February 28th, 2024

HHSC has begun to send out new ANE Reporting Procedure Posters to ICF providers this week.  If you do not get one, please contact 

Even if you have not received your  ANE posters, please go ahead and make your posting of the new phone # for reporting allegations of Abuse, Neglect and Exploitation in the group homes and other appropriate places for your staff and individuals in your program. Please inform all staff, volunteers, individuals, and LARS of the new protocol.

The reporting time is still “within 1 hr of your knowledge or suspicion of Abuse, Neglect or Exploitation”.

The new phone # for reporting ANE to CII is:  1-800-458-9858. 

Please do not report to DFPS anymore starting March 1st, 2024 as they will no longer be investigation ANE for the ICF/IID programs.

A few items of note: 

-CII will be the only place facility or persons reporting ANE will need to make your report.  This should help with redundancies.

-CII will prioritize allegations that are serious health and safety concerns for individuals in the program.

-The facility will not receive a findings report from CII.

-The facility will not receive the findings until surveyors present them to the provider at the entrance meeting during a survey that results from an ANE report and investigation by CII.

-The facility should start protective measures for their individuals and corrections as soon as they are aware of the allegation, so this may start much earlier if the allegation is self-reported (immediately after self-reporting).

-The facility will also need to begin an internal investigation right away and within 5 days of the internal investigation fill out and submit a 3613-A report form to send in to CII.   Facility will no longer wait for a PIR investigation report.

-PIR will no longer be part of the process.  CII will receive all ANE reports, process them and complete Investigations.

-The facility is still required to report to other legal entities as appropriate:  i.e, client’s rights issue contact IDD Ombudsman, robbery or stolen items, missing person-report to law enforcement, etc…

–Resident-to-resident Aggression:  Facilities only need to report resident-to-resident aggression that results in serious injury.  ( See TAC Title 26 Part I Ch 551.213)  What is considered a serious injury?  (See TAC Ch 711.3  for the definitions.)

Things your Report To CII Including ANE (section 551.213)

A facility must report any of the following incidents to HHSC’s Complaint and Incident Intake Section at 1-800-458-9858 within one hour after suspecting or learning of the incident:

Ch 26 Tac 771.3 

Definition of Serious Physical Injury

(34) Serious physical injury—

(A) In state-supported living centers and state hospitals only, any injury requiring medical intervention or hospitalization or any injury determined to be serious by a physician or APRN. Medical intervention is treatment by a licensed medical doctor, osteopath, podiatrist, dentist, physician assistant, or APRN. For the purposes of this subchapter, medical intervention does not include first aid, an examination, diagnostics (e.g., x-ray, blood test), or the prescribing of oral or topical medication;

 (B) For all other service providers, any injury determined to be serious by the appropriate medical personnel. Examples of serious physical injury include:

(i) fracture;

(ii) dislocation of any joint;

(iii) internal injury;

(iv) contusion larger than two and one-half inches in diameter;

(v) concussion;

(vi) second or third degree burn; or

(vii) any laceration requiring sutures or wound closure.

February 25th, 2024

HHSC 2/23/2024 Notice:  

Upcoming Webinars:

February 23rd, 2024

Packet/Documentation Submission Details

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

Packets may also be submitted via fax at 512-438-4249.

Questions:

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

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

Provider Webinar Available:  To access a recording of the “TMHP LTC Portal for HCS/TxHmL Providers and FMSAs” webinar, please visit the HCS and TxHmL Webinars and FAQs web page.

January 19th, 2024

Other Portal Resources:  FAQ’s & Training Webinar:

In case you weren’t aware, there are FAQ’s on using the IDD portal and there is a training webinar for HCS/TxHmL/ICF/CFC Non-waiver programs

IDD Portal FAQ’s

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

November 12th, 2023

IDD Portal Information & Additional Training Resources

The Intellectual and Developmental Disabilities (IDD) Operations Portal is an online based application used by long-term care IDD providers and Local Intellectual Developmental Authorities (LIDDAs) to submit and receive documents to and from Texas Health and Human Services IDD Program Eligibility and Support (PES) and IDD Waivers Utilization Review (UR) sections. The portal is only meant to replace document submissions by fax and mail.

It does not replace the responsibility of providers or LIDDA’s to ensure accurate completion of documents, maintain signed paper copies of forms in individual records, and comply with HIPAA regulations when making submissions to the Health and Human Services Commission (HHSC). During initial account setup, the provider or LIDDA assigns a security authority who is responsible for managing their staff’s access to the portal. Providers and LIDDAs are responsible for ensuring procedures are in place to properly manage staff’s access to individual’s records inside and outside of the portal, just as they did prior to portal implementation.

Click on to see: IDD-operations-portal-user-guide

April 15th, 2019

As of April 1, 2019, Long-term care intellectual and developmental disability providers and local IDD authorities can electronically submit and receive documents to and from HHS IDD Program Eligibility and Support and IDD Utilization Review.

Who Can Use the Portal?

If you contract with HHS to provide IDD services in the following programs, you can register and begin using the portal:

• Community First Choice
• Community Living Assistance and Support Services
• Deaf-Blind with Multiple Disabilities
• Home and Community-based Services
• Intermediate Care Facilities for Individuals with Intellectual Disabilities
• Texas Home Living

What Are the Benefits?

To learn more, read the IDD Operations Portal Flyer (PDF).

Where Do I Register and Learn How to Use the Portal?

Complete the Initial Account Setup and register your business with the portal at txhhs.force.com. To learn more, read the IDD Operations Portal User Guide (PDF).

HHS will use email alerts, information letters, training webinars and in-person communications via existing stakeholder meetings to provide portal updates.

For technical issues, contact the IDD Operations Portal Team at IDD_Ops_Portal@hhsc.state.tx.us.

February 20th, 2024

LTC Provider Bulletin Now Available

The February 2024 Long-Term Care (LTC) Provider Bulletin has been published on the LTC homepage on TMHP.com.

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

For questions, see the LTC Provider Resources Guide under Reference Material.

See links to 2024 editions below:

February 2023 LTC Provider Bulletin No. 97

See links to the 2023 editions below:

May 2023 Long-Term Care (LTC) Provider Bulletin

February 2023 LTC Bulletin No. 93 (456.32 KB)

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

For questions, see the LTC Provider Resources Guide.

