May 26th, 2025

As of May 25th, 2025, the House and Senate have passed a bill that will create a plan for greater inclusion of children with disabilities in early education programs.

The Texas Senate gave final passage to House Bill 2310. The bill was authored by Rep. Claudia Ordaz and sponsored by Senator Tan Parker.   It would require the TEA (Texas Education Agency), TWC (Texas Workforce Commission), and HHSC (Health and Human Services Commission) to develop a strategic plan to increase the inclusion of children with disabilities in public early childhood education programs. 

It is now left up to Governor Abbott for consideration.

May 22nd, 2025

IDD Operations Portal (IDD Ops Portal) Administrators will provide a brief overview of the new and enhanced view of the system.

Attendees are recommended to attend either session as they provide the same information.

Register for the May 23^rd IDD Operations Portal

Enhanced View Training 11 a.m. to 12 p.m.

OR

Register for the May 28^th IDD Operations Portal Enhanced View Training 2 p.m. to 3 p.m.

Topics include:

• Initial and single user account setup
• Navigation of new portal view
• Types of list views

The webinar will include a handout outlining the new IDD Ops Portal enhanced view. Attendees will receive a copy of the presentation before the webinar starts.

Email questions to idd_ops_portal@hhs.texas.gov.

HHSC has published Information Letter 2025-09 IDD Operations Portal (IDD Ops Portal) Transition to Enhanced View. This letter provides information on the overview of changes in the new enhanced view of IDD Ops Portal.

 On Monday, June 2, 2025, the web address, appearance, and tab navigation for the IDD Ops Portal will change.

You may still navigate to the existing web address to log in, and you will be redirected to the new web address: https://ithhs.my.site.com/.

May 20th, 2025

Home and Community-Based Services – Adult Mental Health Program

CBT trainings

• Home & Community-Based Services – Adult Mental Health (contains provider training and resource information)
• Adult Mental Health Home & Community-based Services

Other information about the program:

https://www.hhs.texas.gov/providers/behavioral-health-services-providers-programs/home-community-based-services-adult-mental-health

May 20th, 2025

These are the most recent postings from HHSC, hopefully, those for 2024 will be posted soon, 

Home and Community-based Services

• 10 Most Frequently Cited Deficiencies in Home and Community-based Services (HCS) & Texas Home Living (TxHmL) — Fiscal Year 2023 (July 16, 2024)

Texas Home Living

• 10 Most Frequently Cited Deficiencies in Home and Community-based Services (HCS) & Texas Home Living (TxHmL) — Fiscal Year 2023 (July 16, 2024)

Intermediate Care Facilities

• 10 Most Frequently Cited Deficiencies in ICFs — Fiscal Year 2023 (May 9, 2024)
• 10 Most Frequently Cited Deficiencies in ICFs: Life Safety Code — Fiscal Year 2023 (May 20, 2024)

May 18th, 2025

From HHSC Deat & Hard of Hearing Services:

“Join the Texas Health and Human Services Commission Deaf and Hard of Hearing Services for EXPLORE!, a webinar presented by the Texas Parks and Wildlife Department (TPWD) Accessibility Team. Discover the latest updates and initiatives across Texas public lands, focusing on accessibility and inclusivity. From camping in a state park to touring a fish hatchery or renewing your hunting license at a law enforcement office, TPWD is committed to outdoor access for all Texans and is making strides every day to increase accessibility to facilities, programs, and services.

Learn about the different programs offered by the agency, including boating education, learn-to-hunt programs, camping, and online education opportunities you can enjoy from home. TPWD staff will share resources for visitors with disabilities and demonstrate how to navigate the TPWD website to find the information you need to visit.”

When:  Tuesday, May 27, 2025, 11:30 a.m. – 1:00 p.m.

Presented by:  Cole Johnson, Accessibility Training Specialist, Texas Parks and Wildlife Department

To register, click here or scan the QR code below.

During this session, TPWD will highlight accessible facilities and outdoor spaces and discuss the role that accessibility plays in new parks and projects. Get information on adaptive equipment and all-terrain wheelchairs, making modification requests, and employment and volunteer opportunities that allow you to make a difference in our parks and beyond.

Make sure that you have everything you need to make an informed decision about visiting a TWPD facility and participating in a program.

This webinar will be presented in spoken English; CART (captioning) and ASL/English interpretation will be provided.

Certificates of Attendance will be awarded to attendees that may be used for continuing education documentation. In addition, participants may earn 0.15 DHHS CEUs (accepted by BEI).

Email questions to DHHS Training & Education.

May 16th, 2025

In accordance with 26 TAC §52.113 (relating to Record Retention and Disposition) and the requirements of the Community Services Provider Contract or Provider Agreement, all records must be developed and retained in the form in which they were created until the latest of the following:

• seven (7) years after a claim is submitted;
• seven (7) years after all issues involving the record have been mitigated; or
• the individual about whom the record relates becomes 21 years of age.

If a contract is expiring or being terminated, the provider must adhere to 26 TAC §52.601 (relating to HHSC Review and Contractor Requirements Related to Expiring or Terminated Contract) and 26 TAC §52.113 (relating to Record Retention and Disposition) until the record retention period is satisfied.

Important: Providers are required to report the location of where the records will be stored and provide the name, address, phone number, and e-mail address of a person HHSC may contact to arrange access to the records. This information must be submitted to the assigned HHSC contract manager at the time of expiration, termination, when an update is necessary, or upon request.

May 15th, 2025

May 15th, 2025

Deadline for Informal Comments: May 30

Texas Health and Human Services Commission (HHSC) is accepting comments from stakeholders on the following draft rules related to an interagency reportable conduct search engine. The comment period ends May 30, 2025.

• Texas Administrative Code, Title 26,
  • Chapter 550,
  • Chapter 551,
  • Chapter 553,
  • Chapter 554,
  • Chapter 555,
  • Chapter 556,
  • Chapter 557,
  • Chapter 558,
  • Chapter 559,
  • Chapter 560,
  • Chapter 565, (HCS) and
  • Chapter 566 (TxHmL), concerning Long-Term Care Regulation (LTCR) Interagency Reportable Conduct Search Engine.

Read the rules here.

Questions and comments can be emailed to HHSC LTCR Rules.

May 6th, 2025

Additional Cost Report Training for HCS/TxHmL and ICF/IID or Related Conditions

The HHSC Provider Finance Department (PFD) has scheduled an additional 2024 Cost Report Training for Home and Community-based Services/Texas Home Living (HCS/TxHmL) and Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) on Wednesday, May 7, 2025, at 9 a.m.

Register here for this training or visit the HHSC PFD Cost and Accountability Report Training webpage to register.

December 15th, 2024

HHSC has published the Information Letter (IL) 2024-XX regarding the 2024 Cost Report and 2024 or 2025 Accountability Report Training Information.

Information on Cost and Accountability Report Training Information can be accessed on the Provider Finance Department’s (PFD) webpage.

Review the IL for more information. If you have further questions, contact PFD-LTSS@hhs.texas.gov or (737) 867-7817.

May 3rd, 2025

The LIDDA Handbook Has Been Revised

The Local Intellectual and Developmental Disability Authority (LIDDA) Handbook, revision 25-3, updates form references.

This revision is effective May 1, 2025. Review the updates linked here.

February 26th, 2025

The LIDDA Handbook Has Been Revised

The Local Intellectual and Developmental Disability Authority Handbook (LIDDA) revision 25-2 updates sections 19220, 19230 and Form 8591.

This revision is effective Feb. 26, 2025.

Click this link to see the updates.

February 7th, 2025

The LIDDA Handbook Has Been Revised

The Local Intellectual and Developmental Disability Authority (LIDDA) Handbook revision 25-1 updates Sections 4000, 4100, 4200, 4300, 4400, 17000, 17100, 17200, 17300, 17400, 17500 and Resources.

This revision is effective Jan. 28, 2025.

Click this link to review the updates.

November  16th, 2024

The LIDDA Handbook Has Been Revised

The Local Intellectual and Developmental Disability Authority (LIDDA) Handbook revision 24-4 updates Appendix V.

