For Previously Recorded Webinars & FAQ’s

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

September 25th, 2022

TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar

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

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

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

Save the Dates

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

• 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.

• Register now for the Oct. 13 webinar.

Email questions about the webinar to your program policy inbox:

HCS Policy

TxHmL Policy

September 12th, 2022

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

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

Read the full alert.

July 15th, 2022

HCS and TxHmL Webinar Recorded From July 14th, 2022

July 13th, 2022

IDD and PI Quarterly Webinars

• July 12, 2022 IDD and PI Quarterly Webinar (PDF)
  • July 12, 2022 IDD and PI Quarterly Webinar Recording

May 5th, 2022

HCS and TxHmL FAQ Updates Available May 9 and May 23

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

HCS-TxHmL-FAQ-TMHP-TexasMedConnect

Read the full alert here.

Updated HCS and TxHmL COVID-19 FAQ

May 6th, 2022 

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

September 1st, 2022

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

August 15th, 2021

 HCS and TxHmL Webinar Recording Available

” WSC Transition into HHSC LTCR”

(From August 10th, 2021)

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

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

Read the HCS and TxHmL Transformation Webinar (PDF).

Listen to the webinar recording here.

.

May 23rd, 2021

June Infection Control Basics for HCS and TxHmL Providers Webinars

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

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

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

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

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

.March 16th, 2021 Updated

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

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

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

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

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

Listen to the webinar recording here.

March 4 Recording of Writing Acceptable Plans of Correction Webinar Available

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

Listen to the webinar recording here.

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

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

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

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

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

Listen to the webinar recording here.

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

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

Listen to the webinar recording here.

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

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

View the video training

September 25th, 2022

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

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

The letter provides guidelines to assisted living facilities,

intermediate care facilities for individuals with an intellectual

disability or related conditions, and nursing facilities about

the amelioration of administrative penalties assessed for state licensure

violations.

Read the provider letter details.

June 12th, 2022

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

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

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

The following rules expired June 6:

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

Here is a copy of the previous rule that expired:

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

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

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

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

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

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

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

Email questions to LTCR Policy.

April 29th, 2022

ICF Visitation Rules Update

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

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

April 10th, 2022

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

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

The revised rule:

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

April 10th, 2022

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

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

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

– New Requirements for Infection Prevention and Control Policies and Procedures

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

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

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

-ANE & Incident definitions

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

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

April 6th, 2022

COVID Screening in ICF’s

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

.ICFs must screen individuals:

•upon admission or readmission to the facility; and

•at least once a day.

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

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

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

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

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

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

Screening Criteria:

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

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

•other signs or symptoms of COVID-19, including

-chills,

-new or worsening cough,

-shortness of breath or difficulty breathing,

-fatigue,

-muscle or body aches,

-headache,

-new loss of taste or smell,

-sore throat,

-congestion or runny nose,

-nausea or vomiting,

-or diarrhea;

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

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

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

April 6th, 2022

Reporting Confirmed Case of  COVID-19 in ICF/IID

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

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

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

April 6th, 2022

COVID-19 Mitigation and Response Emergency Rule Updated

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

It became effective April 6, 2022.

The revised rule:

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

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

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

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

February 27th, 2022

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

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

Key changes to the rule are to:

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

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

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

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

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

Listen to the webinar recording.

Email LTCR Policy for the transcript.

February. 20th, 2022

Mar. 07 ICF COVID-19 Webinar with HHSC LTCR

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

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

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

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

February 13th, 2022

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

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

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

The rule requires ICF/IIDs to:

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

January 7th, 2022

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

Document   Version    Date    Change    Comments

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

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

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

Update your Infection Control Policies and other related policies accordingly. 

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

November 21st, 2021

HHSC Publishes PL 2021-38 Medicaid Bed Reallocation

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

November 4th, 2021

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

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

October 24th, 2021

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

Super important!!!!

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

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

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

September 15th, 2021

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

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

September 5th, 2021

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

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

September 5th, 2021

ICF/IID Leave During COVID-19 Rule Reinstated

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

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

August 1st, 2021

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

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

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

Read the updated ICF FAQs (PDF).

March 24th, 2021

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

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

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

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

March 22nd, 2021

ICF COVID-19 March 22 Webinar Recording Available

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

Listen to the COVID-19 Q&A recording.

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

March 11th, 2021

Recording of ICF COVID-19 March 8 Provider Webinar Available

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

Listen to the COVID-19 Q&A recording.

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

February 8th, 2021

Draft ICF/IID Rule Changes

• 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.

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

January 10th, 2021

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

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

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

HHSC Publishes Revised Reporting Guidance for Long-Term Care Providers

(PL 20-37)

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

November 22nd, 2020

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

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

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

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

ICF Provider Webinar

November 30, 2020

11 a.m. – 12:30 p.m.

Register for the COVID-19 webinar.

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

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

View the COVID-19 Q&A recording.

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

10/16/20

Important Information!

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

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

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

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

• signs and symptoms of COVID-19;

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

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

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

or

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

LTCR Form 2195

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

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

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

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

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

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

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

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

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

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

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

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

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

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

10/05/20

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

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

10/03/20

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

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

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

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

Phase I Visitation Rules, no longer in effect!

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

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

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

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

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

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

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

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

FAQ’s (June 2020)

Survey Operations Resume as of June 15th, 2020

Providers Must Log Residents’ Leave

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

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

Provider Joint Training Opportunities

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

Survey Process for ICF Has Changed: Please Be Aware

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

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

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

Appendix Q of SOMA (Immediate Jeopardy) Changes

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

CMS clarifications letter

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

SOMA appendix Q Section  Immediate Jeopardy 

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

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

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.

Email questions to TMHP.

July 5th, 2022

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

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

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

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

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

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

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

Email EVV Operations for questions.

July 1st, 2022

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

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

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

Email EVV Operations for questions.

June 12th, 2022

EVV Portal and Training Updates

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

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

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

Email questions to TMHP.

June 6th, 2022

EVV Policy Handbook Revision and Training Updates

The Electronic Visit Verification Policy Handbook has been revised.

Revisions include:

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

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

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

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

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

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

Email HHSC EVV Operations for questions about this notice.

May 30th, 2022

EVV Claims Matching for HCS and TxHmL Will Resume July 1

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

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

Email EVV Operations for questions about this notice.

May 8th, 2022

EVV Portal and Training Updates

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

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

Email TMHP EVV Operations with questions

March 7th, 2022

EVV Notice for HCS/TxHmL Program Providers

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

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

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

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

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

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

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

March 3rd, 2022

EVV Policy Handbook Revisions Now Available

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

The handbook includes EVV standards and policy requirements for:

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

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

Email HHSC EVV Operations with questions.

February 28th, 2022

EVV Portal and Training Updates

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

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

For questions, email TMHP EVV Operations.

January 8th, 2022

EVV Policy Handbook Revisions – Jan. 7th, 2022

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

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

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

For questions, email HHSC EVV Operations.

November 21st, 2021

EVV Portal and Training Updates for November 2021

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

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

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

Email TMHP with questions about these updates.

November 18th, 2021

Revised EVV Policy Handbook Now Available

The Electronic Visit Verification Policy Handbook was revised.