See links to the 2022 editions below:

See link to August 2021 edition below:

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

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

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

See link to February 2021 edition below:

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

See link to November 2020 edition below:

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

February 18th, 2024

IDD Services and PASRR want to remind local intellectual and developmental disability authorities (LIDDAs) that Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers are required to provide, or obtain as needed and without delay, the array of services in the respective programs in accordance with Texas Administrative Code (TAC), specifically 26 TAC §565.11(a)(3) for HCS and 26 TAC §566.7(d)(1) for TxHmL.

Program providers cannot limit the program services they offer to an individual. The requirement to provide the full array of services includes individuals receiving Community First Choice (CFC) services and individuals who choose to receive some or all of their services through the Consumer Directed Services (CDS) option.

For a complete list of the program services, see the following TAC references:

• HCS program services: 26 TAC §263.5
• TxHmL program services: 26 TAC §262.5
• CFC program services: 26 TAC §263.6 and 26 TAC §262.6

**If a LIDDA becomes aware that an HCS or TxHmL program provider is not offering the full array of program services, the LIDDA should report this information to the IDD Ombudsman at https://hhsportal.hhs.state.tx.us/heartwebextr/hhscIddo, or call 800-252-8154, from 8 a.m. – 5 p.m. Monday through Friday.

For any questions please email iddservicesacoffice@hhs.texas.gov.

February 10th, 2024

Public Hearing Notice – Home and Community-based Services, Texas Home Living, and Deaf Blind with Multiple Disabilities Medicaid Waiver Programs

January 20th, 2024

January 26th, 2024

We have received information that a suspicious email claiming to be from HHSC asking providers to verify information related to their DAHS ISS Only licenses has been received by some ISS providers. The email was not sent from an HHSC email address but instead from a mndschool.org domain. The email directs the provider to click on a link to verify information and that the provider has 24 hours to verify or they will revoke the license. Please do not click on the link.

January 20th, 2024

Reporting Abuse, Neglect, and Exploitation Changes and Self-Reporting Incidents for Intermediate Care Facilities

Tuesday, Feb. 27
10–11:30 a.m.
Register here for webinar.

January 20th, 2024

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

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

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

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

January 18th, 2024

The Texas IDD billing process through TMHP has been burdening providers since its inception. HCS, TxHmL and ICF providers have been plagued with denied claims, decreased revenue, and inefficiencies in tracking and reporting.

In this video below (Hosted by Twogether Consulting 1/18/24), Millin addresses a range of best-practice topics to help you stay on top of your Texas HCS, TxHmL and ICF billing. They share the functionality they have built into the MillinPro software and their internal process that has led us to an incredible 99.2% collection rate on all eligible claims.

Millin aims to simplify the billing process by bypassing much of the manual work you need to do on TMHP.

Millin aims to automate most of the process with features that include eligibility checks, batch submission capabilities, issue-tracking and a library of reports designed to replace the R+S functions of TMHP.

Click on the link below to watch video

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

Texas Webinar Powerpoint for Twogether – January 2024

Twogether Consulting hopes that this has been a great resource for HCS/TxHmL/ICF providers.  Mention that you are a client of Twogether Consulting for a 50% discount on all initial implementation fees.

Did You Know Millin Billing Pro Can Help Providers With TMHP Billing & EVV?

Check Out This Info From Milling Billing Pro.

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

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

Millin Billing Pro Video

Management System video from Millin Billing

HCS and TxHmL Town Hall Webinars and FAQs

January 16th, 2024

November Webinar 2023

September Webinar 2023

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

Presentation Handout

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

• September 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
• September 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar Recording 

Panelists: • Ashley Wechsler –Program Eligibility and Support (PES) •Holly Lindsey –Utilization Review (UR) •Marie Redman –Provider Claims Services (PCS) • Rhonda Kay Richie –Local Procedure Development and Support (LPDS) • Kali Schmidt –Contract Administration & Provider Monitoring (CAPM) • Rick Bishop –Claims Management • Amy Aubin –Long-Term Services and Supports (LTSS) Policy Unit • Joan Workman –HHSC Information Technology (IT) •Depesh Shah -Texas Medicaid & Healthcare Partnership (TMHP)

Some of The Topics Discussed Included:

-Fiscal Year 2023 Year-End Closeout Process (CARE) & The Process For Closeout in LTC

-Claims Processing Update and Claims Overlapping With IPC’s

-Claims Data Export: How to Remove Duplicate Lines

-Suspensions, Terminations (In particular- screens/forms in TMHP for LIDDA and the Provider that need to be completed)

-How to Use Pivot Tables in Excel  (There are training videos on Youtube for Pivot Tables and it is suggested that providers watch these videos.  My understanding is that these tables may help some with cost reporting data that is needed)

-Requesting Inactivation

-Improvements to the phone system, including the Automated Inquiry System(AIS) as of Sept. 5th, 2023 and updated Contact List For TMHP

FYI- Trending Issues: Upcoming YoutubeTraining Video –Claims DATA Export will come out on September 18th, 2023

Some of the things that will be covered are: •How to convert the Claims Data Export file to a workable file. •Highlight some of the relevant data you can use. •Show how to work with the data.

.

August Webinar 2023

July 24th, 2023

The July 12 recording of the TMHP LTC Portal Town Hall Webinar for HCS Providers, TxHmL Providers and FMSAs is now available. Topics included:

• Trending Issues
• Individual Movement Forms
• Provider Location Updates
• IPC Transfers

The June 14 recording of the TMHP LTC Portal Town Hall Webinar is also available. Topics included:

• Trending Issues
• Release 2 Enhancements
• Navigating the TMHP website
• Entering PC3s
• Adding and Removing CDS Services

Visit HCS/TxHmL Webinars and FAQs for more details.

Contact HCS and TxHmL with any questions.