This revision is effective Nov. 16, 2024. Click this link to see the updates.

October 7th, 2024

The LIDDA Handbook Has Been Revised

Local Intellectual and Developmental Disability Authority Handbook (LIDDA) 24-3 revision updates sections throughout the handbook.

The revision is effective Sept. 30, 2024. Click here for a full-size view of the updates.

April 25th, 2025

“Caytlin Handley Act” 

On April 8, the House Committee on Public Education heard House Bill 1188, filed by Rep. Christian Manuel.

This bill would require school districts to provide families of students identified as eligible to receive special education services due to a diagnosis of  IDD or developmental delay to their  (LIDDA), ensuring students and families are informed about Medicaid waiver programs, long-term services and supports, and other community resources.

From the ARC of Texas Legislative Newsletter April 18th, 2025 Edition
“The Handley Family of Katy, Texas—Caytlin, Carey, and Boyd—have championed this bill from the start, using their voices and lived experience to lead the charge for better access to information and services for families of students with disabilities. In recognition of Caytlin’s advocacy, Rep. Harold Dutton Jr. motioned to rename the bill the “Caytlin Handley Act,” and in a rare and powerful moment, the committee voted to advance the bill immediately following testimony from the Handley family and supporters, including The Arc of Texas.”

WATCH the testimony (see timestamps of interest below).

• Rep. Manuel lays the bill out: 15:23
• The Handley Family testifies: 19:46
• Carey testifies: 20:27
• Caytlin testifies: 22:13 and 25:37
• Boyd testifies: 22:52
• Motion by Rep. Dutton: 46:23

April 15th, 2025

The proposed billing requirement revisions and a summary of changes are located on the Long-term Care Providers webpage and are outlined below:

HCS

• CFC Billing Requirements for HCS and TxHmL Program Providers Draft Revision 25-1(PDF)
• CFC Billing Requirements for HCS and TxHmL Program Providers Draft Revision 25-1 Summary of Changes (PDF)

April 15th, 2025

From our friends at Texas Council on Developmental Disabilities:

IDD Coordinating Council
TCDD Senior Public Policy Analyst Lauren Gerken provided verbal testimony on March 25 to the House Human Services Committee on House Bill (HB) 2807, which would establish a statewide intellectual and developmental disability (IDD) coordinating council. She discussed how this new council would bring multiple agencies together to develop strategies on optimizing the complex system of Medicaid waivers, education, and more. The council would also ensure implementation and proper oversight of a five-year statewide IDD strategic plan. Gerken detailed how this new council would differ from other state disability entities (PDF) such as TCDD and the Texas Governor’s Committee on People with Disabilities. HB 2807 was featured as a TCDD Bill of the Week.

Soft-Skills Training
Gerken also gave verbal testimony on March 25 to the House Subcommittee on Workforce on HB 1147, which would require the Texas Workforce Commission to establish a workplace soft-skills training pilot program. Gerken said that, while the bill is not specifically related to disability, it could allow people with disabilities to gain a certificate for soft skills that they were unable to qualify for previously. The bill would also give people with disabilities an opportunity to engage in the workforce in a more meaningful way to increase their employability.

Resources to Contact Lawmakers and Give Testimony
The House Research Organization recently published its list of legislative staff (PDF, 28 pages, 3.9 MB) for the 89th Legislature. The document provides the names and titles of staff in lawmaker and committee offices, both for the House and the Senate. It is a helpful tool for making initial contact with staff, or for following up after you’ve spoken with an office.

If you’d like to give remarks at an upcoming hearing but aren’t sure how to craft your comments, we’ve created a My Testimony Blueprint (PDF) that can be used as a guide. For more legislative advocacy resources, visit our website.

Bill of the Week: HB 1936

Read More »

**For More information from TCDD or to subscribe to their newsletter please click on this link:  TCDD

April 10th, 2025

March 31st, 2025

Many of you may know our friend and colleague Marie “Lynn” Palmares.  Lynn has worked in ICF and HCS programs in the Dallas/Ft. Worth area for many years.  In the past 8 years or so she has been working with the YES waiver program.  Lynn has helped many providers as an independent contractor and as a consultant for Twogether Consulting over the past 10 years with their HCS and YES waiver programs.  In addition, Lynn has assisted our clients at Twogether Consulting with their HCS-Adult Mental Health and YES waiver applications.

Lynn has been very ill over the past year and was recently diagnosed with stomach cancer.  She really needs some help with her bills for treatment and medications.  Even with insurance, out-of-pocket expenses for treatments and medication are very high.  The medication she needs the most now costs thousands per month. I have posted her daughter’s “gofundme” page she set up for Lynn, if anyone would like to help.

https://gofund.me/1ae1714b

March 30th, 2025

Permanent Policy Change for CFC PAS/HAB- Letter 2025-04 

HHSC has published Information Letter 2025-04 Permanent Change to HCS and TxHmL Policy for Community First Choice (CFC) personal assistance services (PAS)/habilitation (HAB) service providers. This letter informs financial management services agencies (FMSAs), local intellectual and developmental disability authorities (LIDDAs), and providers of Home and Community-based Services (HCS) and Texas Home Living (TxHmL) services that the temporary policy allowing the service providers of CFC PAS/HAB to live in the same home as the person receiving CFC PAS/HAB services is now permanent.

March 15th, 2025

Permanent Policy Change for CFC PAS/HAB

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 allowed 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, was 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 that was extended and effective through March 31st, 2025, has now been made a permanent policy change, effective April 1st, 2025!

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.

If you have any additional questions, please feel free to reach out to LTCR Policy at: LTCRPolicy@hhs.texas.gov.

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.

March 14th, 2025

Deaf and Hard of Hearing Services From HHSC Presents

Overview of the Specialized Telecommunications Assistance Program (STAP)

Wednesday, March 26, 2025

11:00 a.m. – 12:30 p.m., CST

Join Aaron Mowell, STAP manager, for an overview of the Specialized Telecommunications Assistance Program (STAP). The purpose of STAP is to allow people with disabilities to access the telephone network, enabling them to call family and friends, make doctor’s appointments, and reach emergency services. This informative session will explain the program requirements and application process and provide an opportunity for you to ask questions.

This webinar will be presented in American Sign Language (ASL) and spoken English; CART (captioning) and ASL/English interpretation will be provided.

Certificates of Attendance will be awarded to attendees that may be used for continuing education documentation. In addition, participants may earn 0.15 DHHS General CEUs (accepted by BEI).

Click on link below to register and for more information:

Registration Link & Details

March 15th, 2025

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

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

Save the Date

The technical assistance session will be held on:

• Thursday, April 24, from 10am-11:30am

Register for the session.

March 12th, 2026

Employability Status Checks:  March 2026 Update

September 17th, 2025

Employability Status Check Changes As Of September 7th, 2025

HHSC recently moved the Employability Status Check search to the Texas Unified Licensure Information Portal (TULIP).

FYI-An issue was found by HHSC, during the transition process, with the Employability Status Check data retrieval process, which is causing some difficulty for providers conducting due diligence searches.

HHSC is working diligently to resolve the problem..  Providers will be notified about a workaround if it is not fixed in a timely fashion.

• What do you need to do?

  • Providers must now use the my.site.com/EMR/ link to conduct employability status checks in TULIP.
  • If the previous Employability Status Check website is accessed, please click on the home link to be directed to the new employability searches in TULIP.
  • The new searches in TULIP now display the search criteria and “no results found” on the same screen. A fix is now deployed to include a User Guide.
  • The Employability Status Check search checks licensure status (Nurse Aides, Medication Aides and NFAs).
  • The Employability Status Check search does not display anything when no records are found. The lack of results means the person is not part of the searched registry. Screenshot this search, including the search criteria and computer date and time. Until a fix is deployed, follow this guidance.
  • The EMR search displays the first name, last name and social security number when no records are found. To download the results, click the download button in the top right corner of the yellow results bar. The download contains the date and time of the search. If no date is present under “Misconduct Registry Enter Date,” the searched person is NOT on the EMR.
  • Please reference the User Guide which can be accessed on the new Employability Status Check search page under the heading “additional links” located at the bottom left-hand side of the page.
  • To remain in compliance, providers must redo all searches conducted from Sept. 7, 2025, to Sept. 12, 2025, and take a screenshot of the results, including the date and time for searches that yield “no results found.” 
• As required by Title 26 of the Texas Administrative Code, Chapter 561, Rule 561.3, providers must search the Employee Misconduct Registry and Nurse Aide Registry to determine if the person applying for employment is listed as unemployable on either registry. With the transition of the Employability Status Check to TULIP, providers are now required to conduct both searches in TULIP.