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

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

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

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

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

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

Email questions to HHSC EVV Operations.

November 17th, 2021

EVV Visit Maintenance Unlock Request Updates

HHSC published EVV Visit Maintenance Unlock Request spreadsheet updates.

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

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

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

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

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

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

  Review the instructions on the spreadsheets for more information.

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

  ---

July 4th, 2021

EVV Visit Maintenance Policy Now Available

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

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

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

July 4th, 2021

HHSC EVV Webpage Updates Now Available

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

• 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.

Email TMHP with questions.

April 17th, 2021

EVV Policy Training for CDS Employers Now Available in Spanish

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

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

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

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

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

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

March 16th, 2021

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

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

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

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

For questions, email HCS Policy or CDS.

March 10th, 2021

Temporary EVV Policies for the Feb. 2021 Severe Winter Weather

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

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

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

Email questions to the HHSC EVV Mailbox.

February 7th, 2021

EVV Refresher Training on Feb. 19

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

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

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

Certificates of completion will not be issued.

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

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

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

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

Email HHSC EVV for questions.

Reminder:  Entering Schedules for EVV-Required Services

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

EVV is only required for the following services:

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

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

January 24th, 2021

EVV Portal and Training Updates for January

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

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

Email TMHP with questions about these updates.

January 24th, 2021

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

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

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

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

Email questions about EVV policy to HHSC EVV.

January 18th, 2021

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

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

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

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

Next Steps

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

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

January 10th, 2021

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:

December 20th, 2020

Cures Act EVV:

Preparing for Jan. 1, 2021 Implementation

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

Beginning Jan. 1, 2021:

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

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

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

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

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

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

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

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

• 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.

Visit the HHS EVV webpage.

HCS and TxHmL Program Providers Required to Select an EVV Vendor

11/18/2020

HCS and TxHmL Program Providers Required to Select an EVV Vendor Effective Jan. 1, HHSC will require HCS and TxHmL program providers to use EVV for the following services: Community First Choice Personal Assistance Services/Habilitation In-Home Respite In-Home Day Habilitation (Own Home or Family Home only) HCS and TxHmL program providers are required to select an EVV vendor and complete EVV training to meet the Jan.1 deadlines. The requirement to select an EVV vendor and complete training applies to all contracted HCS and TxHmL program providers. Beginning Jan. 1, 2020, service claims for CFC PAS/HAB will be denied by the claims adjudication system and not paid by HHSC if the program provider has not onboarded with an EVV vendor. Read IL 20-07 (PDF) for more information about selecting an EVV vendor and completing training to be EVV-compliant by the Jan. 1 deadline.

Deadline Approaching Soon!!

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

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

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

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

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

Contact EVV if you have questions about EVV requirements.

Oct. 11th, 2020

EVV Revised Policies Effective Oct. 1

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

Claims Matching Policy (PDF)

The policy:

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

Claims Submission Policy (PDF)

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

Email HHSC EVV with your questions.

Oct. 11th, 2020

Updated EVV Service Bill Codes Table Effective Oct. 1

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

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

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

Units Matching

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

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

Home and Community-based Services and Texas Home Living Programs

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

Email HHSC EVV for questions.

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

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

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

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

EVV is only required for the following services:

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

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

Additional Guidance on Day Habilitation Services

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

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

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

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

August 20th, 2020

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

CURES Act EVV Training is Underway for HCS/TxHmL Providers

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

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

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

To register, click the links below:

FMSAs

• 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

• Session 1 – June 9, 2020 – 8:30 am to 12:30 pm
• Session 2 – June 10, 2020 – 8:30 am to 12:30 pm

Additional Training Opportunities

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

Email TMHP for questions about registration or the EVV Portal.

Email questions about EVV training requirements.

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

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

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

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

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

Updated Timeline for Cures Act EVV Expansion     

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

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

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

For questions, contact EVV.

• •  

     EVV Proprietary System page 

    http://www.tmhp.com/Pages/EVV/EVV-Proprietary.aspx

    Providers currently required to use EVV must continue to use EVV under state law and HHSC policy. See the Programs and Services Currently Required to Use Electronic Visit Verification (PDF) 

    For questions about EVV vendors, email evv@TMHP.com

New EVV Proprietary System Onboarding Documents Available

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

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

Resources

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

Trainings Available:

• HHSC EVV Training webpage

EVV Policy Training (Provided by your payer)

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

EVV Aggregator and EVV Portal Training (Provided by TMHP)

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

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

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

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

September 24th, 2022

IDD & PI Webinar October 27th, 2022

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

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

Oct. 27, 2022
10–11 a.m.

Register for the IDD/PI Webinar

September 24th, 2022

Deadline for Comments on HHS Proposed Rules Due Oct. 17

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

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

Questions can be emailed to HHS Rules Coordination Office.

September 24th, 2022

HHSC Moved Individualized Skills and Socialization Webpage

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

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

August 23rd, 2022

No Public Hearing on ISS Licensing Rules

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

Provider Communications

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

August 6th, 2022

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

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

• 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:

September 18th, 2022

THMP has website page with reference material for LTC Waiver Programs.  See link below:

https://www.tmhp.com/programs/ltc/reference-material

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

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

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

Read the full alert.

September 17th, 2022

EVV Mismatches For DH

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

Concern and Issue

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

Which day habilitation bill codes do I use?

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

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

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

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

September 17th, 2022

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

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

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

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

Resources

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

February 27th, 2022

HCS and TxHmL Billing Changes In The Crosswalk for DH

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

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

For HCS program providers:

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

Contact the HCS Policy Box with questions.

September 17th, 2022

HHSC publishes revised PL 20-55

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

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

May 30th, 2022

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

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

Read PL 2021-26 here.

September 5th, 2021

Now Called Billing Requirements Not Billing Guidelines!!!!

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

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

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

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

• HCS Billing Requirements (PDF)
• TxHmL Billing Requirements (PDF)
• CFC Billing Requirements for HCS and TxHmL Program Providers (PDF)

Email questions to TxHmL Policy.

September 5th, 2021

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

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

Register for HCS/TxHmL training here.

September 5th, 2021

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

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

August 15th, 2021

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

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

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

April 26th, 2021

            HHSC’s WS&C Portal

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

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

• A recorded session of The WSC portal training
  • https://register.gotowebinar.com/recording/recordingView?webinarKey=3385319749029434640&registrantEmail=javasbja%40gmail.com

Here are the handouts:

• Basics of portal
  • Provider letter 2021-13
    • PL-2021-13
  • WSC Portal Training Handout
    • WSC Portal Training Handout with links

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

• Where do I find the page to create the portal?
  • Bookmark this link below, because that is where it will be and it will go live closer to the release of the portal.
  • https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/resources/waiver-survey-certification-wsc-provider-portal

March 29th, 2021

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

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

Listen to the webinar recording here.

March 28th, 2021

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

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

Listen to the webinar recording here.

January 10th, 2021

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

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

Listen to the webinar recording here.

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

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

Listen to the webinar recording here.

December 28th, 2020

Letter: PL 20-55  Administrative Penalties HCS & TxHmL

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

December 23rd, 2020

Upcoming HCS and TXHmL Webinars For:

“Hold Harmless” Period & Administrative Penalties & Amelioration

Hold Harmless Period Overview

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

Jan 5, 2021
2 p.m. – 4 p.m.