June 14th, 2023

January 16th, 2023

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Other Important Contacts:

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

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

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

Program Eligibility and Support (PES)

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

For Previously Recorded Webinars & FAQ’s

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

January 16th, 2024

Past  TMHP Town Hall & TxHmL/HCS Provider webinars- recordings from July-December 2023

December Webinar 2023

• December 2023 – Individualized Skills and Socialization Training for HCS/TxHmL Providers and LIDDAs Webinar (PDF)
• December 2023 – Individualized Skills and Socialization Training for HCS/TxHmL Providers and LIDDAs Webinar Recording

November Webinar 2023

• November 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
• November 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar Recording

October Webinar 2023

• October 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
• October 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
  • Claims Data Export Video
  • Overlapping Claims Across Multiple Service Authorizations
  • HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 24, TMHP
  • Staff ID Assignments
  • Best Practice and Troubleshooting: Transfers/Moves

September Webinar 2023

• September 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
• September 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar Recording Topics Discussed:
  • Suspensions
  • Terminations

August Webinar 2023

• August 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
• August 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
  • Volume 22 and 23 additions
  • Span billing across IPC billings
  • Claims Data Export
  • Correction to overall enhancements (not RNS)
  • Revision and renewal IPCs
  • Clarification of Pending DADS Review Notification

July Webinar 2023

• July 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar (PDF)
• July 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs Webinar RecordingTopics Discussed:
  • Individual Movement Forms (IMT)
  • Provider Location Updates (PLUs)
  • Administrative Moves
  • IPC Transfers

June 14th, 2023

July 19 IDD and PI Webinar with HHSC LTCR

February 5th, 2023

IDD and PI Quarterly Webinar with HHSC LTCR Recording Available

The January 26 recording of the Intellectual and Developmental Disability (IDD) Programs and Provider Investigations (PI) Quarterly Webinar with Long-term Care Regulation (LTCR) is available.

Listen to the webinar recording.

Read the IDD and PI Webinar (PDF).

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

November 1st, 2022

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

January 15th, 2024

Revalidations: Important Updates

HHSC/TMHP PEMS Notice: 

January 15th, 2024

HHSC has issued one final extension for Providers with revalidation dates from May 12, 2023, until November 11, 2023, granting these providers an additional 6 months from their revalidation date to submit the request.

Please be sure to check the Provider Enrollment and Management System (PEMS) for your current revalidation date.

Update to Article “Provider Enrollment Revalidation Extensions to End”

              After the November 11th date, providers are required to submit revalidation requests again per Federal guidelines. Revalidation is the process by which a provider updates or confirms information with their enrollment record every 3-5 years. Revalidation requests can be started up to 120 days prior to this date.

January 14th, 2024

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

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

From HHSC:

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

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

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

• Review the Long-Term Care Facilities Council Application for Membership application letter to find out who the council is seeking as representatives and if you qualify.
• After reviewing the application letter and verifying you meet the qualifications for at least one category, click on the application to apply to be on the council.

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

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

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

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

Fax: 512-206-3984 Attn: LTCFC

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

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

January 13th, 2024

TMHP now has a Provider Enrollment Instructional Site which provides written instructions for what is required when completing any type of enrollment request including a revalidation request

PEMS Instructional Site

PEMS Instructional Site

January 13th, 2024

Revalidation Training Links to YouTube video:

Revalidating An Organizational NPI

Revalidating a Performing Provider

TMHP also has a Provider Enrollment Instructional Site which provides written instructions for what is required when completing any type of enrollment request including a revalidation request.

PEMS Instructional Site

PEMS Instructional Site

TMHP has also put together an Enrollment Revalidation Quick Reference Guide (QRG) that goes over the steps to get started, information that is required to be updated or confirmed, along with handbooks and user guides that are helpful for any account assistance that may be necessary.

Enrollment Revalidation Quick Reference Guide

Enrollment Revalidation QRG

January 7th, 2024

A recording of the Dec. 11 Individualized Skills and Socialization Training for HCS/TxHmL Providers and LIDDAs webinar is now available. The webinar recording and presentation slides have been posted on the HCS and TxHmL Webinars & FAQs web page.

May 2nd, 2024

Critical Incident Management System Monthly Provider Demonstrations

FEI Systems will host a monthly provider demonstration webinar on May 14, 2024, from 10–11 a.m. Monthly provider demonstration webinars are offered to providers with access to the Critical Incident Management System. HHSC encourages providers to take advantage of these live training opportunities.

This applies to:

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

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

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

February 25th, 2024

Critical Incident Management System Monthly Provider Demonstrations

June 2nd, 2023

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

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

This Information Letter applies to:

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

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

October 13th, 2022

Please Don’t Forget To Sign Up For CIMS Training

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

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

August 11th, 2022

Critical Incident Management System (CIMS) Now Live

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

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

See IL 2022-23 for more information about CIMS.

This alert applies to:

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

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

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

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

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

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

Email questions to the MCS-CIMS inbox.

April 12th, 2022

• Revised IL 2022-23:   https://www.hhs.texas.gov/sites/default/files/documents/il2022-23.pdf
• CIMS Part II Webinar on April 26th:  https://www.hhs.texas.gov/provider-news/2022/04/04/register-now-april-26-webinar-hhscs-new-cims-part-ii
• Due date for Correcting/Updating Contact Information extended to April 15th:

April 10th, 2022

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

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

Tuesday, April 26, 2022
2:30 – 4 p.m.

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

From HHSC I-2022-23 revised letter: 

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

April 10th, 2022

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

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

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

Submit questions to LTSS_Policy@hhs.texas.gov

February 27th, 2022

HHSC Publishes New Reporting System for Critical Incidents Management

 (CIMS) See Letter (IL 2022-14)

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

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

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

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

HCS and TxHmL Webinar Slated for March 10th, 2022

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

• Webinar topics include:

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

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

  Email questions about the webinar to your program policy mailbox:

  • HCS Policy
  • TxHmL Policy

January 7th, 2024

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

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

• Home and Community-based Services Program Billing Requirements (PDF)
• Texas Home Living Program Billing Requirements (PDF)

May 1st, 2023

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

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.

January 4th, 2024

Clarification Concerning EVV:

In-home ISS requires EVV only for individuals that have an IPC location of own home/ family home. Host home and group homes do not require EVV for anything.

January 2nd, 2023

New Rules

Certification Standards Modules

HCS/TxHmL Certification Standards Modules

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

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

June 14th, 2023

(No longer current)

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

HCS/TxHmL Certification Principles Webinar Series Participant Q&A

FYI Current as of 9/22/21*

August 12th, 2021

HCS/TxHmL Certification Principles Interpretive Guidance Series

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

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

Certification Principle Trainings

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

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

January 1st, 2024

ISS in-Home Attendant Base Wage Rate Requirement

Clarification:

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

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

December 15th, 2023

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

But act quickly as applications are due Jan. 8.