For questions, email CARE@hhs.texas.gov.

February 27th, 2025

February 18th, 2025

HHSC Publishes Payment Rates for Employment Readiness Services in DBMD, HCS, and TxHML Waiver Programs.

HHSC approved payment rates for for Employment Readiness Services in the Deaf-Blind with Multiple Disabilities (DBMD), Home and Community-Based Services
(HCS), and Texas Home Living (TxHmL) Waiver Programs effective Jan. 1, 2025.

More information about the approved payment rates is available on the HHSC Provider Finance Department webpage.

The Employment Readiness Services payment rates, effective Jan. 1, 2025, can be accessed on the HHSC Provider Finance Department webpage.

See Jan 2025 HCS & TxHmL rates here including Employment Readiness rates for HCS:   HCS Rates-Jan-2025

For TxHmL: TxHmL Rates-Jan-2025

February 15th, 2025

From Twogether Consulting!

Hello Everyone!

Hope everyone had a wonderful Valentine’s weekend. I feel like this month is flying by. Don’t forget we have a “Pop-Up”webinar on Feb. 21st,2025 from 1pm-3:30pm.  This is especially great session for any new providers, as well as new program managers and case managers:“Care Coordination Basics:  Admission, Post- Admission & Other Follow-Up Required” (HCS)

Twogether Consulting will be adding additional ICF and HCS webinars for March on the website later this week.  Don’t forget we have a live 2-day training in Austin at the PPAT Office (Private Provider’s Association of Texas) for HCS Care Coordination (Case Management) on February 27th & 28th, 2025.  Seating is limited, so please contact Megan Jones as soon as possible if you want to sign up.  We will also be adding some  live training sessions for Nurses in HCS/TxHmL programs in March in the Austin area. Look for the sessions to be posted in the near future on our home page calendars-www.twogetherconsulting.com.

If you missed the webinar for ICAP’s/IDRC’s/LON’s (ICF Program), please let us know.  We do have the recorded session.  We do have a variety of other pre-recorded trainings for program managers, case managers and nurses,  so feel free to email us at info@twogetherconsulting.com to inquire. Let us know what areas of training you would like, to help us plan future sessions.

Please see our “Updates” section of the website for the latest news for IDD providers.

February 15th, 2025

February 14th, 2025

February 8th, 2025

The Texas Health and Human Services Commission (HHSC) has published the 2024 Children’s Behavioral Health Strategic Plan (PDF).

The five-year plan is intended to foster an environment in which Texas children and their caregivers, based on identified need, have access to compassionate, comprehensive, and innovative behavioral health care, that will help develop their resilience and enable them to thrive emotionally, mentally, and socially.

The plan was developed by the Texas Statewide Behavioral Health Coordinating Council’s Children’s Behavioral Health Strategic Plan Subcommittee and is specific to the behavioral health of children and youth.

If you have any questions or comments, please email mentalhealth_sbhcc@hhs.texas.gov.

January 19th, 2025

New Emergency Communication Tool – AlertMedia.

HHSC Publishes PL 2025-01 New Emergency Communication Tool – AlertMedia. This provider letter informs providers of the emergency communication system called AlertMedia, how it will be used, and their responsibility in signing up for the system.

HHSC will use this system to send emergency and outreach notifications through email, text, voice calls, and app push if available.

All  ALF’s, DAHS’s, HCSS’s, ICF’s, NF’s and  HCS Providers must complete the following steps:

• Register your AlertMedia account by following the steps provided in the Self Registration Guide.

Registration process:

Users will enter their contact information, provider choices, and set a password. Users will be sent an activation pin to enter. Once the user selects Submit, registration is complete.
Registration Page: https://texashhsc.alertmedia.com/public/v2?
• HHS will send a test alert. Please save that number to your phone to ensure receipt of future communication.
• Download the optional AlertMedia mobile app for iPhone or for Android to ensure the receipt of emergency-related messages.
Providers will receive a confirmation code to their email address after registration and should refer to the Self-Registration Guide for any questions regarding registration or troubleshooting.

*Note:  PL-2025-01 contains the AlertMedia Self Registration Guide – Attachment A

Contact Information
Please reach out to RSDAlertMedia@partner.hhs.texas.gov with any questions.

November 10th, 2024

REMINDER TO ALL LONG-TERM CARE PROVIDERS, BLACKBOARD CONNECT ENDED OCT. 31ST, 2024!

The current emergency communication system (Connect) for long-term care providers ended on Oct. 31 and will be replaced by the new system (AlertMedia), which is anticipated to go live no later than Dec. 1.

During this gap, no emergency communication system will be in place, so HHSC will communicate with providers through alerts, email and phone calls. Providers must respond to any request for information related to emergency preparedness and follow any instructions from HHSC.

Once AlertMedia is in place, HHSC will issue a separate communication on how to use the new system. Providers will be required to register in AlertMedia as defined by their Texas Administrative Code rule.

January 16th, 2025

From Twogether Consulting!

Howdy!

Hope everyone is well! Back to the grind for so many of us now that the holidays are over.  Please be sure to check the HCS and ICF home pages on the HHSC website for any new changes in rules, regulations, news, provider letters, training opportunities and more. Remember that Employment Readiness Services kick in as of January 1st, 2025 on the IPC for HCS & TxHmL.  See IL-2025-01.

Twogether Consulting will be offering HCS webinars again this February and some are posted in this newsletter and our website.  We are happy to announce that we will also start offering ICF webinars again in February as well.  Our newest edition, Jo Beth Collier will be our main presenter for the ICF sessions.  She brings some incredible knowledge and years of expertise in the field and I am excited for her to be one of our webinar presenters. We plan to provide webinars for Administrators, QA staff, QIDP’s, Nurses and Direct Support Staff in the homes, so please click on our survey further down in the newsletter and give us your feedback on trainings you would like to see.

FYI- Remember that HCS/TxHmL Billing Guidelines were updated in January of 2025.

I will be setting up webinars for February for some possible live sessions in Houston and/or Austin.  We do have a variety of pre-recorded trainings for program managers, case managers and nurses,  so feel free to email us at info@twogetherconsulting.com to inquire. Let us know what areas of training you would like, to help us plan future sessions.

We do have our free provider resource webinar for January with Dr. Amanda Frias, OT posted on the website for January 30th, 2025 from noon-1pm.  Please check out our home page at www.twogetherconsulting.com and click on our training calendars for more information on next year’s live webinars and live training.

Please see our “Updates” section of the website for the latest news for IDD providers.

January 15th, 2025

The Fair and Fraud Hearings Handbook updates Section 1240.

This revision is effective Jan. 17, 2024. Click this link to see the updates.

January 7th, 2025

From Twogether Consulting!

Happy Holidays!

Bon Jour and Happy New Year to all of you.  I spent some of my final holiday time in Paris.  It was wonderful and I was so glad I got to see some incredible places including the newly renovated Notre Dame Cathedral and eat some amazing food!  I  am feeling refreshed and am looking forward to coming home soon so I can assist providers with their needs.

Twogether Consulting will be officially open to provide services again as of January 13th, 2025.  Thank you everyone for your patience during the holidays and we would be happy to assist you, so please feel free to email me at info@twogetherconsulting.com or my general email address, if you already have it.  You can also contact meghanjones.tx@gmail.com to schedule an appointment or make an inquiry if you can’t reach me for some reason.

FYI- Remember that HCS/TxHmL Billing Guidelines were updated in January of 2025.

