LTCR Form 2195 to the LTCR Regional Director: https://hhs.texas.gov/about-hhs/find-us/long-term-care-regulatory-regional-contact-numbers
If you have any questions about this letter, please contact the Policy, Rules and Training Section by email at PolicyRulesTraining@hhsc.state.tx.us or call (512) 438-3161.
10/05/20
Deadline for Decision To Return to Facility/Payment to Hold Bed/Discharge Option
Information Letter No. 20-43 ICF/IID Services During COVID-19
10/03/20
Quick TIPS on New Changes for Expansion of Facility Visitation Rules & Other Policies Concerning COVID-19
Essential Caregiver Visits and Salon Services Visitor (Visitor types above and beyond normal designated visiting facility type)
Essential Caregivers are allowed even if the facility does not have designated visitation. They must be at least 18 years of age. Can be family, friend, guardian.
- 1.They must wear a facemask. 2. They must have evidence of negative COVID-19 test in the past 14 days and must be screened by facility staff prior to the visit. (Pay attention to the new additional symptoms and discontinuation of asking about international travel). 3. There is a 2- hr limit unless the facility allows a longer period of time. 4.They can have physical contact with their individual (and only their individual) 5.They must be limited to access to their person. 6.An assigned person must escort them to and from the location they are going to meet with the individual- room, outside… 7. The facility must approve the face mask they are going to wear or provide an appropriate mask. 8.If they do not have an appropriate face mask or the facility can’t provide one, they will need to reschedule the visit. 9. The facility must create an identifying badge for the essential caregiver or any salon service visitors. 10. The facility must have attestation stating the essential caregiver has visited and when they left (include time arrived, when they left, who they visited). 11. Essential caregivers must be trained on PPE and how to wear PPE, handwashing, and other infection control practices and there must be proof of this training that the facility maintains. 12..The individual must be COVID-19 negative to have an Essential caregiver visit or Salon Service Visitor.
- ***(If client status is unknown, the essential visitor would have to wear a face mask (not N-95, save that for your staff who need to work with COVID-19 + individuals), gown, gloves, goggles or face shield, so the facility might need to provide these other items)
Phase I Vi