Click here to learn more and apply.

December 1st, 2023

ICF/IID Providers:

December 1st, 2023

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

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

Be sure to sign up for :

Employment First Discover Tool Webinar

Jan. 10, 2024

10–11 a.m.

Register here to attend the webinar.

Email questions to John Huffine.

November 13th, 2023

June 5th, 2023

IL 2023-22

Employment First Assessment Tool: Proposed Rules

November 25th, 2023

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

Julie Andrews Blacklock

November 12th, 2023

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

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

November Caregiver Webinar Series

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

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

Contact

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

November 11th, 2023

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

November 11th, 2023

Q&A’s For EVV HAAeXchange

Contact Information Guide For Program Providers & FMSA’s

Client Support Portal Information

Contact Information Guide For CDS Employers

EVV Mailbox – evv@hhs.texas.gov

November 10th, 2023

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

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

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

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

Health Risk Screening Tool

November 8th, 2023

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

November 2nd, 2023

HHSC Now Posting EVV Known Issues and Resolutions

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

October 30th, 2023

Update From Twogether Consulting!

October 15th, 2023

October 17th, 2023

COVID-19 Resources

COVID-19 Quick Reference (New Guidance)

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

July 11th, 2022

July 7, 2022 MCS COVID-19 Stakeholder Information Session

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

The audio from this session can be found here.

• 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

September 29th, 2023

HCS and TxHmL Waiver Programs: Trending Issue Support, Volumes 21-24

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

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

DH & ISS Billing

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

Units:

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

· ISS is an hourly unit with a maximum of 1560

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

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

Prorating instructions:

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

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

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

Other areas discussed were:

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

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

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

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

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

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

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

January 28th, 2023

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

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

Click on link below for full report

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

Highlights from Vol. 17

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

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

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

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

In addition:

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

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

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

Approved 3rd party biller list

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

January 15th, 2023

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

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

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

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

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

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

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

· IMTs field 18: Location Code

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

· IMT LA Reassignment field 111: New Location Code

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

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

• IMT IBI
• 3608 HCS IPC IBI
• 8582 TxHmL IPC IBI

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

January 12th, 2023

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

• Trending Support Issues, Vol 15:   If you missed it, know that it includes information about determining your ARPA payments:  https://www.tmhp.com/news/2022-12-30-hcs-and-txhml-waiver-programs-trending-issue-support-volume-15

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

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

December 16th, 2022

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

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

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

November 20th, 2022

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

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

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

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

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

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

October 17th, 2022

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

October 7th, 2022

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

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

September 28th, 2023

September 28th, 2023

Beginning December 2024 a third TMHP contract for Claims Processing and Adjudication and Financial Services (Claims) with Conduent State Healthcare, LLC(Conduent) will be implemented.

• The TMHP Claims vendor will perform fee-for-service claim processing and fiscal agent responsibilities such as claim payment and recovery of overpayments.

TMHP claims processing will continue as-is until the new TMHP Claims contract is fully implemented in December 2024.

Remember, if you haven’t already, please sign up for GovDelivery to receive email updates and check tmhp.com regularly, and be on the lookout for HHSC providing more info about the transition prior to Dec. 2024..

September 13th, 2023

Home and Community-based Services (HCS)

September 4th, 2023

September 5th, 2023

As of Sept. 5th, TMHP had implemented improvements to the phone system, including the Automated Inquiry System (AIS).

Here are some of the improvements:

A. Some of the menu options and messages have changed.

B.TMHP is adding direct transfers where applicable.

The new system has the ability to recognize menu options through touch-tone keypad selection or speech recognition to engage callers. For more information call the TMHP help desk at 800-626-4117

LONG Term Care 800-626-4117

Option 1 LTC Customer Service

Option 2 LTC Nurse

Option 3 EDI

Option 4 EVV

Option 5 Fair Hearing (Providers only)

Option 6 Third Party Liability (TPL) , Other Insurance (OI) , Update to MESAV

Customer Service Line: Option 1 (Sub-Options below)

Sub-Option 1 HCS/TxHmL Forms and Claims Inquiries

Sub-Option 2 MN

Sub-Option 3 Claims

Sub-Option 4 All Other Forms

Sub-Option 5 All Other Inquiries

August 24th, 2023

August 24th, 2023

August 16th, 2023

HHSC is preparing a provider letter for distribution to stakeholders to explain the revised survey process (i.e., the unannounced surveys – no more advance notice.

• In addition,  it will discuss the new health and safety checks that will be conducted.
• The letter should be issued before September 1, 2023.
• The letter will explain the changes and what providers should expect.
• We do realize there has been some confusion in what has been relayed previously at different times and the 3 IDD Provider Associates have requested a meeting to discuss these issues, which will take place on August 21st, 2023.

August 23rd, 2023

Person-Centered Training Opportunities

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

Staff Member and Service Provider Requirements

The session is a $275 per person.

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

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

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

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

HHSC Person-Centered Planning/Practice Training Information

What Training Is Required?

Online Introductory Course

The Texas Health and Human Services Online Introductory Course is appropriate for any member of the planning team, including:

• Legally authorized representatives
• Family members
• Friends
• Nurses (required in some instances)
• Behavior specialists (required in some instances)
• Employment specialists (required in some instances)
• Attendants (required in some instances)
• Direct support professionals (required in some instances)
• Anyone asked to be a member of the planning team

Note: To access and complete this free online training, please go to the HHS Learning Portal, create a user login, and follow instructions to complete the training.

Person-Centered Thinking Classroom Course

To register for the Person-Centered Thinking 2-day classroom course, please go to the HHS Learning Portal, create a user login, and follow instructions to register for a class that is most convenient to your location. Begin Training An introductory course also is offered by DirectCourseOnline. The online offering includes courses in Person-Centered Counseling (PCC) and Person-Centered Thinking and Practice. There are 12 lessons in all.

2-Day Online Training for Person-Centered Training (with virtual classroom).  Be sure to sign up for the e-learning portal from HHSC, if you have not done so already, before taking the course.

HHS Approved Full Training

The following training is approved by Texas Health and Human Services for people required to take the full training, specifically case managers, service managers and service coordinators. If you would like to submit a training course to HHS for approval, email: Medicaid_HCBS_Rule@hhsc.state.tx.us. Remember to keep your training certificate.