Here’s the link to record session:

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

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

Administrative Penalties and Amelioration

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

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

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

November 25, 2020

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

 Billing Guideline Changes

June 20, 2020

Survey Process:  Timelines

HHSC Provider User Guide (CARE)       

Please go to the following link:

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

.

September 15th, 2022

Updated Webinar Resource Document and TMHP Account Setup Quick Reference Guide 

(HCS and TxHmL Waiver Program Providers)

From HHSC Alert September 12th, 2022

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

September 12th, 2022

Avoiding HCS and TxHmL Overpayment of Services

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

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

Read the full alert.

Read More Button

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:

• 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.

August 31st, 2022

September 11th, 2022

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

-Termination Forms Submitted by LIDDAs

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

Read more on the following items:

–Long-Term Care Online Portal Sessions Must Be Restarted Daily

–Using the “Resubmit to SAS” Button

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

August 31st, 2022

Migration Trending Issue Support Vol 7:  

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

 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.

September 1st, 2022

Rising To The Challenge!

PPAT Fall Conference

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

They are:

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

 Advertising in the Conference Program

 Marketing your services in the Exhibit Hall

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

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

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

Read more…

Other Registration Options

Conference forms in pdf

Registration form in pdf

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

From our friends at PACSTX!

2022 Annual PACSTX Conference November 1st & 2nd

Embassy Suites Conference Center

San Marcos, Tx

FOR THE FULL BROCHURE CLICK HERE

HOTEL REGISTRATION

August 23d, 2022

From our friends at the Texas Council for Developmental Disabilities!

Last Chance to Apply! The Texas Council for Developmental Disabilities (TCDD) has issued Requests for Applications (RFA) for four new grant opportunities. The deadline to apply for all four RFAs is this Friday, Aug. 26, 2022, by 11:59 p.m. CT.These grants will help expand inclusion, training, and cultural understanding for people with developmental disabilities (DD) in Texas communities. You can learn more about these RFAs on the TCDD Funding Available page and find details on how to apply for them. Disability Cultural Humility Training for Elected Officials TCDD has funding available for one project to develop a training program for elected officials in Texas to better understand people with disabilities. To increase the cultural humility of elected officials and their staff, the project will develop informational videos and materials and a comprehensive yet approachable training program. TCDD has approved funding for up to $150,000 per year for up to five years. Learn More and Apply Self-Advocates in Participatory Action Research  Funding is available to develop Participatory Action Research projects for people with disabilities. All projects must focus on enhancing self-advocate opportunities to have a voice in research about disability issues and increasing connections between researchers and the community. TCDD has approved funding for $150,000 per year, per project, for up to three years. There is funding available for up to two projects. Learn More and Apply Civic Engagement for People with Disabilities  TCDD has funding available to develop a civic engagement training program for people with disabilities. Programs must incorporate disability issues and language that reflect disability culture and strategies for participants to connect with peers, civic organizations, the media, and elected officials. The total funding amount is up to $100,000 per year for up to two years for one project. Learn More and Apply Treatment for Substance-Use Disorders  Funding is available to promote statewide capacity building and systems change improvements in the prevention, identification, and treatment of substance-use disorders among individuals with DD. Projects should include the development of training modules on substance-use disorders for the use of providers specializing in DD as well as modules on DD for the training of substance-use disorder professionals. TCDD has approved funding for up to $150,000 per project, per year, for up to three projects. Learn More and Apply How to Apply Proposals must be submitted through SM Apply. To learn more about TCDD’s RFAs, including the application process and what is required of grantees, visit the How to Apply webpage.

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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

August 22nd, 2022

PEMS

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

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

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

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

• Provider Enrollment Help on TMHP.com

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

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

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

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

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

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

Informational Videos Available on the TMHP YouTube Channel

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

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

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

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

Get More Information

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

• “The Benefits of PEMS” guide
• Recent news about PEMS
• Provider Enrollment Help on TMHP.com

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

August 15th, 2022

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

For more information and registration please click on the link below

Texas AAIDD Conference Registration

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

Reserve Your Room Today!

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

Make your reservation today
by calling 409-515-2154.

August 14th, 2022

Extreme Drought Conditions

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

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

A few tips from us at Twogether Consulting: 

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

-Maintain your A/C/Cooling systems:

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

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

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

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

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

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

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

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

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

Email questions to LTCR Policy.

Recording of Individualized Skills and Socialization Provider Webinar

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 webinar

  Email questions about the webinar to your program policy mailbox:

  • HCS Policy
  • TxHmL Policy

August 8th, 2022

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

See new map

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

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

All LTC providers are affected by the new regional boundaries.

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

Read the PL details.

August 4th, 2022

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

• Applicants that intend to bill through TMHP for acute care or long-term care only services must enroll through TMHP.

July 30th, 2022

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

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

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

Read the PL details.

July 30th, 2022

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

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

Read the full alert.

July 30th, 2022

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

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

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

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

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

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July 15th, 2022

July 1st, 2022

June 16th, 2022

June 1st, 2022

May 17th, 2022

May 2nd, 2022

April 9th, 2022

Change is inevitable, as we all know well in this line of work.  Our editor for the newsletter (James) has been with us for almost 8 years now and we will miss him, but his schedule has gotten super busy and he will not have as much time available. Meghan Jones will be transitioning as the new editor.  Many of you know Meghan as she is our administrative assistant and you have probably contacted her for registrations and such in the past.  Due to this change as well as the upcoming Easter and Passover Holidays, we have decided to not put out a mid-month edition for April.  Our next newsletter will go out on May 1st, 2022.  Thank you for your patience and understanding.

April 6th, 2022

March 20th, 2022

March 1st, 2022

February 20th, 2022

February 2nd, 2022

January 17th, 2022

January 2nd, 2022

December 18th, 2021

December 2nd, 2021

November 17th, 2021

November 1st, 2021

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

October 3rd, 2021 

September 16th, 2021

September 2nd, 2021

August 15th, 2021

August 2nd, 2021

July 18th, 2021

July 5th, 2021

June 15th, 2021

June 1st, 2021

May 15th, 2021

May 2nd, 2021

Newsletter Library

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

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

April 18th, 2021

April 18th, 2021 PDF Version

If you would like to be on our mailing list for this free publication, please subscribe on the following newsletter subscription page:  https://twogetherconsulting.com/newsletters/

Or you can subscribe directly to our Mailchimp account by clicking on the subscriber link at the bottom of this latest newsletter.

From HHSC:

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

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

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

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

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

Below is the full FAQ document

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

July 27th, 2022

American Rescue Plan Act HCBS & TxHmL Provider Retention Payments

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

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

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

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

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

Here are the 3 new ARPA reports are provided below:

Approved To Pay Report:          HC064110.TXT

Claims Detail Extract:               GC063979.TXT

Remittance and Status Report:  HC064112.TXT

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

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

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

July 18th, 2022

Monthly Reporting Required

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

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

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

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

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

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

January 9th, 2022

Reminder: SB 809 / Rider 143 COVID-19 Reporting

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

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

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

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

December 30th, 2021

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

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

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

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

December 14th, 2021

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

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

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

November 30th, 2021

November 14th, 2021

PROVIDER REPORT GRACE PERIOD

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

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

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

Read More….