I will be setting up webinars for January and February shortly, as well as some possible live sessions in Houston and/or Austin.  We do have a variety of pre-recorded trainings for program managers, case managers and nurses,  so feel free to email us at info@twogetherconsulting.com to inquire. Let us know what areas of training you would like, to help us plan future sessions.

We do have our free provider resource webinar for January with Dr. Amanda Frias, OT posted on the website for January 30th, 2025 from noon-1pm.  Please check out our home page at www.twogetherconsulting.com and click on our training calendars for more information on next year’s live webinars and live training.

Please see our “Updates” section of the website for the latest news for IDD providers.

January 6th, 2024

From HHSC:

The Promoting Independence Plan report has been publicly posted in accordance with Executive Order RP-13 and is now available for viewing

This plan outlines accomplishments in the last two years as well as key strategies and goals that support people with disabilities to live independently within their communities. Highlights of the 2024 plan include activities to expand and improve services and an overarching theme of collaboration between multiple state agency partners.

Please review the Promoting Independence Plan and explore how it aims to improve the quality of life for people with disabilities by promoting independent living across Texas.

View the report here: Click here to view the Promoting Independence Plan 2024.

The report can also be found on the HHSC Reports and Presentations website located here: Reports and Presentations | Texas Health and Human Services

If you have comments or questions, please email HHSCOfficeofDisabilityServicesCoordination@hhs.texas.gov

December 26th, 2024

 Individualized Skills and Socialization FAQ’s:  Updated Dec 2024

HHSC Long-term Care Regulation updated the Individualized Skills and Socialization frequently asked questions document on December 4, 2024.

Read the FAQ here.

June 5th, 2023

HHSC’s Response to Three Recent ISS-Related Questions From Providers

January 13th, 2023

ISS FAQs:  Updated January 13th, 2023

August 23rd, 2022

Frequently Asked Questions HHSC shared during the ISS draft rules webinar on August 23rd, 2022.

These are questions received during the ISS webinar on July 19th, 2022

Q1: Will current day hab providers be grandfathered into the new
program? Or do they have to be program provider to have a day hab
contract with HHSC?
A1: No, Day Hab Providers are not grandfathered into the Individualized Skills and
Socialization program. Any provider who is interested in delivering Individualized
Skills and Socialization services must obtain a Day Activity Health Services or DAHS
– Individualized Skills and Socialization service category license, even those who
are currently providing day habilitation services.

Q2: Are the off-site activities generated from the individual PDPs or does the
ISS facility plan the activities?
A2: Off-site activities are generated from the individual’s Individual Plan of Care
and Individual Program Plan in the DBMD waiver program. In TxHmL and HCS, an
Individualized Skills and Socialization provider must provide off-site Individualized
Skills and Socialization in accordance with an individual’s PDP, IPC, and
implementation plan.

Q3: If the in-home service provider does not need to be an ISS
provider, does that mean that they can be a parent?
A3: A person who meets the Service Provider Qualifications for In-Home
Individualized Skills and Socialization, including a parent of an adult child
can provide Individualized Skills and Socialization.

Q4: What is the enhanced staffing rate? How does that work?
A4: An enhanced staffing rate is available in the HCS and TxHmL Programs
for an individual who requires more service provider support than the
individual would receive with the individual’s assigned LON. The requirement
for additional support may be because of the individual’s mobility, medical,
or behavioral needs. The program provider may request the enhanced
staffing rate for an individual with an LON 1 or LON 5 in the HCS Program, or
any LON in the TxHmL Program.

Q5: If the PDP do not specify how often a client needs to go out, will that be up
to the discretion of the individualized skills organization to decide how often
they go out?
A5: It is the individual’s choice for how they choose to receive off-site Individualized
Skills and Socialization and off-site Individualized Skills and Socialization must align with
the individual’s PDP, IPC, IP, and in DBMD the individual’s IPP.

Q6: Do we need to provide meals and snacks? Have a paid nurse on site? Can it
be an LVN?
A6: An Individualized Skills and Socialization provider does not need to provide meals
and snacks to the individuals, but they must provide personal assistance for an
individual who cannot manage personal care needs including eating during an
Individualized Skills and Socialization activity. An Individualized Skills and Socialization
provider must also be able to provide assistance with medications and the performance
of tasks delegated by a registered nurse.

Q7: Is there going to be an open enrollment period for ISS with times of the year
that are closed, or is it an open enrollment?
A7• An individual in the HCS, TxHmL, and DBMD Program can add Individualized Skills
and Socialization to their IPC at any point during the plan year. It is the individual’s or
their LAR’s choice if they would like to receive individualized skills and socialization.
• Any provider who is interested in delivering Individualized Skills and Socialization
services must obtain a Day Activity Health Services or DAHS – Individualized Skills
and Socialization service category license. The provider may apply at any time once
the online licensure portal (TULIP) is operational. HHSC anticipates that the license
application process will be available late November or December.

Q8: Are staffing ratios minimum or maximum? Will providers be reimbursed if
they go over the ratio?
A8: The staffing ratios described in the rule indicate that they are “no higher than” i.e.,
they describe the maximum ratio of individuals to service providers of Individualized
Skills and Socialization. To receive reimbursement and avoid recoupment of funds,
Individualized Skills and Socialization services (on-site, off-site, or in-home) must be
provided in accordance with the HCS, TxHmL, or DBMD Program rules.

Q9: Will ISS providers be required to have RNs as part of staff now that
medication management is part of the program? Additionally, our day hab does
not currently enroll individuals that need help with toileting or feeding needs,
will the program require that we do enroll these LONs individuals?
A9: If an individual receiving Individualized Skills and Socialization needs assistance
with medication or other nursing tasks, the HCS program provider’s nurse must ensure
the Individualized Skills and Socialization service providers are delegated/trained to
deliver the service. Individualized Skills and Socialization providers like day habilitation
providers can refuse to accept a person for services.

Q10: Is there any guidance regarding scheduling? For example, is the service
only Monday-Friday, etc.
A10: There is not a requirement for how many hours per day an Individualized Skills
and Socialization provider needs to provide services. There is a service limit for the
combined total of on-site, off-site, and in-home Individualized Skills and Socialization for
HCS and TxHmL of 1560 hours during an IPC year, six hours per calendar day, and five
days per calendar week.

Q11: Does an HCS, TxHmL or DBMD provider have to apply to be licensed as ISS
provider?
A11: An active day habilitation site could choose not to participate in Individualized Skills and
Socialization and not apply for a license. They would no longer be able to provide day
habilitation to individuals in HCS, TxHmL, and DBMD after March 1, 2023, since day hab will
no longer be a service at that point. Any provider who wishes to deliver Individualized Skills
and Socialization services will be required to have a Day Activity and Health Services –
Individualized Skills and Socialization license. A provider must obtain a temporary license
prior to delivering Individualized Skills and Socialization services and may choose to do so at
any time once the licensing system is available. HHSC Long-term Care Regulatory will issue a
provider a final license after conducting an on-site visit that results in final approval of the
license.
Q12: In the examples of ratios given, there was not an example that included an ICF
client. What are the expectations when mixing ICF clients with waiver clients?
A12: If a person is not in the TxHmL, HCS, or DBMD Program and is receiving services by a
staff member who is also providing on-site Individualized Skills and Socialization to an
individual in the DBMD Program or off-site to an individual in the HCS, TxHmL, and DBMD
Program, the appropriate HCS, TxHmL, and DBMD staffing ratio must be applied, and that
individual must be included in the staffing ratio.

Q13: If someone’s PDP says they need XX hours in the community, but we do
not have the manpower, are we still able to work with the client?
A13: Waiver providers can engage the Individualized Skills and Socialization

providers in the development of the implementation plan by identifying free or low-
cost activities (affordable by the individual) the Individualized Skills and Socialization

providers can offer within their community and match well with the individual’s
interests. Off-site Individualized Skills and Socialization is provided in a community
setting chosen by the individual from among available community setting options.
Community settings are settings accessible to the general public within an
individual’s community.