• Delmarva Foundation’s Person-Centered Thinking Training or call 1-866-755-3506
• DirectCourseOnline
  • Person-Centered Counseling (PCC), Person-Centered Thinking and Practice (online) and Person-Centered Thinking and Practice In-Person Course (one-day facilitated training)
  • eCourse Catalog Person-Centered Counseling: Person-Centered Thinking and Practices [12 lessons; 8.5 contact hours]
• Lara Consulting Services
• Institute for Person-Centered Planning Person Centered Thinking
• Learning Community for Person Centered Practices’ Person Centered Thinking Training, which can be provided by any Learning Community-certified trainer
• United Health Care Person-Centered Transitions to Community Living providerservicestx@uhc.com or uhc_cp_prov_relations@uhc.com Provider call center: 888-887-9003, 877-842-3210 or 800-905-8671

Get Your Promotions for Becoming A New ADP Client:

 – 1st  3 months free 

 – Other Discounts Available!

*Please Let ADP know how you found out about their services to get your 1st 3 months free!

August 21st, 2023

Twogether Consulting strives to find a variety of good resources for our IDD providers and hope that ADP may be able to help some of you out there with Payroll and HR needs.

Our newest contact from ADP is, Sophia Luna. She is the Small Business Consultant For Central Texas.  She is located in the Austin Area, but can help you with your business needs anywhere in Texas  She can assist our HCS/TxHmL/ICF & ISS providers that have 50 or fewer employees, although she is able to refer those with more than 50 employees to an appropriate consultant from ADP.  ADP works with many partners that may be able to help with ADP packages and partners to work with you on your HR concerns such as employee onboarding/new hire process and keeping track of background checks (including monthly OIG/LEIE checks) and tracking employee training-initial and renewal, EVV (Electronic Visit Verification), and assistance with your 1099 contractors.  In addition, some of the other needs we see from our providers are help with finding insurance (they have great insurance brokerage partners) as well as general policies and procedures that ADP can assist with or provide some resources.

Sophia is our main provider liaison with ADP and she also works with other health related programs such as home health agencies, hospice ahd behavioral health programs.  Some of you may also be providers of these services as well, so please don’t hesitate to reach out to her..

Sophia’s contact info: 956-648-1265 and his email is, Sophia.Luna@ADP.com

Tanner Harmon is our ADP contact for programs with 50 + employees.  You can contact Tanner at 214-802-6966 or his email is Tanner.Harmon@ADP.com

November 15th, 2021

From Stevie Laas at WorldMarket  (ADP Company/Partner):

WorldMarket Platform Overview-Youtube video

1099 Solutions

“When I think of clients in the healthcare industry, we know they are facing a few outside factors:

 With the aging population there is a greater demand for services in nursing facilities and home health

 Healthcare services companies are looking to quickly onboard and maintain talent pools of highly skilled health professionals

 These organizations are facing inefficient and outdated solutions to maintain 1099s resulting in increasing administrative burden

 Due to the nature of this sector, utilizing secure and reliable systems are important to stay in compliance.”

WorkMarket can help in a many ways. A few that stand out:

• Streamlined onboarding
• Automated vetting to quickly ensure all workers have up to date and accurate certifications, background checks, etc
• Streamlined payment process that allows flexibility on payments, as often as daily pay if needed
• Compliance safeguards
• Year-end 1099 administrative burden offloaded so the business can focus on generating revenue

I have included a few items that will help give you an overview of WorkMarket. Please see the 2 attachments. This video is also a quick way to highlight what we do for clients. WorkMarket Overview  Keep in mind, the system is very customized so not all clients would need everything outlined in the video. We build it out to be specific to what they need!

Stevi Laas/Enterprise Sales Executive   
Cell: 830 708 3384
Stevi.Laas@adp.com

WorldMarket At A Glance PDF

September 13th, 2021

Attention:

Employees Returning From COVID-19

As more people continue to return to the workplace, ADP is excited to share tools that are designed to help them, and their people transition back safer, easier, and more effectively. To ensure we are consulting our clients on the best solutions for their business, we are constantly evaluating our preferred vendors. As a result, Twogether Consulting has developed a relationship with ADP where our clients will receive preferred pricing. Our local point of contact, Katie DeMayo, consults with small businesses to streamline their payroll and HR processes, to help them improve their cash flow, retain high-quality employees, and keep businesses in compliance from an HR perspective.

Please check the following items that you would like information on:

• Payroll Processing
• Direct Deposit
• Medical and Dental Benefits                                                                                 
• Employee Background Checks
• Employee Handbook
• Workers Comp Insurance Pay as you go system: Helps you manage cash – you pay for what you owe per payroll with NO prepay in advance and no worry of the unknown audits
• Web-Based Time and Attendance system: Time clocks that interface directly into payroll (eliminate keying)
• 401k Plan/SEP/Simple IRA plans: We do plan documentation, investing and all necessary year-end reporting
• Section 125 Premium Only Plan: Pre-tax medical/dental
• Compliance Posters: Employer mandatory Federal, and State labor law posters

Click here for ADP’s COVID-19 Resource Center

How is ADP addressing Covid-19 with their clients?  See links below:

Don’t forget if you are trying to develop training and policies around Covid-19, ADP can help!!

https://www.adp.com/about-adp/data-security/client-resources/adp-covid-19-preparedness.aspx

https://www.adp.com/spark/articles/2020/03/covid-19-protecting-your-employees-and-business.aspx

http://chrome-extension://oemmndcbldboiebfnladdacbdfmadadm/https://www.adp.com/-/media/who%20we%20are/pdf/business-resiliency-brochure.ashx?la=en&hash=0125A6ECCCF06EDBF9E503030B18EA7023358032

August 19th, 2023

Exception Extended to August 31st, 2024

In March 2020, HHSC started a temporary policy change for respite and Community First Choice (CFC) Personal Assistance Services (PAS)/Habilitation (HAB) provided in the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver programs.

This change allows service providers of respite and CFC PAS/HAB to live in the same home as the person receiving these services. A person’s spouse, or parent if the person is under 18, is not allowed to be a paid service provider of these services in accordance with the HCS, TxHmL and CFC Billing Requirements.

This temporary policy change is effective March 27, 2020, through Aug. 31, 2024. HHSC will provide guidance if anything changes.