October 3rd, 2021

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

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

Grace Period

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

Sept. 18th, 2021

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

Introduction:

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

Frequently Asked Questions (FAQ):

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

Reporting: 

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

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

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

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

Failure to submit:

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

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

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

List of Some Of The Providers Required to Complete Reports: 

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

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

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

September 18, 2021

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

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

Rider 143

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

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

July 14th, 2022

Important Medicaid Coverage-Don’t Wait-Please Respond to Medicaid Letters- Changes To Occur in Medicaid Coverage

After Public Health Emergency Ends

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

PL-2022-39

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

July 10th, 2022

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

2022 AccessAbility fest & abilitySTRONG Parade

REGISTRATION IS NOW OPEN!

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

Early bird discounts end on August 15^th, 2022!

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

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

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

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

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

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

Juliy 11th, 2022

Our good friend at IntellectAbility, Patrick Lane has provided a link where providers or anyone else interested can register for online Person-Centered Thinking training.  FYI-this is a requirement in the HCS/TxHmLTAC rules for all persons who are a part of the development of the Implementation Plan (IP), to have this training within the first 2 year of hire.

Staff Member and Service Provider Requirements

The session is a $275 per person.

This is a 3-day series of zoom sessions, each 6 hrs long.

There are multiple live Zoom training dates listed, so take your pick.

https://replacingrisk.com/virtual-person-centered-thinking-training/ 

To learn more about IntelectAbility, here is their main website page https://replacingrisk.com/

TAC 9.177 (d) A program provider must:

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

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

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

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

July 11th, 2022

Hurry, Hurry this onference is filling up quickly!

HHS, in collaboration with The University of Texas Steve Hicks School of Social Work, will host an informative two-day, free conference on quality in long-term care.

2022 QLTCC

“Resilient, Responsive and Ready”

Aug. 11–12

Renaissance Austin Hotel

9721 Arboretum Blvd.

Austin, TX 78759

Register for the conference.

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

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

July 11th, 2022

July 11th, 2022

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

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

Read PL 2022-13, Version 2 here.

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

July 5th, 2022

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

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

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

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

May 7th, 2022

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

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

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

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

February 20th, 2022

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

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

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

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

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

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

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

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

The rules became effective Feb. 17, 2022.

January 7th, 2022

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

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

September 23rd, 2022

HCS COVID-19 Mitigation & Expansion of Visitation Rules: 

Revision Response Plan

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

Update:   April 17th, 2021

HHSC Publishes HCS Expansion of Reopening Visitation Rules

Original Published:  March 25th, 2021

3.0 HCS Expansion of Reopening Visitation Rule

To read more, please click on the link below: 

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

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

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

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

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

Visitor Limitations: (Indoor and Outdoor)

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

3.3.1 Indoor Visitation

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

3.3.2 Outdoor Visitation

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

3.3.3 Limitations for Visitation

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

Limited Visitation Designation and Attestation

4.0 Limited Visitation Designation and Attestation Requirements

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

4.1 Essential Caregiver Visits

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

4.2 Limited Visitation without Attestation Form

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

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

HHSC Publishes HCS Expanded Visitor Attestation Rules & Guidance Letter

September 25th, 2020

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

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

HCS Emergency COVID-19 Mitigation Rules 

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

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

COVID-19 Resources

July 11th, 2022

July 7, 2022 MCS COVID-19 Stakeholder Information Session

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

The audio from this session can be found here.

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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

May 8th, 2022

May 5, 2022 MCS COVID-19 Stakeholder Information Session

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

The audio from this session can be found here.

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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

April 10th, 2022

April 7, 2022 MCS COVID-19 Stakeholder Information Session

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

The audio from this session can be found here.

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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

January 9th, 2022

January 6, 2022 MCS COVID-19 Stakeholder Information Session

The audio from this session can be found here.

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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

December 30, 2021

COVID-19 Cases Rise – Guidance for LTC Providers

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

Please review the following guidelines and rules:

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

Find COVID-19 resources on:

• Your provider portal under the COVID-19 Resources section
• The HHSC COVID-19 Provider Information page

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

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

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

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

• Intermediate Care Facilities
• Home and Community-based Services
• Texas Home Living

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

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

December 30th, 2021

Dec. 13 ICF COVID-19 Webinar Recording Available

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

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

Listen to the webinar recording here.

Email LTCR Policy for the transcript.

December 29th, 2021

COVID RESOURCES FOR HCS/TXHML

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

• HCS Visitation Comparison Table (PDF)
• HCS COVID-19 Expanded Visitation Rules (PDF)
• TxHmL COVID-19 Updated Emergency Rules (PDF)
• COVID-19 Response for Home and Community-based Services Residential Providers (PDF)
• Updated COVID-19 FAQs for HCS and TxHmL Providers (PDF)

Additional Guidance and Resources

• Guidance for LTC Facilities Experiencing Staffing Shortages Due to COVID-19 (PDF)
• National Healthcare Safety Network Long Term Care Facility COVID-19 Module Enrollment (PDF)
• Long-term Care COVID-19 Vaccination Options (PDF)
• Attestation for Free COVID-19 Testing Kits for ALF, HCSSA, ICF/IID and NF Providers (PDF)
• Questions and Answers from Long-term Care Facebook Live Discussions Hosted by Sen. Zaffirini (PDF)
• Expanded Visitation in Texas Long-term Care Facilities (PDF)
• HHSC Reminds Long-term Care Providers to Check for Updated COVID-19 Guidance (PDF)
• COVID-19 Vaccination-Pharmacy Partnership for Long-Term Care (PDF)
• COVID-19: Questions and Answers Regarding Facemasks and Respirators (PDF)

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

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

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

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

Resources

• Strategies to Mitigate Healthcare Personnel Staffing Shortages
• Infection Control Basics: Personal Protective Equipment Webinar
  • Infection Control Basics Webinar Slides (PDF)
• Provider and Information Letters
• Proper N95 Respirator Use for Respiratory Protection Preparedness
• Helping Residents with Dementia Prevent the Spread of COVID-19 in LTC Communities (PDF)
• Helping Individuals with Intellectual Disabilities and Related Conditions Prevent the Spread of COVID-19 (PDF)

November 5th, 2021

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

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

The audio from this session can be found here.

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

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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

September 15th, 2021

Oct. 4 ICF COVID-19 Webinar with HHSC LTCR

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

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

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

September 15th, 2021

Sept. 13 ICF COVID-19 Webinar Recording Available

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

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

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

August 30th, 2021

LTC Providers May Request COVID-19 Emergency Support

For Emergency Staffing Support:

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

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

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

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

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

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

The emergency plan must include:

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

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

Long-term care providers can request:

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

To Request Support:

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

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

HHSC LTCR staff may request supporting documentation to verify need.

August 15th, 2021

LTC Provider COVID-19 Resource Contacts Have Changed

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

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

LTC providers can now order COVID-19 therapeutics directly.