Q14: Day hab allowed for 5-hour minimum days, so now under ISS is it going
to be required to be 6 direct services timer?
A14: The service limit for the combined total of on-site, off-site, and in-home
Individualized Skills and Socialization for HCS and TxHmL is:
(1) 1560 hours during an IPC year;
(2) six hours per calendar day; and
(3) five days per calendar week.
Individuals can receive less than six hours per calendar day.

Q15: If the individual/LAR choses not to utilize the ISS program, will
they still be able to receive funding from TxHmL/HCS?

A15: The individual or LAR can choose to receive in-home Individualized
Skills and Socialization if the individual meets the policy for in-home
delivery. Individuals living in three and four person residences would need
to participate in employment or day activity with natural supports if the
LAR or individual does not choose to receive individualized skills and
socialization and does not meet the policy guidance for in-home
individualized skills and socialization. Access to HCS and TxHmL waiver
services is not dependent upon receiving individualized skills and
socialization.

Q16: Can we have a combination of HCS waivers and private pay? Does private
pay also need to be in the community?
A16: Individualized Skills and Socialization providers will have a choice about how to
conduct business. They will be allowed to accept all payor sources, or they may choose
to accept only waiver (HCBS) or non-waiver. The HCBS settings regulations do not apply
to ICF/IID, private pay or general revenue and therefore, day habilitation can continue
to be provided without changing the service to individualized skills and socialization;
however, if a provider wants to serve individuals in the waiver programs, the provider
must do so as a licensed individualized skills and socialization provider after March 1,
2023. Individualized skills and socialization has both on-site and off-site services that
must be offered to individuals in the waivers.

Q17: Will ISS provided in the client’s home require EVV verification for HCS and
TxHmL funded clients? If the client lives in a group home or a Host
Home/Companion Care home, will the EVV verification be required?
A17: In-home Individualized Skills and Socialization provided in the individual’s own
home or family home will require the use of EVV verification, similar to in-home day
habilitation today. If the individual lives in a 3-person or 4-person residence, or a host
home/companion care residence, EVV verification will not be required.

Q18: Will we need a separate license for each day hab our individuals
attend including any families that provided in-home day hab due to
their LON and medical need?
A18: Each physical location that provides on and off-site Individualized Skills
and Socialization services will require its own license and application process.
In-home services will not require a license.

Q19: Can you give a few examples of offsite locations?
A19:Visits to the museums, libraries and parks are examples of off-site
Individualized Skills and Socialization activities if they are chosen by the
individual, integrate the individual into the community, and promote the
development of skills and behavior that support independence and personal
choice.

For further questions, contact:

HCSPolicy@hhs.texas.gov
TxHmLPolicy@hhs.texas.gov
LTCRPolicy@hhs.texas.gov

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

December 20th, 2024

TMHP Email:  TMHP sent this email to keep providers up to date regarding a recently published article, which details the recent Provider Revalidation Extension that was granted by the Health and Human Services Commission (HHSC).

The fully published article can be found here: https://www.tmhp.com/news/2024-12-13-revalidation-due-dates-extended-and-retroactive-enrollment-period-be-implemented. It covers the recently granted revalidation extension, how it will affect currently applied enrollment gaps and enrollment effective dates and enrollment periods for providers, as well as general timeframes for implementation, and future claims filing and enrollment instructions. Additional publications and notifications are also in the works, and we will share these, as well, once they are publicly available.

If you have questions about the article mentioned above, and wish to contact TMHP directly for assistance, please call the TMHP Contact Center at 800-925-9126, or email provider.relations@tmhp.com.

12/02/24

Revalidation Due Date Extension and Grace Period

The Texas Health & Human Services Commission (HHSC) and the Texas Medicaid & Healthcare Partnership (TMHP) are taking actions to assist providers experiencing difficulty completing the provider enrollment revalidation process in the Provider Enrollment Management System (PEMS). The actions described in this notification are designed to provide near-term relief for providers while HHSC and TMHP pursue longer-term system and process improvements. HHSC and TMHP continue to analyze the scenarios that must be addressed with these actions and will provide additional clarification and information as needed. These flexibilities are currently planned to last through May 31, 2025.

Please read the full notice Revalidation Due Date Extension and Retroactive Enrollment Period Effective Dates | TMHP.

December 18th, 2024

Guidance Related to the Regional Offsite Review Process for Critical Incidents Reported into CIMS

HHSC Long-term Care Regulation published Provider Letter 2024-22, Regional Offsite Review (ROR) Process for Critical Incidents Reported into the Critical Incident Management System (CIMS), for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) providers and a frequently asked questions document. Both documents are available on the HCS and TxHmL provider portals.

December 16th, 2024

Changes are coming to CIMS!

December 14th, 2024

Home and Community-based Services and Texas Home Living stakeholders can now comment on the proposed revisions to the HCS and TxHmL Billing Requirements by 5 p.m. on December 16.

The proposed billing requirement revisions and a summary of changes are located on the Long-term Care Providers webpage and are outlined below:

HCS

• HCS Billing Requirements Draft Revision 25-1
• HCS Billing Requirements Draft Revision 25-1 Summary of Changes (PDF)

TxHmL

• TxHmL Billing Requirements Draft Revision 25-1
• TxHmL Billing Requirements Draft Revision 25-1 Summary of Changes (PDF)

Email stakeholder comments to TxHmL Policy.

December 13th, 2024

Subject: TMHP LMS Knowledge Management Bulletin

Employment Assistance & Supported Employment Training Options From HHSC

December 10th, 2024

The Texas Health and Human Services Commission (HHSC) is pleased to host a free in-person Employment First / Employment Services training on January 28, 2025, at the Starlight Event Center – Trans Mountain Room, 6650 Continental Drive, El Paso, Texas 79925.

Training will be one day in duration and is scheduled for 9 a.m. to 4 p.m, MST.

Training topics will cover:

• Overview of Employment First and the National movement with Employment First.
• Providing Employment Services
• Family Concerns and Disability Inclusive Communities
• Employment Readiness Skills
• Apprenticeship Programs
• Employer Relationships

This training is valuable to anyone who has a role either indirectly or directly in promoting employment services and helping individuals achieve their goal of competitive and integrated employment.

November 11th, 2024

June 28th, 2021

There were 2 Home and Community-based Services and Texas Home Living trainings in this series:

• HCS and TxHmL Employment Assistance Training
• HCS and TxHmL Supported Employment Training

The web-based trainings cover employment services provided through HCS and TxHmL, information about the payer of first resort for employment assistance, and the basics of providing these services. They are designed to enhance staff knowledge about providing quality employment services to people enrolled in the waivers.

Each training has a corresponding quiz.

• HCS and TxHmL Employment Assistance Quiz
• HCS and TxHmL Supported Employment Quiz

The Direct Service Workers web-based training provides information about employment services and how direct service workers can support people achieve their employment goals. The training covers federal and state initiatives related to employment for people with disabilities and touches on issues related to people who work and receive SSI or SSDI benefits. The training has a corresponding quiz.

• Direct Service Workers Training
• Direct Service Workers Quiz

December 5th, 2024

The STAR+PLUS Handbook updates Appendix XXII. This revision is effective Dec. 1, 2024.

Click this link to see the updates.

December 3rd, 2024

The Provider Investigations Handbook (PIH) revision 24-2 updates sections throughout the handbook. This revision is effective Dec. 2, 2024.  Does apply to HCS/TxHmL/ICF programs.

Click this link to see the updates.

December 1st, 2024

Register for the 2024 ICF Conference Webinar

The Intermediate Care Facility Conference webinar for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) program staff and providers will be held on Tuesday, Dec. 5. There is one track, so register for each session for the complete educational activity.

Welcome to the 2024 ICF Conference: Embracing Change to Enhance Value
8:30–8:45 a.m.
Register for Webinar

Keynote: Scott Abel, “The Strive to Thrive”
9–9:45 a.m.
Register for Webinar

ICF Deficiency Trends
10:15–11:45 a.m.
Register for Webinar

Understanding Survey Rules: What Surveyors Look for During an ICF/IID Survey
1–2:30 p.m.
Register for Webinar

Surrogate Decision Making
3–4:15 p.m.
Register for Webinar

November 28th, 2024

The informal comment period for new proposed changes to the rule for HCS & TxHmL (TAC 565 and 566) ended on November 27, 2024: Comment on Proposed & Draft Rules | Texas Health and Human Services.