Program providers must complete the required background checks for all service providers, including respite and CFC PAS/HAB providers living in the same home as the individual receiving services. Requirements can be found in the following references:

• The Texas Administrative Code (TAC), Title 26, Part 1, Chapter 263, and Chapter 262.
• HCS and TxHmL Rules, 26 TAC §565.9(b) and §566.9(r) and (s).
• The HCS Program Billing Requirements and the TxHmL Program Billing Requirements, Section 3400 for service provider qualifications, and the CFC Billing Requirements for HCS and TxHmL Program Providers.

Exception Ending August 31st, 2023

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

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

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

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

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

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

October 4th, 2022

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

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

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

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

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

Email questions to HCS Policy.

May 30, 2022

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

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

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

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

• 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.

August 16th, 2023

August 15th, 2023

Remediation & Validation Process

August, 15th, 2023

Compliance with new rules in Ch 565 on additional oversight for HH/CC service providers & Individuals receiving services

• Concerning the now required quarterly HH/CC On-site Visits to review specific areas that providers must conduct, providers have expressed concerns about HH/CC service providers being very upset with this new change of more oversight by the provider and HHSC, and they have concerns that it will be too intrusive.
• There are also concerns that this will be an added cost to the provider to add these additional visits..  HHSC has explained that the purpose of the change was to ensure the health and safety of persons receiving HH services.  
• HHSC stated they would discuss the increased cost matter, as well as the concerns about the type of documentation surveyors would expect providers to maintain as evidence that the visits were made, internally and follow up with providers.
• HHSC also stated that as the rule is new, there is no expectation (at least for now) on behalf of Regulatory that providers should have already initiated the visits!
•   Surveyors will expect to see a plan of action or schedule for conducting the visits.

July 31st, 2023

Just wanted to post some helpful tips for all of the new ISS providers out there. 

#1. Be sure you date your ISS policies, and specifically for any Evacuation &/or Emergency Response Procedures  When you revise them, show the revision dates on those policies. ISS Service Providers can receive a violation from the survey team for not doing so.

#2. Be sure to get with your local emergency response coordinators in your areas, to help you with developing your Evac/ER Response procedures.

#3  Be sure to utilize a Hazard Valuation Assessment Tool to evaluate the potential hazards and issues for emergencies that occur in your area (fire, flood, hurricane, tornado, earthquake, chemical spills, active shooters, etc..) and assess how you are preparing currently and again re-assess after any emergencies to see how your ISS facility did in responding to the situation and how you could improve.

#3. Be sure you review your ISS policies and procedures and discuss how you will implement those policies and/or procedures, as part of the implementation process involves training staff/employees.

For example:

1. Can you show in-service/training resources or material used to teach employees about what is expected for documenting ISS services or documenting critical incidents?
2. Can you show that employees are trained on how and where to report critical incidents?
3. Can you show what resources you will use to train the staff about fire drills, fire evacuation, and other emergency protocols for the facility, including during off-site ISS?
4. Can you show how you trained employees on the complaint process and the individuals in the program or about Abuse, Neglect and Exploitation and how to report it?

We will continue to add “TIPS” for ISS Service Providers periodically on this page!

July 25th, 2023

Please click on the link below to register for the Caregiver Webinar Series from HSC

• HHSC Caregiver Webinar Series Starts August 16

July 6th, 2023

If you need some help with training your On-Site and Off-Site ISS staff on Abuse, Neglect, and Exploitation, Twogether Consulting has developed a short 45 min-1hr training to address everyone from direct support staff at your ISS to your Administrator.

Included are but not limited to: definitions of Abuse (Physical, Mental, and Sexual), Neglect, Exploitation, and Mistreatment as well as signs and symptoms of each one of these. This session also discusses who to report to, CII (Critical Incident Intake), and some discussion about the 3613-A  PIR (Provider Investigation Report) Form, as well as which other critical incidents need to be reported to CII.

We provide handouts, ppt with narrative and recording of the training.  You will need to have your staff sign off on training inservice/signature sheet for proof of training or contact us to discuss other options

(we can set it up as a scheduled pre-recorded webinar for you and staff. Each person registered will receive a certificate at the end of watching the entire video and filling out the post-test or post-survey).

Cost:  $75

You may use this general payment link to pay and notify us before doing so, so we can send you the training once payment is made. Or you may ask to make payment via Zelle or our business Venmo account.

June 20th, 2023

June 26th, 2023

EVV Policies

Policy Handbook

• EVV Policy Handbook

Policy Handbook Revision Log

• Jan. 6, 2023, revisions (PDF)
• Sept. 1, 2022, revisions (PDF)
• June 1, 2022, revisions (PDF)
• March 1, 2022, revisions (PDF)
• Jan. 7, 2022, revisions (PDF)
• Nov. 1, 2021, revisions (PDF)

July 25th, 2023

Thought I would share this information from a recent Linkedin post I received.

“Centers for Medicare & Medicaid Services (CMS) offers this resource for state Medicaid and partner agencies seeking to address the needs of adults with intellectual and developmental disabilities (I/DD) and their aging caregivers with the aim of improving access to high-quality home and community-based services (HCBS) for people eligible for Medicaid. This resource synthesizes information on innovative state strategies and programs designed to strengthen supports for adults with I/DD and their aging caregivers.”

*Interagency Partnerships & Relationships
*Engagement and Navigation Supports
*Person- and Family-Centered Systems of Support
*Planning for the Future
*Data Resources

Click on link below:
https://lnkd.in/gVFNf6vg

June 19th, 2023

June 15th, 2023

New Portal Enhancement Training Information:

More Info and Registration

From the TMHP website:

“Registration is now available for two training webinars to discuss the Long-Term Care (LTC) Online Portal enhancements for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs. The webinars are offered by the Texas Medicaid & Healthcare Partnership (TMHP).

A TMHP training services representative will conduct the webinars, which will include question-and-answer sessions. During the live webinars, attendees can access training materials and submit questions.

Note: Attendees should already be familiar with the LTC Online Portal. Those who are not familiar with the portal should complete parts 1 and 2 of the LTC Online Portal Training for HCS & TxHmL Waiver Programs Webinar in the TMHP Learning Management System (LMS) before participating in the enhancements webinar. A TMHP LMS account is required to access and view these recordings. Note that webinars are no longer accessible through Internet Explorer. The preferred browsers are Google Chrome or Microsoft Edge.”