July 18th, 2021

August 2 ICF COVID-19 Webinar with HHSC LTCR

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

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

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

July 16th, 2021

July 6 ICF COVID-19 Webinar Recording Available

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

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

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

May 12th, 2021

Quality In LTC Conference Online

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

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

From HHSC May Newsletter

COVID-19 updated resources, see link below:

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

May 6th, 2021

APR 29 MCS COVID-19 Stakeholder Update

The audio from this session can be found here.

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

April 17th, 2021

March 18, 2021 MCS COVID-19 Stakeholder Information Session

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

The audio from this session can be found here.

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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

April 17th, 2021

Reminder: Providers Can Request Free COVID-19 Testing Kits

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

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

March 28th, 2021

Free BinaxNOW COVID-19 POC Tests Available for LTC Providers

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

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

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

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

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

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

March 22 ICF COVID-19 Webinar with HHSC LTCR

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

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

ICF Provider Webinar

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

Helpful Vaccination Information

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

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

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

CDC’s Moderna Clinical website is live: Moderna COVID-19 Vaccine Information. This website includes the following documents:

• Storage and Handling Summary
• BUD Guidance and Labels
• Storage and Handling Labels
• Vaccine Expiration Date Tracking Tool
• Freezer Storage Loggers (F) and (C)
• Prep and Administration Summary
• Standing Orders Template

CDC   Coronavirus Disease 2019 (COVID-19)

Resources For Posters For The Facility For Staff & Individuals

https://www.cdc.gov/coronavirus/2019-ncov/communication/print-resources.html?Sort=Date%3A%3Adesc&Search=stop%20the%20spread%20of%20germs

AADMD Webinar Series to Return in January 2021

https://open.texas.gov/

HHSC COVID-19 Provider Information

https://hhs.texas.gov/services/health/coronavirus-covid-19/coronavirus-covid-19-provider-information

Webinar – NHSN November 2020 Updates to LTCF COVID-19 Module Pathways

The National Healthcare Safety Network had updated the Long-term Care Facility COVID-19 Module pathways, specifically the Resident Impact and Facility Capacity and Staff and Personnel Impact. Revised forms, form instructions, and CSV templates are now available on the LTCF COVID-19 Module website.

The webinar will review the November 2020 updates.

Long-term Care Facility Webinar

November 24, 2020

10:00 – 10:45 a.m. CST

See Recording below

Register for the Webinar.

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

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

View the video training.

https://www.txdisabilities.org/news-events/coronavirus-information-resources

ANCOR’s COVID-19 Resource Center

https://www.ancor.org/covid-19

CDC information for persons with IDD

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-disabilities.html

Resources from HRS

“As the situation with Coronavirus (COVID-19) develops, HRS is committed to providing those who work in the field of IDD supports with practical, sensible, and usable health information regarding identifying those at most risk and steps that can be taken to reduce the severity of the impact of this disease.”

Below are links to free helpful resources from HRS  (Training Videos, Webinars, and Bulletins)

https://hrstonline.com/covid-19-resources/

December 22, 2020

Risk/Benefit Return to Activity Form (Free from our friends at HRS) 

This could be very helpful for considerations for returning to work, Day Hab, Volunteer Jobs, etc…

https://hrstonline.com/download/risk-benefit-return-to-activity-form/?wpdmdl=3104&refresh=5fc779cf9f80e1606908367

Risk/Benefit Return to Activity Form

Thought this was great info. and wanted to share-

From IntellectAbility

Long-haul COVID in People with IDD

“People with intellectual and developmental disabilities (IDD) are at a greater risk of infection and poorer COVID-19 related health outcomes than the general population. Prevalence of comorbidities, living in congregate settings, and difficulties practicing preventative measures contribute to this risk; however, the inability to effectively communicate symptoms of illness may be the most significant hurdle to identifying and managing symptoms of COVID-19 infection, especially for those experiencing the lasting effects of long-haul COVID.”

Read more

Download this 10-page document for more info on symptoms in individuals with  “Long-haul COVID-19” issues

July 4th, 2022

The Provider Finance Department (PFD) Open Enrollment Portal experienced technical difficulties. Those issues have been resolved. The portal is now available for providers to complete Open Enrollment for the Attendant Compensation Rate Enhancement and Direct Care Staff Enhancement programs and Liability Insurance Rate Add-ons for Nursing Facilities.

The PFD portal is available. Please click here to access the portal. The PFD portal will be open from July 1, 2022 to August 1, 2022. For questions, contact HHSC Provider Finance Department: CostInformationPFD@hhs.Texas.gov.

The Texas Health and Human Services Commission (HHSC) announces Open Enrollment for the following programs:

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

For this state fiscal year (SFY) 2023, enrollment will be open until Aug 1, 2022. Title 1, Texas Administrative Code (TAC) Sections 355.112 and 355.308 states if the last day of open enrollment is on a weekend day, state holiday, or national holiday, the next business day will be considered the last day requests will be accepted. This enrollment pertains only to providers contracted with HHSC as described in 1 TAC Sections 355.112 and 355.308.

Providers contracted directly with a Managed Care Organization (MCO) will continue to enroll for rate enhancement through that MCO. They may not enroll through the process discussed below without a fee-for-service contract with HHSC.

Providers who participate in this optional program receive additional funds to provide increased wages and benefits for attendants or direct care staff. They must comply with enhanced staffing or spending requirements on future cost or accountability reports.

To request participation or an increase in level, complete an online Enrollment Contract Amendment (ECA) by 5:00 p.m. on August 1, 2022. The ECA must be completed online. No faxes, mail, or emails will be accepted. This letter does not include any forms. The ECA, all instructions, and worksheets are available on the HHSC Provider Finance Department Website at: https://pfd.hhs.texas.gov/long-term-services-supports.

July 5th, 2022

Use the following instructions to access these resources:

1.   Open the Provider Finance Long-term Services & Supports website;

2. select the appropriate program;
3. scroll down to the heading “Rate Enhancement – Attendant Compensation” or “Rate Enhancement – Direct Care Staff Compensation” (for Nursing Facility); and
4. click on “View 2023 Rate Enhancement.”

Access the ECA by clicking on “Enrollment Contract Amendment Form” under “Other Documents Important to the 2023 Enrollment Information.”

In the same “Other Documents” section, instructions for completing the ECA are available by clicking on “Enrollment Contract Amendment Instructions.” It is important to review the instructions prior to completing the ECA.

The Open Enrollment Video is available under “View 2023 Rate Enhancement” on the Provider Finance Department website. There are no rate enhancement webinars for fiscal year 2023.

For more information, please visit the Provider Finance website.

July 5th, 2022

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

TMHP has received feedback from providers indicating more support is needed. Read the full alert.

July 5th, 2022

Joint Training Page Available for HCS and TxHmL Program Providers

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

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

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

July 2022 LTCR Provider Training Opportunities

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

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

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

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

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

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

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

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

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

• Joint Training website.
• HCS and TxHmL Training website.

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.

July 5th, 2022

 Information Validation on LTC Claims IL 2022-35

IL 2022-35 is posted on the HHS nursing facility and Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions webpages.

Effective June 10, provider information on long-term care claims is being validated using data stored in the National Plan and Provider Enumeration System and the Texas Medicaid and Healthcare Partnership Provider Enrollment and Management System.