These proposed new and amended rules implement House Bill (HB) 1009 by Turner the 88th Legislature, Regular Session, 2023. HB 1009 imposes a new requirement on a Medicaid provider providing services under a 1915(c) waiver to conduct criminal history record information and employee misconduct registry reviews and to suspend the employment or contracts of individuals who engage in reportable conduct. New rule language in §565.12 requires HCS providers to notify HHSC of opening a new location or the voluntary closure of an HCS residence. Added language under §565.15 prohibits minor children from sharing a bedroom with an adult in HCS residences, including host/home and companion care settings. Added language under §565.23 clarifies the authority of LTCR. 

November 16th, 2024

From HHSC Weekly Digest Bulletin:

Adverse Childhood Experiences (ACES) and Trauma Informed Care (TIC) Conference Online, December 5, 2024

Join us for this online conference on best practices for person-centered care around Adverse Childhood Experiences (ACEs), traumatic stress, and trauma-informed care (TIC) interventions for adults and children with intellectual and/or developmental disabilities (IDD). The ACEs-TIC Conference will focus on equipping service providers, caregivers and any others interested in information that will enhance their understanding of the unique behaviors and needs of people with IDD or behavioral health (BH) issues who have or are experiencing traumatic situations. It’s a great way to learn and connect, kind of like getting started with ufabet สมัคร, where joining in feels easy and engaging. Discover a wide range of gaming options, generous bonuses, and the convenience of flexible access only at spinit-casino.ca. On the topic of investments, grandparents might like to explore everything they need to know about Junior ISAs with The Children’s ISA.

Six (6) hours of FREE continuing education units (CEUs) will be provided by HHSC. See registration for details.

ASL and CART will be provided.

Presentations will include:

• “Recognizing and Responding to Adversity: Embracing Trauma-Informed Care in Intellectual and Developmental Disability Services” by John Keesler, Ph.D., MSW, LMSW Associate professor, School of Social Work, Indiana University Bloomington
• “The Road to Recovery: Supporting Children with Intellectual and Developmental Disabilities Who Have Experienced Trauma” by Laura Buckner, Community Education, Texas Center for Disability Studies, UT Austin; Mentor trainer, The Learning Community for Person-Centered Practices
• “Trauma and Healing in the Lives of People with Intellectual and Developmental Disabilities” by Karyn Harvey, Ph.D., Psychologist, author, and director of programs for the Park Avenue Group; and
• “Addressing the Impact of Adverse Childhood Experiences in Children with Intellectual and Developmental Disabilities” by Kynthia Brooks, Child Health Specialist, Family Health Strategy division, Texas Health and Human Services Commission

November 15th, 2024

Submitting HCS and TxHmL Individual Movement Forms

Home and Community-Based Services Waiver (HCS) and Texas Home Living Waiver (TxHmL) providers should refrain from submitting the following Individual Movement Forms (IMTs) via the Long-Term Care (LTC) Online Portal:

• IMT-Local Authority Reassignment

• IMT-Service Coordinator Update

These specific purpose codes are designated for LIDDA-use only and should not be submitted by HCS and TxHmL providers for any reason!

HCS and TxHmL providers can only submit the IMT for purpose codes “IMT-Suspension” and “IMT-Individual Update.”  See page 193 in the LTC HCS and TxHmL Waiver Programs Provider User Guide for details.

**Questions For issues encountered while submitting the IMT on the TMHP LTC Online Portal, call TMHP at 800-626-4117, select option 1, then option 1.

November 15th, 2024

Computer-Based Training in the TMHP Learning Management System

The following long-term care (LTC)-specific computer-based training (CBT) course is currently available on the Texas Medicaid & Healthcare Partnership (TMHP) Learning Management System (LMS):

• LTC Online Portal Basics—This interactive CBT provides a basic overview of the LTC Online Portal, including information about creating an administrator account and an overview of the features of 5 November 2024 LTC Provider Bulletin, No. 100 Training and Events the blue navigational bar and the yellow Form Actions bar. Demonstrations and simulations appear throughout the CBT to provide opportunities for an interactive experience.

• TexMedConnect for Long-Term Care (LTC) Providers—This CBT demonstrates effective navigation and use of the LTC TexMedConnect web application.

Providers will learn how to:

‒ Log in to TexMedConnect

.‒ Verify a client’s eligibility

.‒ Enter, save, and adjust different types of claims

.‒ Export Claim Data.

‒ Find the status of a claim

.‒ View Remittance and Status (R&S) Reports.

LTC Online Portal Training for HCS and TxHmL Waiver Programs Webinar – Provides information on the features and navigation of the LTC Online Portal, management of waiver program assessments and forms in the LTC Online Portal, and the purpose and workflow of the forms. For a list of webinar or CBT descriptions, upcoming broadcast dates, registration links, recordings of past webinars, and Q&A documents, visit the TMHP Learning Management System (LMS) at learn. tmhp.com.

The TMHP LMS can be accessed through the TMHP website or directly at learn.tmhp.com.

Providers must create an account to access the training materials on the LMS. To create an account, click Don’t have an account? Sign up here on the LMS home page. For questions about the LTC training CBTs and webinars, call the TMHP Contact Center at 800-626-4117 or 800-727-5436. For LMS login or access issues, email TMHP LMS support at TMHPTrainingSupport@ tmhp.com.

November 12th, 2024

Reminder for HCS and TxHmL Providers Entering IPC Revisions to Add Individual Skills and Socialization

This is a reminder for Home and Community-based Services (HCS), Texas Home Living (TxHmL) program providers, and local intellectual and developmental disability authorities (LIDDAs) that 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.

If you don’t perform this step, the form processing will be delayed. Contact the Texas Medicaid & Healthcare Partnership (TMHP) Long-Term Care (LTC) Help Desk at 800-626-4117 or 800-727-5436 for assistance with submitting forms.

Renewal and Revision IPCs 

If they are in either Pending DADS Review or Pending Coach Review status require action from the submitter, usually the submission of supporting documentation. The IPC will not be reviewed until action is taken. This is the same process that is in place for Exceeds flags in ID-CARE.

A packet submitted to Utilization Review (UR) must include the following:

• IPC Cover Sheet (Form 8599, which can be found at hhs.texas.gov/regulations/forms/8000-8999/ form-8599-individual-plan-care-ipc-cover-sheet)

• Copy of signed IPC (all pages)

• Person-directed Plan

• Implementation Plans for all services on the IPC, including a breakdown of nursing and behavior hours if they are part of the request A packet may include the following, depending on the services that are requested: • Comprehensive Nursing Assessment (Form 8584 or a form with all the same elements) for nursing hours

• Occupational therapy (OT) evaluation, treatment plan, or assessment (including orders) for OT hours

• Physical therapy (PT) evaluation, treatment plan, or assessment (including orders) for PT hours

• Speech and language therapy evaluation, plan, or assessment (including orders) for speech hours

• Dietary evaluation for dietary hours (including orders)

• Dental treatment plan, if applicable

• Behavior support plan for behavioral support hours that meets HHSC criteria

• PAS/HAB Assessment (Form 8510) for personal assistance services and habilitation (PAS/HAB) hours

• Transportation Plan (Form 3598) for transportation hours

• Audiology treatment plan (including orders), if applicable

• Cognitive rehabilitation therapy plan, if applicable (in HCS)

• Support consultation plan, if applicable (in HCS) • Social work plan, if applicable (in HCS)

• All documentation for adaptive aids, if they are included in the request, including:

 ‒ A list of items to be purchased, the number of each item needed, and the cost (based on the lowest bid) for each item.

     ‒ Three bids for each item. Bids from online vendors are acceptable. If an annual vendor is used, three bids are needed only if an item costs $500 per month or more; otherwise, an annual vendor bid can be     submitted.

     ‒ Proof of Medicaid denial and professional recommendations, as required in Appendix VII of the HCS Program Billing Requirements.

See Section 6100 of the HCS Billing Requirements at hhs.texas.gov/sites/default/files/documents/ doing-business-with-hhs/provider-portal/long-term-care/hcs-billing-requirements.pdf for more information.

• All documentation for minor home modifications (three bids based on specs from licensed professional recommendations) if they are part of the request.

See Section 6200 of the HCS Billing Requirements.

Enrollment and Transfer IPCs

Enrollment and transfer IPCs remain in Pending DADS Review status while the enrollment or transfer is being processed.

Enrollment IPCs may require additional documentation to be submitted to Program Eligibility and Support (PES).

*If an enrollment requires additional documentation, PES will contact the LIDDA that submitted the enrollment IPC.

Transfer IPCs always require a transfer packet to be submitted to PES. If a transfer packet requires additional documentation, PES will contact the LIDDA that submitted the transfer IPC.

A transfer packet submitted to PES must include the following

: • Request for Transfer of Waiver Program Services (Form 3617)

• HCS only: Individual Plan of Care – HCS/CFC (Form 3608)

• TxHmL only: Individual Plan of Care – TxHmL/CFC (Form 8582)

If an enrollment or transfer requires utilization review, UR will contact the LIDDA that submitted the enrollment or transfer packet.

Packet and Documentation Submission Details

The most efficient way to submit HCS and TxHmL documentation is through the Attachment function in the Long-term Care Online Portal (LTCOP). For more details on attachments, refer to the “LTC Online Portal to Allow Electronic Attachments on HCS and TxHmL Waiver Program Forms” notification posted on tmhp.com on June 28, 2023.

For questions about renewal, revision, or requested call back of IPC review packets, call HHSC UR at 512-438-5055, or email deskURLONIPC@hhs.texas.gov. For questions about enrollments or transfers, call PES at 512-438-2484, or email enrollmenttransferdischargeinfo@hhs.texas.gov.

November 5th, 2024

From the October 28 Ambassador Program call. Presentation slides are also included below and resource links are below.

Actions You Can Take Now

• Visit the Ambassador Toolkit page on the HHS website.
• Visit the End of Continuous Medicaid Coverage page on the HHS website.
• If you know someone who could benefit from joining the Ambassador Program, invite them to sign up using this link: Ambassador Program Signup.

We Value Your Feedback

To help us improve the Ambassador Program and ensure it meets your needs, please take a moment to complete our brief survey: Ambassador Program Feedback Survey. Your insights are invaluable to us!

Next Ambassador Program Call

Ambassador Program calls are held once a month. The next call will be on November 18^th at 3:00 Central Time. If you have any questions or concerns, please feel free to reach out to this mailbox: update@hhs.texas.gov.

• Ambassador Check In Deck 10.28.2024 Slides.pdf

October 1st, 2024

Resources:
Actions You Can Take Now
1. Download Ambassador Toolkit
2. Visit End of Continuous Medicaid Coverage
3. Email Stakeholder Engagement with questions at:
update@hhs.texas.gov
4. Join the Ambassador Program –Ambassador
Program Contact List
5. Explore the Interview Toolkit: Questions About Your
Benefits | Texas Health and Human Services
6. Explore the Extended Postpartum Coverage Toolkit
https://www.hhs.texas.gov/services/health/women-
children

June 15th, 2024

HHSC stated that If people are not able to obtain assistance from the community partners or 211, they can contact the Office of the Ombudsman 877-787-8999 or complete our online form  . More information on the initiative can be found at:  https://www.hhs.texas.gov/providers/medicaid-business-resources/end-continuous-medicaid-coverage-ambassador-toolkit

October 30th, 2024

The HHSC Joint Training unit will host its annual Intermediate Care Facility Conference webinar, “Embracing Change to Enhance Value,” on Dec. 5.

This daylong virtual conference is for providers and survey staff of intermediate care facilities for people with intellectual disabilities or related conditions.

Registration for sessions begins Nov. 1. Links will be provided when registration opens.

October 25th, 2024

HCS and TxHmL Annual Vendor Submission Timeframe

The timeframe to submit for annual vendor approval is Nov.1, 2024 through Jan. 31, 2025. Required documentation for annual vendor requests are in the HCS and TxHmL Billing Guidelines, Section 6160(b)(2), Approval of Annual Vendor. Email packet submissions to Billing and Payment with the subject line: Annual Vendor Approval. Submissions sent to any other email addresses may not be received.

Required documentation for annual vendor requests are in the HCS (PDF) and TxHmL (PDF) Billing Requirements, Section 6160(b)(2), Approval of Annual Vendor.

Email packet submissions to providerfiscalcompliance@hhs.texas.gov  with the subject line: Annual Vendor Approval. Submissions sent to any other email addresses may not be received.

If you are unable to meet the deadline to submit, you may request an extension prior to Jan. 31, 2025. Email Provider Fiscal Compliance with any questions.   Call 512-438-5359  with your questions.

Submissions sent to any other email addresses may not be received.

October 17th, 2024

Please be sure to provide education about voting, if needed as well as opportunities for your individuals to vote. Twogether Consulting recommends checking out the “My Voter Portal” at the Secretary of State’s website before voting to look for your voting location and to ensure an individual is still registered, as the individual may not be registered anymore if they have moved for example.  FYI, the voter registration deadline ended on Oct. 7th, 2024.  Information on services for voting available to persons with disabilities can be found at: https://www.votetexas.gov/mobile/voter-with-special-needs.htm

Here is the information on dates for absentee and general voting deadlines

Important Action You Can Take With Your Individuals

• Make a voting plan with this guide for voters with disabilities from Disability Rights Texas.
• Watch this video for voters with disabilities and poll workers from Texas Council for Developmental Disabilities.
• Vote early Oct. 21-Nov. 1!
• If voting by mail, the deadline to apply for a mail-in ballot is Oct. 25.

If you need assistance in registering to vote, have questions regarding voting or feel that any of your voting rights have been violated, please contact:

Disability Rights Texas
2222 West Braker Lane
Austin, Texas 78758
1-888-796-VOTE (8683)
vote@drtx.org

Texas Secretary of State
P.O. Box 12060
Austin, Texas 78711-2060
512-463-5650 or 1-800-252-VOTE (8683)
Fax: 512-475-2811; TTY: 7-1-1
Texas Secretary of State website

October 16, 2024

Effective Oct. 16, HHSC moved the News and Information and the Provider Letter content to new locations on the Long-Term Care Regulation (LTCR) Provider webpages.

This change to the LTCR Provider webpages was made to improve the visibility of the content and to fix a technical issue that wouldn’t let people use the search feature of the Provider Letter content more than once.

News and Information and Provider Letters now have separate links accessible from the main webpage for each provider type. These links are found on the left-hand menu of each provide page along with the links for how to become a provider.

All providers listed here are affected by the updated web links.

Email questions to LTCR Policy.

October 13th, 2024

This is a reminder that HHSC will host Electronic Visit Verification training webinars for Consumer Directed Services (CDS) employers required to use EVV. Attending the webinar will complete the annual EVV policy training requirement.

Webinar Registration

Agendas are included in the registration link.

• Oct. 31, 2-3:30 P.M.

Alternatively, CDS employers can also complete the annual EVV policy training requirement on the HHS Learning Portal.

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

Email questions to HHSC EVV Operations.

October 13th, 2024

​Advocacy Groups:
Advocacy, Inc.
Best Buddies
Center for Public Policy Priorities
Disability Policy Consortium
The Arc of Texas
The Arc of San Antonio
The Arc of the United States
The Texas Council for Developmental Disabilities

October 13th, 2024

National Organizations:
American Association on Intellectual and Developmental Disabilities (AAIDD)
American Network of Community Options & Resources (ANCOR)
National Association of Qualified Developmental Disability Professionals
National Parent Network on Disabilities (NPND)
The Accreditation Council

State Associations:
Private Providers Association of Texas (PPAT)

Providers Alliance for Community Services of Texas (PACSTX)

Southwest Society of Service Coordinators (SWSSC)

Special Olympics Texas

Texas Council of Community Centers

October 12th, 2024

From OIG: Update emergency plans

October 9th, 2024

Tarrytown Expo Pharmacy Zoom Webinar  (Complimentary CE Credits)

Click here for the printable PDF version

September 14th, 2024

** This is especially important for all of you new HCS/TxHmL Providers.

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

HHSC is hosting Electronic Visit Verification (EVV) policy training webinars for program providers and financial management services agencies (FMSAs), and Consumer Directed Services (CDS) employers. You will complete the annual EVV policy training requirement by attending one of the webinars.

Webinar Registration

Agendas are included in the registration links. Select from the dates below to register for one webinar.

• Annual EVV Policy Training in September for Program Providers and FMSAs:
  • 19, 2-3:30 P.M.-Sept
  • 17, 2-3:30 P.M.
• Annual EVV Policy Training in October for CDS Employers:
  • 3, 2-3:30 P.M.
  • 31, 2-3:30 P.M.

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

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

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

Email questions to HHSC EVV Operations.

September 13th, 2024

The Texas Health and Human Services Commission (HHSC) is offering virtual Positive Behavior Management and Support (PBMS) and Advanced PBMS workshops at no cost for attendees on the following and times:

• September 23 (PBMS)
• October 9 (PBMS)
• October 25 (Advanced PBMS)
• November 8 (Advanced PBMS)

**Please click on a date above to register for that workshop.

The workshops are available to the public, including family members, caregivers, providers (educational, foster care, geriatric, long-term services and supports in the intellectual and developmental disabilities and aging population, and mental health), Adult Protective Services, and case managers.

Upon completion of the training, HHSC will issue continuing education units (CEUs) for social workers, certified nurse aides, licensed nursing facility administrators, nursing facility activity directors, assisted living facility managers, day activity and health services managers, qualified developmental disabilities professionals, and qualified intellectual disabilities professionals. Behavior analyst certification board CEU will be issued by the University of North Texas.

For training resources, visit the Training Initiatives webpage.

September 11th, 2024

Effective September 1, HHSC began transitioning contracts for the STAR+PLUS program.

This document below provides STAR+PLUS members and providers with resources for assistance with go-live concerns.

 STAR+PLUS Providers by service area (MCO’s leaving, staying and new)

For any STAR+PLUS transition related issues, please contact the STAR+PLUS Go Live inbox.

May 12th, 2024

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

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

Star Plus Transition Member Information

Updates For Medicaid Interest Waiver List

September 10th, 2024

TxHmL New Rates

Click on link below:

TxHmL Rates: Sept. 1st, 2024- PDF Download

The Texas Health and Human Services Commission (HHSC) approved payment rates for Support Consultation under Community Attendant Services (CAS), the Community Living Assistance and Support Services (CLASS) waiver program, the Deaf Blind with Multiple Disabilities (DBMD) waiver program, Family Care (FC), the Home and Community-based Services (HCS) waiver program, Primary Home Care (PHC), and Texas Home Living (TxHmL) to be effective Sept. 1, 2024.

HHSC reviewed Support Consultation payment rates and methodology as part of the fiscal year 2024 biennial fee review.

The approved Support Consultation payment rates, effective Sept. 1, 2024, can be accessed at: https://pfd.hhs.texas.gov/long-term-services-supports

Contact PFD-LTSS@hhs.texas.gov or (737) 867-7817 if you have questions

September 3rd, 2024

September 1st, 2024

September 1st, 2024

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

Avondale House,

Center for Pursuit

Volunteers of America

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

July 16th, 2024

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

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

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

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

Additionally, the survey found that:

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

To read the full survey report, please click here.

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

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

July 11th, 2024

“Time To Care Coalition”  

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

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

August 31st, 2024

From Our Friends At Neighborhood LTC Pharmacy

NRx Upcoming FREE Educational Webinar: Cannabinoid Science 101

August 30th, 2024

August 18th, 2024

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

Listen to the webinar recording.

Read the IDD and PI Quarterly Webinar (PDF).

Email LTCR Policy for the transcript.

August 18th, 2024

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

New TxHmL Certification Principles modules available for Providers

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

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

Click here to access these pre-recorded modules.

August 16th, 2024

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

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

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

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

August 15th, 2024

LIDDA Handbook Revision

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

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

From our friends at PACSTX!

2024 Annual PACSTX Conference October 1st-3rd

Embassy Suites Conference Center

San Marcos, Tx

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

FOR MORE INFORMATION CLICK HERE

FOR REGISTRATION

HOTEL REGISTRATION

July 29th, 2024

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

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

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

SEE NOTICE BELOW:

July 26th, 2024

New PCS Contact

July 25th, 2024

Register Now For Extra Help Before a Power Outage

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

July 24th, 2024

Correction to “LTC Dashboard Data Export Report Column Names”

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

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

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

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

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

Past Due

• Medicaid Eligibility

• LOC/LON Assignment

• Individual Plan of Care

Due

• Medicaid Eligibility due in 90 days

• LOC/LON Assignment due in 60 days

• Individual Plan of Care due in 60 days

Exceptions

• Suspension Over 30 days

• Pending Termination Over 60 days

• NO Billed Svcs. Over 60 days

Other Dashboard Data

• Individual by Program

• Individual by LA

• Individual by WCA

• Individual by Status

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

July 23rd, 2024

SEVERE WEATHER POLICY REMINDER

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

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

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

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

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

EVV Reason Code

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

Reason Code: Disaster

Number: 130

Description: B – Hurricane

EVV Compliance Impacts

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

Contact EVV with questions.

July 15th, 2024

July 12th, 2024

July 1st, 2024

June 30th, 2024

Town Hall about HCS enrollment requirements in PEMS

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

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

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

Add Practice Locations

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

Sign Up for the Town Hall

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

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

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

Use These Resources

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

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

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

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

June 28th, 2024

Town Hall about HCS enrollment requirements in PEMS

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

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

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

Sign Up for the Town Hall

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

• Thursday, June 27, 2024, 9 a.m. to 10:30 a.m. Central time
• Tuesday, July 2, 2024, 10 a.m. to 11:30 a.m. Central time

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

Use These Resources

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

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

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

June 20th, 2024

Information Letter 2024-06

June 10th, 2024

Update:  Issues Concerning Challenges With The Revalidation Process at PEMS

March 11th, 2024

June 7th, 2024

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

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

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

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

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

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

Contact information: 

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

Helpful Tips:

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

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

** Contact your local representative or legislator for help

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

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

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

June 4th, 2024

BLACKBOARD CONNECT EMERGENCY SYSTEM

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

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

June 26th, 2023

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

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

(This  also applies to DAHS-ISS Providers)

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

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

Blackboard Connect sign-up process:

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

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

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

May 30th, 2024

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

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

·       Providers may need to contract with new MCOs.

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

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

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

May 28th, 2024

Presentation On The Extension of The Autism CARES Act

Hosted by AAIDD

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

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

Register here

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

May 22nd, 2024

May 20th, 2024

May 18th, 2024

May 13th, 2024

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

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

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

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

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

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

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

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

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

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

Sincerely,

Sergio Castillo

Our Lady of the Lake University

Doctoral Candidate

Cohort 10 -RGV Campus

scastillo16fl@ollusa.edu

(956) 279-9653 cell

May 13th, 2024

IDD & PI Webinar April 30th , 2024

January 5, 2024

IDD & PI Webinar January 31st, 2024

May 2nd, 2024

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

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

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

April 29th, 2024

Dyslexia Handbook 2024 For Special Education

Discusses procedures for educating individuals with Dyslexia and related conditions

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

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

April 29th, 2024

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

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

Click on the link below to see the guidelines

TED Guidelines

April 30th, 2024

April 30th, 2024

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

Click the link below to download this resource.

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April 24th, 2024

2024 IDD Group Home Provider Report

Reminder:  April 14th, 2024- in case you missed this in March 

March 11th, 2024

April 14th, 2024

Please click on this video from local ABC News Channel 2