For HCS and TxHmL Providers Webinar

Select one of the following dates to register:

Tuesday, June 20, 2023, 10 a.m.–11:30 a.m.

Tuesday, July 11, 2023, 10 a.m.–11:30 a.m. (repeat)

Note: The webinars will not provide billing training.

For information about TMHP billing, refer to the “Claims Resources” section of the 1915(c) Waiver Programs Reference Material web page.

For more information, email TMHPWebinarSupport@tmhp.com, or contact the TMHP LTC Help Desk at 800-626-4117 (select option 1 and then option 7).

June 14th, 2023

New!

June 10th, 2023

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

Aug. 22-23

This year’s theme is, “Making a Commitment to Person-Centered Long-Term Care.”

The conference offers presentations from nationally and internationally recognized experts.

Topics include:

• Caring for people with dementia.
• Infection prevention and control.
• Long COVID considerations in long-term care
• Current health care trends.

Cutting-edge advances in long-term care, aging and disability services.

The conference is free to attend, and continuing education credit will be available for various healthcare disciplines.

Renaissance Austin Hotel

9721 Arboretum Blvd.

Austin, TX 78759

May 13th, 2023

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

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

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

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

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

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

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

Download These Fact Sheets:

mySchedules

Integrating mySchedules with Kronos and Other Time and Attendance Systems

Client Scheduling

Integrating Maps and Mileage into Scheduling

Encouraging Employees to Request Extra Hours

UPCOMING EVENTS & WEBINARS

Managing Group Homes? Calculate Your Payroll Savings Opportunities

With payroll costs rising, agencies need better control over time and attendance. These seven features all help to minimize unauthorized attendance. The latest time and attendance software provides agencies methods to not only collect payroll but also control payroll.

Use this spreadsheet to estimate your potential savings.

Not all these new features will work for every agency, but customers using some of these features are telling us it is saving them thousands of dollars a year. Don’t miss out!

1. Stop employees clocking-in early using schedules
2. Stop employees clocking-in early using job restrictions
3. Stop employees clocking-in on block-out dates
4. Stop employees clocking-in in overtime without permission
5. Stop employees clocking-in if client is over authorization
6. Worried about buddy punching and fake employees? Use two-factor authentication
7. Track whether managers and employees are colluding to inflate payroll

Email agencysuccessteam@mitcsoftware.com to discuss your potential ROI.

“MITC’s Staff and Client Solutions are designed specifically for providers serving the I/DD and behavioral health communities.

MITC’s solutions are perfect for agencies that manage group homes, HCBS, or day, vocational, and supported employment programs!  Because we’ve worked with thousands of agencies like yours, MITC delivers the most cost-effective solutions that lead to lower payroll costs, higher performance, and compliance with state and DOL regulations.”

June 5th, 2023

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

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

June 5th, 2023

Just A Reminder About Consent For Synchronous Audio-Visual Technology

Revision 22-3; Effective Oct. 19, 2022

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

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

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

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

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

May 28th, 2023

When to Call the IDD Ombudsman

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

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

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

                                                                                                                  OR

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

Online: Submit your question or complaint online

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

Fax: 888-780-8099

.

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

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

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

Or click on the links below to download a copy

Resources for people with intellectual or developmental disabilities:

• Your Rights in the Home and Community-based Services Program (PDF)
• Your Rights in the Texas Home Living Program (PDF)
• Your Rights in Local Authority Services (PDF)

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

• Have a question or problem with Texas Health and Human Services Office of the Ombudsman brochure (PDF)
• Office of the Ombudsman Reference Guide (PDF)

May 27th, 2023

 Attestation and Initial & Final Reports

May 10th, 2023

 

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

Wednesday, May 24, 1-2 pm EDT

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

Register Today

Now that the public health emergency (PHE) has ended, providers are navigating how to unwind from emergency flexibilities and funding—both of which may have implications regarding compliance with wage and hour laws.

For example, many states included reimbursement rate increases or hazard bonuses for direct support professionals through time-limited Appendix Ks or American Rescue Plan Act funding, and the rules governing these pay increases may be viewed differently now compared to during the PHE.

Through the unwinding, it is critical that providers have a clear understanding of when to exclude and include increases from overtime pay calculations and remain in compliance when discontinuing the use of premiums.

To help you make sense of it all, this webinar will provide participants with a better understanding of the Fair Labor Standards Act, with emphasis on emerging topics from the unwinding of the PHE.

Presenters

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

May 15th, 2023

From HHSC

Resources on Aging

• Know Your Neighbor
• Food Security
• Nutrition at Any Age
• Understanding Nutrition
• Social Determinants of Health in Aging
• Aging: By the Numbers
• Why Age Well Live Well

May 15th, 2023

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

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

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

HHSC does not play a role in the hiring process.

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

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

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

May 15th, 2023

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

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

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

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

Email questions to: update@hhs.texas.gov

May 14th, 2023

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

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

May 14th, 2023

May 14th, 2023

On a quarterly basis, TMHP will calculate all services that have been paid through Client Assignment and Registration System (CARE) and TMHP and will recoup services that exceed the authorized IPC amount. (From May 1st, 2023 forward)

View the full alert here.

May 13th, 2023

Community Attendants & Direct Care/Support Workers:

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

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

Please take time to call:

• Senator Lois Kolkhorst (Article II): 512-463-0118, 512-463-0360
• Representative Jacey Jetton (Article II): 512-463-0710

 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.

May 12th, 2023

Important Reminder:  Denial of Medicaid Eligibility

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

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

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

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

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

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

May 2nd, 2023

Infection Control Resources from HHSC

• Infection Prevention and Control Measures for Common Infections in LTC Facilities (PDF)
• Infection Control Basics & PPE Training for Essential Caregivers (PDF)
• Helping Individuals with Intellectual Disabilities and Related Conditions Prevent the Spread of COVID-19 (PDF)
• Long-term Care COVID-19 Vaccination Options (PDF)

Resources Created by HHSC

• Evidence-Based Best Practices: Infection Control is a guide for developing a facility-wide system for infection prevention and control.
• Quality Monitoring Program Immunizations web page includes information for developing a system for immunizations, as well as the current CDC guidelines for common vaccine-preventable diseases.