This enhancement ensures the consistency of provider information and helps avoid claim rejection. Attending provider information is validated on NF and ICF/IID claims. Referring provider information is validated on hospice claims.

Email questions to the Managed Care Initiatives and ICF/IID Questions inboxes.

July 4th, 2022

Don’t Forget, Informal Comments on HCS & CFC Draft Rules Are Due by July 13th!

Texas HHS is accepting comments from stakeholders on the following draft rules:

• Title 26, new Chapter 565, Home and Community-based Services Program and Community First Choice.

The comment period ends July 13.

Email comments to Long-term Care Regulation Policy and Rules.

July 4th, 2022

American Rescue Plan Act (ARPA) Home and Community-Based Services (HCBS) Provider Retention Payments

Initial report is now due by August 15, 2022.

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

HHSC is providing funds to agency providers and consumer-directed services employers to support recruitment and retention efforts for direct care staff delivering HCBS services. Payments made under this section can include one-time financial compensation directed toward direct care staff, including lump-sum bonuses, retention bonuses, and paid time off to receive a COVID-19 vaccination or to isolate after receiving a positive COVID-19 test.

Providers who may be eligible to receive funds are:

• 1915 (c) Texas Home Living (TxHmL) Provider Agency
• 1915 (c) Home and Community-Based Services (HCS) Provider Agency
• 1915(i) Home and Community-Based Services – Adult Mental Health (HCBS – AMH) Provider Agency
• 1915 (c) Home and Community-Based Services (HCS) CDS Employer
• 1915 (c) Texas Home Living (TxHmL) CDS Employer
• see the HHSC HCBS website for other types of additional information on ARPA funds.

HHSC is providing time-limited reimbursement increases to strengthen and stabilize the HCBS workforce. Temporary rate increases will be made on eligible HCBS service claims with dates of service between March 1, 2022, and August 31, 2022.

Providers receiving temporary rate increases must complete an attestation and complete an initial report by August 15, 2022.

HHSC will announce the due date for the final report in a follow-up notice. Providers will have at least 30 days to complete the final report.

Providers who fail to complete the required attestation and reporting will be subject to recoupment of HCBS ARPA funds.

Consumer Directed Services (CDS) Employers and Financial Management Services Agencies (FMSAs)

The CDS participant, as the employer of record, may choose to submit the required attestation and reports or work with the Financial Management Services Agency (FMSA) to submit the attestation and reports on the CDS participant’s behalf. FMSAs may also reach out to the CDS participants to offer assistance in submitting the attestation and reports. FMSAs can submit the required information for multiple CDS participants in the FMSA HCBS ARPA Attestation and Initial Report Template. Pursuant to Texas Administrative Code rule 1 TAC 355.207(c)(4), to be eligible for the temporary rate add-on, providers must submit required reports regarding the use of funds and provide data to document vacancy rates in direct care staff and other indicators. If completing the attestation and reports on behalf of a CDS participant, FMSAs should work with the CDS participant to collect all required data. The deadline for the attestation and initial reporting has been extended to August 15, 2022.

Information regarding ARPA HCBS Provider recruitment and retention payments is available on the HHSC Provider Finance website.

June 2nd, 2022

Don’t Forget!

American Rescue Plan Act (ARPA) Home and Community-Based Services (HCBS) Provider Retention Payments Attestation and Initial Reporting

Initial report is due by July 1, 2022.

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

HHSC is providing funds to agency providers and consumer-directed services employers to support recruitment and retention efforts for direct care staff delivering HCBS services. Payments made under this section can include one-time financial compensation directed toward direct care staff, including lump-sum bonuses, retention bonuses, and paid time off to receive a COVID-19 vaccination or to isolate after receiving a positive COVID-19 test.

HHSC is providing time-limited reimbursement increases to strengthen and stabilize the HCBS workforce. Temporary rate increases will be made on eligible HCBS service claims with dates of service between March 1, 2022, and August 31, 2022.

Providers receiving temporary rate increases must complete an attestation and complete an initial report by July 1, 2022.

HHSC will announce the due date for the final report in a follow-up notice. Providers will have at least 30 days to complete the final report.

Providers who fail to complete the required attestation and reporting will be subject to recoupment of HCBS ARPA funds.

Information regarding ARPA HCBS Provider recruitment and retention payments is available on the HHSC Provider Finance website.

May 19th, 2022

HCS/TxHmL providers:

Please be aware of the following for claims being paid from March 1st, 2022-August 31st, 2022 in TMHP:  There are new Procedure/Billing Codes in TMHP that reflect the ARPA short-term funding as retention payments you may be receiving for these claims billed during this time period.  If you are seeing new or different codes than you are used to, listed when you pull up “paid” claims, then you are receiving ARPA Retention payments and will be responsible for documenting how these funds were used and reporting this by July of 2022, or you are subject to recoupment from the MCO’s.  (Example: M0115, M0116, M0117…)

See rates and new codes listed in link below:

https://acrobat.adobe.com/link/track?uri=urn:aaid:scds:US:cca5939a-6173-346e-9fc2-3409490a5447

Personally, I was under the assumption that providers would have to request this assistance if they wanted it, meaning they would choose whether they utilized this funding or not.  Apparently not necessarily as some providers have noted this is showing up on their payments.  From everything I am reading, the provider letters from HHSC do seem to indicate every provider will receive the funding.

Meaning additional (ARPA) monies that the provider is receiving in claim payments for that time period, will need to be accounted for, and reporting on how funds were utilized will need to happen and be sent into HHSC. Some providers are noticing a difference in the regular rates they submitted claims for when they look at their “paid claims”.  If the provider uses the ARPA intended, attestation and reporting to HHSC must occur.

If the HCS/TxHmL provider chooses not to utilize the added-on payments to the normal rates, I believe they will need to hold back/save these additional amounts for each claim paid from March to August of 2022, in order to pay them back at a later date.  If these ARPA funds are utilized, then the HCS/TxHmL Provider will need to complete a report by July of 2022. I believe, to HHSC by the provider, or they will have to keep it in an account and saved for repayment/recoupment when requested by the MCO’s if I understand correctly.  I will keep you posted!  Also, please look for the additional FAQ’s to be published on May 23rd, 2022 for hopefully important answers to the TMHP questions and issues many providers have expressed with entering IPCs in particular (especially revisions) entering billing claims, and only getting paid for part of billing claims submitted.

Here Are Just Some Of The FAQ’s HHSC Recently Published May 5th, 2022 (specifically related to this issue I have noted above)

Q: What are the ARPA HCBS Provider Retention Payments?

A: HHSC’s ARPA HCBS spending plan included recruitment and retention payments for providers delivering attendant and direct care HCBS for retention bonuses or other activities. HHSC’s spending plan requires providers to use at least 90 percent of HCBS ARPA funds for one-time financial compensation for their direct care workforce, including, but not limited to, lump-sum bonuses, retention bonuses, and paid time off to receive a COVID-19 vaccination or to isolate after receiving a positive COVID-19 test.

Q: What Services are eligible for Provider Retention Payments?

A: HCBS ARPA temporary rate add-on will be applied to HCBS personal attendant and nursing services as defined in 1 TAC 355.207.  A list of eligible services is defined in Section 355.207(b)(1). An updated service list and fee schedule is available on the Provider Finance Homepage.

Q: What identifying information do I need to include with my attestation and required reports?

July 3rd, 2022

Overview

The Provider Finance Department (PFD) develops reimbursement methodology rules for determining payment rates or rate ceilings for recommendation to the Health and Human Service as Commission (HHSC) for Medicaid payment rates and non-Medicaid payment rates for programs operated by the Health and Human Services Commission (HHS) and the Department of Family and Protective Services (DFPS). PFD develops payment rates or rate ceilings in accordance with these rules and agency policy guidelines.

For more information please click on this link below for the website

https://pfd.hhs.texas.gov/long-term-services-supports

Texas Local IDD Authorities (LIDDA)

Click on link below:

https://www.google.com/maps/d/viewer?mid=1x52WNDpmumg3J5ANB-G1aWfCSFFnHKM&usp=sharing

HCS Group Home Vacancy Search

To find out which companies have group home vacancies, you may go to the following link:  https://resources.hhs.texas.gov/find/HCS.  Please be sure if you are an HCS provider that you are reporting any vacancies in your group home to the state.

June 23rd, 2022

2022 Conference for Intellectual & Developmental Disabilities

Innovating, Developing & Defining the Future of Service Delivery

August 12, 2022

Norris Conference Centers – Dallas Northpointe Centre

(Located in: Brightwood College in Dallas:  12005 Ford Rd #200, Dallas, TX 75234)

The exhibitor information is available now. See link below.  Registrant information to be posted later this month.

Please click on this link for Exhibitor Information

June 23rd, 2022

Please see the recent alert below from HHSC.  This has been brought to my attention just recently, however, I find it in conflict with the billing guidelines/requirements prior to even COVID-19, which allows for nurses to complete assessments per video chat  So, most likely they will revise billing requirements.  But know, it was in place prior to the Pandemic.

Revised Guidance for COVID-19 Flexibility for Registered Nursing Services Provided by Telehealth for  HCS & TxHmL

During the COVID-19 pandemic, flexibilities were put in place to allow comprehensive nursing assessments to be provided by telehealth (synchronous audio-visual technology).

This revised guidance applies to:

• Home and Community-based Services
• Texas Home Living

At the end of the COVID-19 public health emergency, this flexibility will end, and a registered nurse will be required to complete the comprehensive nursing assessments in person.

HHSC is notifying providers now so they can prepare for in-person activities as soon as the COVID-19 public health emergency ends. HHSC will notify providers of that date as soon as the federal government determines the end date. HHSC will be making updates to waiver handbooks to reflect this policy. Until handbook updates are completed, this interim guidance will serve as official HHSC policy.

For questions, email one of the policy mailboxes below:

• HCS policy mailbox
• TxHmL policy mailbox

June 17th, 2022

Employment First Training Series

Amerigroup and the Association of People Supporting Employment First (APSE) are hosting a free, eight-week training series on competitive integrated employment and Employment First. The training is intended for Supported Employment providers throughout the state of Texas. It is not required for providers that maintain the TWC-VR Supported Employment credential. The kickoff for the training series is June 29, 2022. For more information about the training, visit the Vocational Rehabilitation Providers’ Resources website. To register, send an email to info@apse.org.

Cool new TWC provider locator tool

Instructions on how to use provider locator tool:  https://www.twc.texas.gov/files/partners/vr-provider-locator-documentation.docx

June 16th, 2022

June 12th, 2022

Potential Long-Term Care Remittance and Status Report Delays

Due to the Home and Community-Based Services American Rescue Plan Act Provider Retention Payments (Add-On) for personal attendant and nursing services, rates are being updated.

Refer to Information Letter No. 2022-30 for additional information.

From TMHP

“Because of the Home and Community-Based Services (HCBS) American Rescue Plan Act (ARPA) provider retention payments (add-on) for personal attendant and nursing services, rates are being updated. Refer to Information Letter No. 2022-30 for additional information.

Providers do not need to take any action because these claims will be systematically adjusted during the regular adjustment process. Providers should confirm claim status and paid amounts on the Remittance and Status (R&S) Report.

Potential delays are expected in the generation of all provider R&S Reports on Wednesdays for the next few weeks because of the high volume of adjustment claims that will be systematically generated. Therefore, R&S Reports will be available later in the day, and providers may expect to see more records on the R&S Reports because of these adjustments.

For additional questions, contact the TMHP LTC Help Desk at 800-626-4117, option 1, then option 7.”

June 6th, 2022

Register for June 8 HCBS ARPA Stakeholder Update Webinar

HCBS providers are urged to attend this HCBS ARPA Stakeholder Update Webinar.

HHSC will provide updates on the Texas Home and Community Based Services Spending Plan authorized under Section 9817 of the American Rescue Plan Act

HCBS ARPA Stakeholder Update
June 8
2:30 p.m. – 3:30 p.m.
Register for the HCBS ARPA Stakeholder Update webinar.

June 3rd, 2022

Guidance related to Emergency Preparedness- Exercise Exemption based on A Facility’s Activation of their Emergency Plan *** Revised to provide additional guidance and clarifications due to the ongoing COVID-19 public health emergency (PHE) REVISED 05.26.2022 ***

Memorandum Summary

• Emergency Preparedness Training and Testing Program Exemption -CMS regulations for Emergency Preparedness (EP) require facilities to conduct exercises to test the facility’s EP plan to ensure that it works and that staff are trained appropriately about their roles and the facility’s processes. During or after an actual emergency, the regulations allow for a one-year exemption from the requirement that the facility perform testing exercises.

• This worksheet presents guidance for surveyors, as well as providers and suppliers, with assessing a facility’s compliance with the EP requirements, in light of many of the response activities associated with the COVID-19 Public Health Emergency (PHE).

• As the PHE continues, many facilities continue to operate under their respective activated emergency plans. Therefore, CMS is providing additional guidance related to the exercise requirements (full-scale/functional drills and exercises) for inpatient and outpatient providers/suppliers.

• This exemption only applies to the next required full-scale exercise (not the exercise of choice), based on the facility’s 12-month exercise cycle. The cycle is determined by the facility (e.g. calendar, fiscal or another 12-month timeframe).

***All revisions are in red on this letter from CMS, click the link below for the complete document. 

Read more……

September 13th, 2021

Very Important Updates on Emergency & Disaster Preparedness During the Pandemic

Resources Listed Are From CMS & HHSC 

See Info For ICF Facilities Below

Life Safety:  Updated Guidance for Emergency Preparedness-Appendix Z of the State Operations Manual (SOM)

Emergency Preparedness Participant Workbook

 Interim Guidance for Hurricane Evacuation Transport to General Population Shelters during the COVID-19 Pandemic

Interim Guidance for General Population Disaster Shelters During the COVID-19 Pandemic

Screening Tool For COVID-19 During Pandemic For Arrival At General Population Shelters

Based on the many phone calls, emails and contacts through our social media pages concerning Job Positions Desired and Job Openings with HCS providers, I have decided to use our “Updates” page to provide a place where both those persons desiring a position with an HCS Provider and those Posting a Job Position can find each other!