Center for Disease Control and Prevention (CDC)

• Infection Prevention and Control Assessment Tool for Long-term Care Facilities (ICAR) can be used by nursing facilities to evaluate their Infection Prevention and Control programs and practices.
• Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19 Pandemic) provides strategies for preventing the spread of COVID-19, as well as the latest testing and treatment recommendations.
• Nursing Homes and Assisted Living (Long-term Care Facilities) is a website for clinical professionals, residents and their families. Resources include a number of fact sheets, guidelines and toolkits that address infection control and prevention.
• Core Elements of Antibiotic Stewardship for Nursing Homes provides nursing facilities with resources for developing an effective antibiotic stewardship program.
• Influenza (Flu) is a comprehensive resource for influenza-related information.
• Hand Hygiene in Healthcare Settings provides healthcare workers and their patients with helpful information, including hand hygiene guidelines, self-assessment tools and other educational resources.
• Carbapenem-Resistant Enterobacteriaceae (CRE) Control and Prevention Toolkit will help facilities develop interventions to prevent infections caused by CRE.

Statewide Program for Infection Control & Epidemiology (SPICE)

• Competency for Proficient Infection Preventionists can be used to document the ongoing competency of the facility’s Infection Prevention and Control coordinator/Infection Preventionist.
• Environmental Rounds Worksheet can be used to monitor environmental cleaning and infection prevention practices throughout the facility.
• Hand Hygiene Audit Tool can be used by the Infection Preventionist to monitor compliance with the facility’s hand hygiene policies and procedures.
• Hand Hygiene Competency Validation Tool can be used by the Infection Preventionist to document individual employee’s competency with hand hygiene protocols.

World Health Organization

• WHO Guidelines on Hand Hygiene in Health Care 2009 provides health care workers with evidence-based recommendations for hand hygiene in healthcare settings.
• Five Moments for Hand Hygiene is a graphic representation of the WHO Guidelines for Hand Hygiene in Health Care.

Agency For Healthcare Research & Quality

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

National Association of County & City Health Officials  (NACCHO)

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

April 27th, 2023

In addition, see following webinar with handout

April 14th, 2023

April 12, 2023 town hall meeting

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

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

PDF handout

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

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

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

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

2022 Cost Reporting:

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

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

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

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

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

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

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

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

ISS Units

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

•260 DH days= 1560 ISS hrs

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

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

April 11th, 2023

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

Training Resources

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

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

Suggested training resources include:

• HCS and TxHmL Waiver Programs Frequently Asked Questions
• Long-Term Care (LTC) Online Portal Basics Computer-based Training (CBT)
• TexMedConnect for Long-Term Care (LTC) Providers CBT
• Remittance and Status (R&S) Reports for LTC Providers Quick Reference Guide (QRG)
• Claim Appeals for Medicaid CBT
• TMHP Claims Video
• TMHP Account Setup for HCS and TxHmL Waiver Programs QRG
• Long-Term Care (LTC) User Guide for Online Portal Basics, General Information, and Program Resources
• Long-Term Care (LTC) User Guide for TexMedConnect

For more information, email tmhptrainingsupport@tmhp.com

April 1th, 2023

Link to HCS/TxHmL TMHP Youtube Video Playlist

April 4th, 2023

New HCBS Rules (HCS and TxHmL)

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

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

March 30th, 2023

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

https://www.texasfoundationofhope.org/

 2845 Thousand Oaks Dr.

San Antonio, TX 78232

(210) 265-3351

txfoundationofhope@gmail.com

Office Hours:

Monday – Friday  9:00 AM to 5:00 PM

March 30th, 2023

Review of this important section in 9.174 Service Delivery

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

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

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

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

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

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

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

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

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

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

(i) is a single-action lock;

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

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

March 30th, 2023

Service Delivery Logs for Individualized Skills and Socialization

March 1st, 2023

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

February 21st, 2023

Service Delivery Logs Finally Available for Individualized Socialization Skills Services

March 29th, 2023

 Heightened Scrutiny Process For ISS (Individualized Skills and Socialization)

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

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

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

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

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

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

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

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

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

Questions

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

March 26th, 2023

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

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

March 15th, 2023

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

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

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

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

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

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

Handy Dandy List of Items In The Toolkit:

• SMDL: Home and Community-Based Settings Regulation – Implementation Timeline Extension and Revised Frequently Asked Questions – July 14, 2020
• March 2019 Updated Frequently Asked Questions on Heightened Scrutiny Provisions
• July 2019 CIB: Heightened Scrutiny Review of Newly Constructed Presumptively Institutional Settings
• All State Call Slides: FAQs on Heightened Scrutiny – March 2019
• FAQs concerning Medicaid Beneficiaries in Home and Community-Based Settings who Exhibit Unsafe Wandering or Exit-Seeking Behavior
• A summary of the regulatory requirements of fully compliant HCB settings and those settings that are excluded.
• Schematic drawings of the heightened scrutiny process as a part of the regular waiver life cycle and the HCBS 1915(c) compliance flowchart.
• Additional technical guidance on regulatory language regarding settings that isolate.
• Exploratory questions that may assist states in the assessment of:
  • Residential Settings
  • Non-Residential Settings
• Questions and Answers Regarding Home and Community-Based Settings
• Statewide Transition Plan Toolkit for Alignment with HCB Settings Regulation Requirements Suggestions for alternative approaches and considerations for states as they prepare and submit Statewide Transition Plans for the new federal requirements for residential and non-residential home and community-based settings. The regulatory requirements can be found at 42 CFR 441.301(c)(4)(5) and 441.710(a)(1)(2).
• Frequently Asked Questions Regarding the Heightened Scrutiny Review Process and Other Home and Community-Based Settings Information
• Frequently Asked Questions on Planned Construction and Person-Centered Planning Requirements

REQUEST TECHNICAL ASSISTANCE WITH HCBS SETTINGS CRITERIA

March 20th, 2023

​88th Legislative Session in Texas!

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

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

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

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

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

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

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

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

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

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

Feb 2023 HB’s

Feb 2023 SB’s

March 2023 HB’s

March 2023 SB’s 

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

March 5th, 2023

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

1915(c) Waiver Interest Lists by Legislative District

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

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

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

Clicking on each district with show more detailed information.

• State House
• State Senate
• Congress

February 27th, 2023

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

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

February 25th, 2023

February 22nd, 2023

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

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

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

February 22nd, 2023

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