We will not neccesarily be posting the job description or information on this page directly.  If you contact Meghan Jones at meghanjones.tx@gmail.com and let her know where you are posting a position and who to contact, we can put a link and the contact person’s name, # and/or email.  For example, you are posting on Indeed, Linkedin, BenefitMall, Facebook, PACSTX job postings, an online newspaper, etc…

We will also continue to repost openings when we can on our Linkedin page as well as our Facebook and Instagram pages for Twogether Consulting.

There is no charge, we just ask you all to keep referring us to others who don’t know about us for their HCS business needs and of course we hope you will continue to use our services to assist you with your training needs, on-site and off-site assistance. 

Julie Blacklock/ Owner

Current Job Postings (See below)

TMHP & HHSC Response to Common Migration Issues:   Click on link below

TMHP Migration Complaints-HHSC Responses-060222

https://www.tmhp.com/news?created=2&title=HCS&program_id=56&topic_id=All&category_id=All

May 25th, 2022

Tip

So a provider mentioned that it might be a good idea to just have a stamp made that says “ENTERED” on the top and underneath it the letters “DLN” with a box next to it to write in the DLN #. This way, every time someone enters their ID/RC’s and IPC’s,  into TMHP for renewal, revision, etc.. and then you click  “submit” you can write down the “DLN” on the document.  The provider will have to know what DLN # goes with which entry.

May 30th, 2022

LTC Online Portal Dashboard Accessibility Issue Resolved

An accessibility issue with the Long-Term Care Online Portal Dashboard has been resolved.

“I have received quite a few calls about this issue.  And unfortunately, that made it also very difficult to get a status on claims billed for many providers. So hopefully the issue is now truly resolved.”

From HHSC:

“Home and Community-based Services and Texas Home Living waiver programs providers and local intellectual developmental disability authority agencies can access the LTC Online Portal Dashboard by ensuring that they have the correct user permissions.”

Read the full alert here.

If you have any questions about accessing the LTC Online Portal Dashboard, contact the TMHP LTC Help Desk by calling 800-626-4117, selecting Option 1, & then selecting Option 7.

May 30th, 2022

In Case You Don’t Have Enough To Worry About…..

HHSC Publishes Information on Preparing for Fee-for-Service Claims Billing Closeout IL 2022-31

IL 2022-31 (PDF) is posted to the HHS site.

Just some thoughts: Understand, that this also might mean a period of time where regular payments will be delayed a few weeks, right when the fiscal year closeout occurs at end of August.  Hopefully not, but it has been an issue in past years with CARE. Please be sure to take care of all claims that you can possibly bill, by 8/31/22!!!  

From HHSC:

“IL 2022-31 is for providers to prepare for the Aug. 31 end of fiscal year closeout. It is important for providers to promptly submit claims to be paid by HHSC for any unbilled services. HHSC will publish additional details regarding cutoff dates for fiscal year 2022 in an upcoming HHSC information letter when they are available.”

Submit questions about this project by calling Texas Medicaid and Healthcare Partnership at 800-626-4117, Option 1. Invalid or inappropriate recoupments should be immediately reported to HHSC Provider Recoupments and Holds by calling 512-438-2200, Option 3.

May 30, 2022

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

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

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

This temporary policy change is effective March 27, 2020 through June 30, 2022, unless the COVID-19 public health emergency ends sooner. HHSC will provide guidance if anything changes. Program providers must complete the required background checks for all service providers. They must follow:

• 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.

February 28th, 2022

COVID-19: HHSC Publishes In-Home Day Habilitation Information for Program Providers (IL 2022-15)

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

HHSC has published a revision to this guidance in IL 2022-15 In-Home Day Habilitation Information for Program Providers for COVID-19 (PDF). This replaces IL 2022-09.

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

Email questions to HCS Policy

February 28th, 2022

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

HHSC has lifted the ban on service providers of respite and Community First Choice PAS/HAB. They can now live in the same home as the person receiving Home and Community-based Services and Texas Home Living program services.

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

This is a temporary policy change. It is effective March 27, 2020 through March 31, 2022, unless the COVID public health emergency ends sooner. HHSC will provide guidance if anything changes.

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

• 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.

May 29th, 2022

2022 Hurricane Season Emergency Preparedness with COVID-19

Long-term care providers in Texas are reminded to review their emergency preparedness and response plans before the Atlantic hurricane season begins, which runs June 1–Nov. 30. LTC providers should make updates, if necessary.

Providers should factor in COVID-19 contingencies when reviewing their preparedness plans. For example, as applicable:

• Are your receiving facilities and transportation contracts still viable?
• If your provider type is allowed to evacuate to a hotel and that is in your plan, are hotels open in your destination?
• How will you maintain infection control measures during evacuation or sheltering-in-place?
• If you have COVID-19 positive persons in your facility, how will that affect evacuation or sheltering-in-place?
• How will you make sure personal protective equipment is available in addition to food and medicine?

Providers affected by an adverse event, such as severe weather, or expects it will need to temporarily exceed capacity due to a disaster, should contact their HHSC LTC Regulatory regional office.

Please refer to your program’s rules for more important information regarding emergency preparedness.

Hurricane and Flooding Readiness for HCS/TxHmL
Wednesday, June 1
1:45–3 p.m.
Register for the training.

August 15th, 2021

August and September 2021 LTCR Provider Training Opportunities

Long-Term Care Regulatory providers are invited to attend the following trainings hosted in August and September. Visit the Joint Training Opportunities page to register and learn more about each of these events.

Emergency Preparedness in Long-Term Care Facilities
August 18
1:30 p.m.
Register for the webinar.

August 25
1:30 p.m.
Register for the webinar.

September 13
1:30 p.m.
Register for the webinar.

September 23
1:30 p.m.
Register for the webinar.

July 4th, 2021

Hurricane and Flooding Readiness Webinars for LTC Providers

Home & Community-based Services:

Wednesday, July 21
2 -3:30 p.m.
Register for the webinar.

Intermediate Care Facilities:

Wednesday, July 21
10 -11:30 a.m.
Register for the webinar.

July 2021 LTCR Provider Training Opportunities

Long-Term Care Regulatory providers are invited to attend the following trainings hosted in July.  Visit the Joint Training Opportunities page to register and learn more about each of these events.

Emergency Preparedness in Long-Term Care Facilities

July 21
1:30 p.m.
Register for the webinar.

July 28
1:30 p.m.
Register for the webinar.

July 3rd, 2021

CMS Provides Guidance on Full-Scale Emergency Preparedness Exercises

ICF Providers, please make sure you see this.

The Centers for Medicare and Medicaid Services issued Quality Safety & Oversight Memo QSO-20-41-ALL Revised (PDF). The memo gives more guidance to providers on full-scale exercise requirements that are part of CMS regulations for emergency preparedness.
The following provider types are exempted from completing a required full-scale exercise for the 2021 cycle based on a provider’s activation of their emergency plan.

• Nursing facilities
• ICFs-IID
• Home health agencies
• Inpatient hospice providers

This exemption does not apply to the exercise of choice.
Providers should still follow all other emergency preparedness guidance in the March 26, 2021 State Operations Manual, Appendix Z (PDF).

May 23, 2022

Very Important!

Please see information from TMHP below: