Twogether Updates

Tips Concerning Survey Expectations For HCS Providers

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November 16th, 2025

HCS providers have been contacting Twogether Consulting about certain requirements and/or changes in what surveyors are asking for this year from HCS providers. Below are a few things you should make sure you have completed and/or corrected prior to your survey.  I will try to update this as we receive feedback from providers, provider associations, and even HHSC staff.

Here are some areas surveyors are focusing on:

    1.  Smoke detectors: must be in working order and have working batteries, and they need to have appropriate placement inside each bedroom and “immediately” outside of the bedrooms
      1. (This last part is subject to interpretation, but to be safe we would recommend you have a smoke detector just outside of each bedroom, even if they are in the same hallway)
        1. This goes for Host Homes and Group Homes
      2. In some cases, surveyors have asked providers for their “smoke detector” policy, but I am assuming this is due to the fact that batteries were not being replaced regularly..
        1. We advise making this part of a regular inspection process of the home or scheduling your direct care staff in the home to inspect 1 x a month/qtr, or perhaps if you have maintenance staff or residential/house managers, this might be a part of their responsibilities.
    2. Emergency evacuation plans, policies, and training
      1. Provider must have a current and appropriately updated ER/EVAC Plan. Review and revise at least annually
      2. ER/EVAC policy and procedures
      3. Evidence of training on ER/EVAC plans to staff
      4. Posting of exit routes/egresses
      5. Fire drills:
        1. Must be completed quarterly for both Group Home and Host Home
          1. Group Homes: (1 per shift, per qtr/Q 90 days)
          2. Host Homes: (quarterly).  At least 2 of which must be overnight/when individuals are asleep.
        2. Documentation: For each drill, the facility must maintain a record that includes the date, time, and the name of the staff member who conducted the drill. Copies must be maintained in the home.
        3. Reporting: Providers must complete and maintain the HHSC Fire Drill Report form (4719) for each drill.  Please be sure you are using this form. 
        4. Availability: Records must be provided to HHSC surveyors upon request
        5. Staff training:
          • New staff must participate in a fire drill within 90 days of being hired.
          • Staff must participate in a fire drill at least once per year.
          • The provider must ensure staff can explain the emergency plan for the residence.
          • If a staff member does not follow the emergency plan during a drill, they must receive additional training
    3. Registering with the new emergency communication tool-AlertMedia  ( This also applies to  providers of ICF/IID,TxHmL, HCSSAs and DAHS which includes ISS)
    4. Matresses
      1. In the Group Home or Host Home
      2. Must have a mattress cover
      3. mattress must not be on the floor (needs to be on bed frame)
      4. Any modification (a reason for not having the mattress cover or having an individual sleeping on a matress on the floor) must be discussed with SPT, approved by SPT, and written into the PDP
    5. Adaptive Aids
      1. Are the individuals’ AA’s in the home of the individual requiring them?
      2. Are AA’s in working order?
      3. Has the individual and/or all appropriate staff received training on the AA?
      4. Is there evidence of this training with signatures and inservice sheet or material for any staff trained?
      5. Have they been replaced if the equipment is broken/not working anymore and did you document when that was replaced?
    6. Ensuring that Group Homes have working equipment for taking vitals signs (blood pressure devices, digital thermometer or other device for temps, pulse oximeters for SAO2’s, etc.. specifically for persons with these  “special needs” requiring for them to have regular vitals taken (blood pressure, temperature, oxygen saturation levels, etc.
      1. If you do have someone in the home requiring regular vital checks it might be a good idea to have staff check the equipment regularly (monthly/quarterly) to ensure the items are in the home, working and have working batteries is necessary

 

Note:  Enforcement and Survey are 2 different departments. Enforcement applies the administrative penalties based on scope and severity of the violation.

In addition, please be sure to appeal any violations you do not agree with, including the severity (critical vs non-critical), immediately upon receiving your final report.  You only have 10 days from receiving your final report/ statement of deficiencies to request an informal dispute resolution (IDR).  If you need help with your IDR or Plans of Correction (POC’s), please contact us at: info@twogetherconsulting.com.  We have resources, contractors, and other consultants who can help you.

CLASS and DBMD Quarterly Webinar on December 17th, 2025

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November 16th, 2025

HHSC will be providing ongoing opportunities for CLASS and DBMD providers and FMSAs to hear about recent program updates.

CLASS and DBMD Quarterly Webinar

December 17, 2025

10 a.m. – 11:30 a.m.

Topics discussed will include:

  • CLASS – Training Module Updates, Adding AA to an IPC
  • DBMD – Region 1 Update, SPT meetings
  • PES – Submission standards for ID/RCs, IPC Pre and Enrollment Packets
  • Fair Hearings – The appeals process with a loss of financial eligibility
  • HCS – Crisis Diversion and NF Diversion process
  • EVV – Updates
  • CAPM – New PM webpage and monitoring documentation

Register here for the webinar.

Run a test of your computer’s connectivity if you have never attended a webinar from your computer. You can run this test at any time before the date of the webinar. Perform this test early to allow time to address any technical issues.

Email questions to:

CLASSPolicy@hhs.texas.gov and DBMDPolicy@hhs.texas.gov

February 28th, 2025

HHSC will be providing ongoing opportunities for CLASS and DBMD providers and FMSAs to hear about recent program updates.

CLASS and DBMD Quarterly Webinar

March 19, 2025 10–11:30 a.m.

Topics to be discussed will include:

  • CLASS/DBMD — Upcoming form updates, June webinar.
  • UR/PES — UR/PES responsibility changes.
  • EVV — EVV updates.
  • Fair Hearing — Fair hearings information.

Register for the webinar.

Email CLASSPolicy@hhs.texas.gov and DBMDPolicy@hhs.texas.gov with any questions.

Medical Care Advisory Committee: Concerning Rider 23

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November 15th, 2025

On 11/13/2025 -Medical Care Advisory Committee had a meeting discussing Rider 23.  You can access the recording of this meeting using the link below:
Also, there is a PowerPoint and you can click on agenda item #9.
STAIRS is moving to STEPS, the HHSC link below serves as a reminder as to how you can find the most current information about this upcoming change.
This webpage includes access to the 3 notices HHSC has issued as well as the FAQs developed to date.

Recordings of Previous DAHS and ISS Webinar with LTCR

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November 11th, 2025

A recording of the October 30 DAHS and Individualized Skills and Socialization provider webinar with HHSC Long-term Care Regulation is now available. The presentation (PDF) is also available.

Listen to the webinar recording.

Email LTCR Policy for a transcript.

May 4th, 2025

A recording of the April 24 DAHS and Individualized Skills and Socialization provider webinar with HHSC Long-term Care Regulation is now available. The presentation (PDF) is also available.

Listen to the webinar recording.

Email LTCR Policy for a transcript.

IL 2025-25 Now Published- HHSC Rider 23

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November 10th, 2025

HHSC Rider 23 from the 2026-2027 General Appropriations Act, Senate Bill 1, 89th Texas Legislature

HHSC has published the Information Letter IL 2025-25 regarding the Rider 23: Texas Administrative Code Rule Amendments, Personal Attendant Base Wage Discontinuation, Rate Enhancement Discontinuation, Established Average Hourly Wage Assumed in Methodology, and Established Direct Care Wage and Benefits Expense Ratio, effective September 1, 2025. Review the IL for more information.

At the bottom of page 4 and top of page 5, HHSC details its plan to align the definition of attendant cost component with the CMS rule related to Ensuring Access to Medicaid Services.  This federal rule modified the definition of direct care to include nurses and other staff providing clinical supervision.
 HHSC’s timeline for making this change:
HHSC says they are still evaluating the scope of this alignment. They do anticipate the change will align with a state fiscal year, in part because the cost reports are not collected on a state fiscal year time-period.  Therefore, the earliest alignment would be effective 9/1/26. HHSC will be issuing public notices once the timeline is finalized the advising of the changes.

More information about the attendant programs and payment rates is available on the HHSC Provider Finance Department (PFD) webpage.

If you have questions, contact the HHSC PFD, Long-term Services and Supports (LTSS), Center for Information and Training at PFD-LTSS@hhs.texas.gov or (737) 867-7817.

Where To Find Medicaid Eligibility Information for LTC Providers: TexMedConnect

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October 28th, 2025

Medicaid Eligibility Reports – SSI Medicaid

HHSC has been working on enhancements to improve awareness and visibility of the Medicaid recertification date to increase timely submission.  HHSC announced that be making changes to the current training video on this subject and will release info about this in the near future.

Current video on this topic (updated 7 months ago) is available at:  https://www.youtube.com/playlist?list=PLIe60BLvrbESNOLho-L03v4Vf-GH4TNv1

March 25th, 2025

Video About Medicaid Eligibility Reports on the LTCOP Dashboard Now Available on YouTube

An educational video focused on Medicaid eligibility reports on the Long-Term Care Online Portal (LTCOP) Dashboard has been added to the Texas Medicaid & Healthcare Partnership’s HCS and TxHmL YouTube Playlist. Read the full alert.

November 14th, 2024

Eligibility Information Available for Long-Term Care Providers and LIDDAs

LTC providers and LIDDAs that are seeking eligibility information can pull Medicaid Eligibility and Service Authorization Verification (MESAV) using any of the following field combinations through TexMedConnect.

This service can be accessed 24 hours a day, 7 days a week

. • Medicaid/Client No. and Last Name

• Medicaid/Client No. and Date of Birth

• Medicaid/Client No. and Social Security Number

• Social Security Number and Last Name

• Social Security Number and Date of Birth (DOB)

• Last Name, First Name, and DOB

MESAV can provide the Medicaid eligibility Program Type, Coverage Code, and Medicaid Recertification Due Date to help providers ensure appropriate and continued Medicaid eligibility for long-term care services.

Upcoming Webinars Presented By Consolidated Planning Group

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October 28th, 2025

Click On The Webinar Name Below To Register For Upcoming Webinars From Consolidated Planning Group

November 4, 2025

12:00p – 1:00p

Webinar

Educational Options After High School for Special Needs Families – Plus Bonus Content About The New Texas Education Savings Account!

 

November 6, 2025

12:00p – 1:00p

Webinar

4 Things You Need to Know About Protecting Your Child With Special Needs with Special Needs Attorney Michele Goldberg

 

November 11, 2025

12:00p – 1:00p

Webinar

College Planning for Families with Special Needs

 

November 12, 2025

12:00p – 1:00p

Webinar

Discover a Whole New Life at Marbridge – A Texas Residential Community

 

November 13, 2025

12:00p – 1:00p

Webinar

Understanding Social Security Administration Programs and the Benefits of Establishing a Trust

 

November 18, 2025

12:00p – 1:00p

Webinar

Practical Conversations for Special Needs Planning: Coordinating Your Estate Planning with Beneficiary Designations with Special Needs Attorney Elisa Rainey

 

November 18, 2025

6:30p – 7:30p

Webinar

Transitioning and the ADD/ADHD Student with Transition Specialist Anna Kluth

 

 

The Team at Consolidated Planning Group

contact@cpgcares.net   

281-690-1177

https://www.consolidatedplanninggroup.com/

SNAPS Status Update: Beginning Nov. 1st, 2025

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October 28th, 2025

November SNAP Benefits & Information Resources 

Due to the current federal government shutdown, there will be insufficient funds to pay SNAP benefits for November.
For Texas and the millions of Texans who will be affected, and more specifically, the individuals in the Texas HCS and TxHmL programs who receive SNAP benefits, as well as possibly many of your own staff that you may employ, we want you to know the following:
 
The three IDD associations are working together on this issue and ask that you share any financial or operational impacts you experience so we can communicate this to HHSC and policymakers.
Please also share the information below with persons who may need it; i.e., individuals and families you serve and your staff.
Here are the resources for more information:

OIG Audits & Inspections: Update

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October 28th, 2025

OIG Beginning Auditing of Cost Reports

If you attended the Office of Inspector General (OIG) session at PPAT’s 28th Annual Conference you may recall Susan Biles, OIG, stating that the OIG’s FY 2026 Work Plan would include auditing HCS/TxHmL cost reports. We have received updated information since their presentation at PPAT, as a result of some of the inquiries during the session.
 
Some providers have already began receiving requests from OIG for a copy of the cost report preparation contract or agreement they have with the entity which prepares the company’s cost reports to include details related to payments for the cost preparer’s services provided during a specified period of time.
 OIG was contacted by PPAT to inquire if they could obtain additional information about the audit process. 
Below please see response from OIG and the link to the OIG’s Audit Work Plan for FY 2026 should you wish to review.  
 
Link to OIG FY 2026 Audit Work Plan:  
https://oig.hhs.texas.gov/sites/default/files/documents/inspector-general-audit-and-inspections-plan-fy-2026.pdf
 
OIG Response To Inquiries:

-We will look at the cost reports for this audit. Since many cost report preparers are external to the entity providing the cost report and one cost report preparer might be used for multiple entities, we wanted to gain an understanding of how the contracts with cost report preparers are written. 

-After reviewing the contracts, we will determine next steps.  For the audit we will probably engage both the entity submitting the cost report and the preparer. Those entities selected will receive more information about the scope and objective(s) of the audit.  More information will be requested after that to support the expenses and to ask specific preparation questions as needed.

-We probably will not look at all and it is not a random sample either.  We have not decided yet how many we will look at. 

 –We take multiple factors into account when determining which entities to look at, including how much is reported in the cost reports, are some outliers, can we gain efficiencies in any way, like the same preparer did multiple cost reports.  If we decide to narrow our scope to a specific line item in the cost reports, we might look at more providers than we would if we focus on the cost report as a whole.

 –Once we are farther along in the process and have determined our preliminary scope and objective(s), I will be happy to have further discussions about which entities we determined to include in the audit

October 5th, 2025

What triggers an OIG audit or investigation?

The Texas Health and Human Services (HHS) Office of Inspector General (OIG) is charged with preventing fraud, waste and abuse in health and human services programs to protect taxpayer dollars and program clients. To achieve this, OIG conducts audits, inspections, and investigations to ensure that Medicaid funds are used appropriately and efficiently.  Another important fact is that TMHP (Texas Medicaid Health Portal), HHSC, and OIG are all part of the enrollment and revalidation process for HCS/TxHmL.

Some of you may be familiar, for example, with the “site visit”  conducted by CMS for TMHP, for all new applications submitted for enrollment to PEMS (Program Enrollment Management Services).  The OIG reviews these site visit reports and enrollments into TMHP. Some common deficiencies in this area are:

Incomplete Items-such as criminal hx checks, license checks, and managing employees or subcontractor checks.

Tips: Double-check disclosures before submitting the application or revalidation. OIG also recommends that you start the revalidation process early, it can be a very long process. During Revalidation, you may expect site visit to verify if the provider is actually at that location.  This would be for re-enrollment or revalidation, as far as my understanding, and that this is not the same as the federal OIG site visit.  This is the state OIG visit to verify your program is actually at that location.

 

Audits: To mitigate their own risks, providers should be aware of some of the issues that could lead to OIG scrutiny. Some of the common HCS/TxHmL errors seen:

–LIDDAS-lack sufficient progress notes

–Missing progress notes, service delivery logs

–False Documentation

-Facility did not have records to support telehealth-consents and records for what they are billing that meets billing requirements for what is billable

–Telemedicine must have written permission and include observation, diagnoses, training and testing

–Medication Administration: Billing For services not rendered

–Quality of Care-billing for expensive services but giving low end service/care

–Misappropriation of Funds

Some new areas that OIG has noted they are concentrating on that come under their purview are:

-Solicitation (Can’t do anything to influence the individual’s choice of provider).  OIG is hitting hard in this area now and in the next year!

-Also Reviewing Cost Reports in some cases as well now.  Due to complaints and due ot risk assessments they have completed concerning cost reports.

 

 

Common Triggers:

Billing errors

High Dollar Claims

Unusual Payment Patterns

Inappropriate Documentation (missing documentation for service billed, missing appropriate dates, times, signatures for each service entry of billable services, etc…)

Billing For Services Not Defined As Billable in The “Billing Requirements”

A note about common triggers 

**It’s important to note that being flagged for an OIG data review does not automatically indicate wrongdoing. These flags may simply reflect billing or service patterns that differ from peers and may warrant a closer look.  Tip from OIG: If you self-disclose during an audit, you may get to keep some or all of the money or at least avoid additional fees being charged.

Report waste, fraud, and abuse of HHSC programs to: ReportTexasFraud.com 

For questions, please email: Jeremy.fuchs@hhs.gov

Rider 56:  Appropriate Care Settings for Individuals with Severe and Persistent Mental Illness and Co-Occurring Conditions Study 

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October 27th, 2025

HHSC Rider 56 (89th Texas Legislature):  According to HHSC, it’s in the beginning stages of implementation but plans to engage stakeholders in the process in early January as well as publish a communication about the Rider and related implementation plans.
Rider 56:  Appropriate Care Settings for Individuals with Severe and Persistent Mental Illness and Co-Occurring Conditions Study.   Out of funds appropriated in Strategy D.2.5, Community Behavioral Health Administration, the Health and Human Services Commission (HHSC) shall study and develop a proposal to implement a pilot program that provides residential intermediate care services for individuals with severe and persistent mental illness who may have co-occurring conditions, including traumatic brain injury, and intellectual or developmental disabilities, who, due to the acuity of their conditions, are inappropriate for community placement but no longer meet criteria for inpatient psychiatric care.

(a) For the purposes of developing the study and proposal:

(1) An individual must meet the following eligibility criteria to qualify for the pilot program:

(A) Have a diagnosis of severe and persistent mental illness and may have a cooccurring condition, such as a traumatic brain injury or intellectual and developmental disability; and

(B) Spent three or more of the past five years in a psychiatric hospital; or

(C) Have been incarcerated more than three times and experienced two psychiatric crises in the previous three years; and   or,

(D) Have been admitted to hospital emergency rooms more than three times with psychiatric crises.

(2) The proposed location of the pilot program shall not be classified as an Institution of Mental Disease under federal Medicaid regulations and shall be designed to ensure compliance with federal funding requirements.

(b) The study and proposal shall:

(1) Assess the existing unmet needs in the service continuum for the target population;

(2) Assess the need for nursing-level care and other specialized services for the target population;

(3) Identify opportunities to modify or expand eligibility criteria for existing programs and services;

(4) Scalable options for implementing the program at residential care facilities and nursing facilities;

(5) Evaluate whether vacated buildings on state hospital campuses or other state facilities could be rehabilitated and used to provide intensive residential services for the target population; and

(6) Evaluate statutory changes and funding needed to establish the pilot program to serve the target population, including the estimated cost to provide intensive residential services for the eligible population and the estimated cost to rehabilitate vacated buildings on state facility campuses to serve as the location of the pilot program.

No later than October 15, 2026, HHSC shall submit findings and recommendations from the study to the Senate Finance Committee, the House Appropriations Committee, the Legislative Budget Board, the Office of the Governor, and permanent standing committees in the House of Representatives and the Senate with jurisdiction over health and human services.

Cameras In Private Areas (HCS Program): Update

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October 23rd, 2025

HCS Program & Cameras in Private Areas: 

HHSC Medicaid division sent Regulatory staff at HHSC an email informing them that “CMS thinks there’s a privacy concern regarding cameras being allowed in private areas (even if justifications are in place), and that CMS will no longer permit this practice.”

According to HHSC, currently, there are no HCS rules specific to this matter.  HHSC stated that more details will be forthcoming, but for now, members should be informed that, in the future, this will no longer be permissible. They will provide more clarification in the near future.

Change in IDD Waiver Cost Limits

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October 23rd, 2025

New cost limits for the IDD waivers are as follows:

  • For DBMD and CLASS, HHSC updated the individual cost limits from $114,736.07 to $149,774.
  • For TxHmL, HHSC updated the individual cost limit from: $17,000 to $31,684.
  • For HCS, HHSC updated the individual cost limit based on level of need (LON) as described below:
    • Intermittent (LON 1), Limited (LON 5), and Extensive (LON 8)
  • The amount is increasing from $167,468 to $169,182.
    • Pervasive (LON 6)
  • The amount is increasing from $168,615 to $211,822.
    • Pervasive plus (LON 9)
      • The amount is increasing from: $305,877 to $392,318

PEMS Streamlining Process For TMHP Enrollment

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October 22nd, 2025

PEMS Update:
HHSC and TMHP have been working on changes to the Provider Enrollment and Management System (PEMS)  process in conjunction with a workgroup comprised of external stakeholders which cross all Medicaid programs subject to this federal requirement.  Though not all changes can be made at once, HHSC will soon begin making incremental changes.
HHSC/TMHP will test changes with volunteer representatives before initiating permanent changes.

April 15th, 2025

Beginning May 30, the Provider Enrollment and Management System (PEMS) will be enhanced to streamline the process for Texas Medicaid enrollment, managed care organization (MCO) and dental maintenance organization (DMO) credentialing.

PEMS will feature a new Credentialing Tab for the credentialing application that will allow providers to complete and submit their credentialing information as part of the enrollment process, the reenrollment process, or as a maintenance request.

For more information, refer to Coming Soon: PEMS to Be Updated to Allow Provider Credentialing on TMHP’s Provider Enrollment webpage.

ANE Investigations Backlog Issue: HHSC Rider 164

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October 22nd, 2025
There has been and still currently is a big backlog of ANE Investigations:  Currently, over 3,000 ANE intakes in the HCS program are pending investigations. The 89th Texas Legislature appropriated one-time funds for HHSC to hire 31 staff to investigate and close these cases.  See excerpt from HHSC Rider 164 below.
Is there a point of contact that providers can reach out to check on the status of an open case and how they can obtain a final report if informed that a case has been closed?
~   To check on the status of a case (even an old case), contact the HHSC Regional Office. If the Regional Office is not able to provide the status of an ‘open’ case, contact Michelle Dionne-Vahalik at Michelle.Dionne-Vahalik@hhs.texas.gov
~   To obtain a copy of a final report, contact Michelle Dionne-Vahalik at the above email address.
Excerpt from Rider 164:  In addition to funds appropriated to address the backlog in ANE investigations, HHSC Rider 164 (Article II, FY 2026-2027 General Appropriations Act) states the following:
-It is the intent of the Legislature that HHSC address and clear all backlogs relating to abuse, neglect, and exploitation investigations in the RSD by December 31, 2026.

AAIDD: Texas Chapter Annual 49th Convention (Sept. 30th-Oct. 3rd, 2025) Post Convention Update

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October 14th, 2025

Post Convention Report

This year’s AAIDD-Texas Chapter 49th Annual Convention was on Sept. 30th-Oct. 3rd, 2025, and we had a wonderful turnout.  As you may or may not know, this is my first year on the board, and it was an awesome experience.  I know there were some providers, LIDDA’s, and individuals who just didn’t have funding to come this year or possibly the timing was just not right, and we thank all of you who could make it to the convention.  This has been a tough year for everyone in IDD services, especially in the state of Texas.

Next year is our 50th anniversary,  so I hope even more of you can attend the convention next year.  We plan to go all out for the event!  Please don’t forget to sign up to be a member of AAIDD, which gets you so many professional resources, including free material, webinars, and discounts on other resources for IDD, as well discounted rate on the registration for our annual Texas Chapter of AAIDD Convention.  Basic Membership cost is very good rate ($90-$185 per year for basic) for national membership, and there is no extra cost for Texas Chapter membership.

I would like to thank all board members for their tireless work to make this happen this year, as well as all the sponsors and vendors.  I would like to also thank all the wonderful presenters for the breakout sessions, like Nursing Innovations, Rachel Hopkins from Molina Health Care,  and the Transition Support Team members from several of the LIDDAs– Integral Care, Texana, Nueces County. We had an incredible guest, James Meadours for the Opening Session.  James is a passionate self-advocate for persons with disabilities and for those who have suffered abuse and has been presenting across the US for many years.

Shelbi Davenport (of the Shelbi Show podcast) did a wonderful job in the general session of hosting her live podcast interview with 3 incredible individuals with Down Syndrome:  Martha Haythorn, Jenny Stone (now Underwood), and Austin Underwood. The premise of the interview was to look at the personal perspective of 3 incredible people with Down Syndrome and how the lives of these three people were given the support and freedom to pursue their dreams and how they are now living their best lives.

Austin and Jenny Underwood were actually married not long ago and are both working in jobs they love, which has been a lifelong dream for both of them.  After earning a certificate as a prep chef and working as a head of house and chef at an Italian restaurant,  Austin founded his own company in 2016 and owns a food truck called “Austin’s Underdawgs” in the DFW area. I have been told they also cater for events!   Jenny and Austin both have amazing family support, and we were able to meet their parents at this year’s convention.  Jenny has worked as a Teacher’s Aide at the KinderFrogs School at Texas Christian University (TCU) for 20 years. KinderFrogs is a family-focused, early intervention program for children with developmental delays. In her role as a teacher’s aide, Jenny performs many duties from assisting with circle time to preparing lunches and assisting children on the playground.

Martha Haythorn came all the way from Atlanta, Georgia to be with us, and she stole everyone’s heart this week.  Martha is incredibly passionate and quite funny, I discovered as well!  She was a recipient of a scholarship from Ruby’s Rainbow that allowed her to fund her college time at Georgia Tech and graduate.  She has been asked to present at Emory College in 2026 and now has a job providing social media marketing for a medical supplier of respiratory aids that also happens to help many individuals with Down Syndrome with respiratory issues.  Martha also sits on the Council for Developmental Disabilities for the State of Georgia.  It was my privilege to ask her to present this year and host her for her time here. So happy I got to meet her in person.

Check out some of our photos of the convention!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

August 29th, 2025

We invite you to this year’s Texas State Chapter of AAIDD 49th Annual Convention. I am officially a board member this year (Julie Blacklock), and I will also be presenting a breakout session on October 2nd, 2025 especially for HCS providers. Please share with providers, families, and individuals.  All are welcome to come. For more information and registration, go to:  https://www.aaiddtx.org/2025-convention

KEYNOTE SPEAKER

Self-Advocate-of-the-Year-James-Meadours-3-262x272.jpeg
Opening Session
Wednesday, October 1, 8:45 – 10:30 a.m.
James Meadours, Self-Advocate, National Speaker, Disability Rights Leader
A Journey from Group Living to Independent Living

James Meadours, a nationally recognized self-advocate, shares his powerful story of moving from a group home to living independently in “The Right Direction.” With honesty and courage, James outlines the milestones, setbacks, and supports that helped him take control of his life. From building daily living skills and speaking up for his rights, to embracing community inclusion, James offers a message of hope and empowerment. Attendees will leave with deeper insight into how to support others on their own path to independence.

GENERAL SESSION

Wednesday, October 2nd, 3:00 p.m.-4:30 p.m.
Taking Our Lives in the Right Direction

• Shelbi Davenport, B.S. Better Lives Senior Associate/Practicum Coordinator at TAMU

• Martha Haythorn, Georgia Tech ExCel Graduate, Policy Specialist-Georgia State Legislature

• Austin Underwood, Operator-Austin’s UnderDawgs

• Jenny Stone, Outspoken Self-Advocate and Austin’s partner

This presentation is intended to be a general session in the format of a structured interview that will provide the audience with a personal perspective on how the lives of three people with Down Syndrome were given the support and freedom to doggedly pursue their dreams and who are now living their best lives, with even better things to come. Shelbi Davenport of The Shelbi Show will host the session, interspersing interview questions with video snippets to facilitate and drive the discussion. The audience will be motivated to encourage others with disabilities to let nothing get in the way of following their desired path.

 

For Complete Program PDF

OR

Click on: Tx Chapter AAIDD Convention 2025-brochure-agenda

Remember, as an AAIDD member, you receive a discounted rate for this year’s Texas Convention

Membership: How To Join AAIDD

AAIDD welcomes you to become a member or renew your annual membership now. Click on the link below to choose from the benefit packages that best match your needs.

https://www.aaidd.org/about-aaidd/membership-join/member-types

AAIDD membership advantages include access to a global network of professionals, free webinars, discounts on publications and the annual meeting, eligibility to vote and hold office, access to members-only content like Interest Networks and newsletters, and subscriptions to peer-reviewed journals like AJIDD and Inclusion. Members can also participate in scholarship opportunities and join the Students and Early Career Professionals (SECP) Interest Network.

 

Why Should I Join AAIDD?

Joining AAIDD lets you tap into a network of top professionals from around the globe on IDD, who can show you the ropes, deepen your involvement in your profession, and advance your career.
Professional Development & Information
  • Journals and Publications:

    Members gain access to peer-reviewed journals and resources on the latest research and policy developments in the field of intellectual and developmental disabilities (IDD).

  • Webinars:

    Free access to educational webinars and an archive of past sessions is available to members.

  • Interest Networks:

    Members can join specialized groups to connect with peers who share similar interests or disciplines.

Networking & Community
  • Global Network:

    Connect with a worldwide network of professionals working in the IDD field.

  • Interest Networks:

    These provide a forum to share information, network, and find leadership opportunities.

Discounts & Savings
  • Annual Meeting: Receive discounts on registration for the AAIDD Annual Meeting.
  • Bookstore: Get discounts on books and other resources from the AAIDD bookstore.
Other Advantages

Information on Job Opportunities working with IDD services

Member Updates on Upcoming Events
For more information about one of our guest presenters, Martha Haythorn, check out some of her “Ruby’s Rainbow” YouTube videos and accomplishments

Phishing Alert: Emails From “Fake” HHSC Email Addresses

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October 12th, 2025

 DO NOT CLICK FILES, LINKS, OR FWD!

The Texas Health and Human Services Commission has identified an active phishing attempt.

The message may appear to come from a trusted colleague, sender, or HHSC email address and often includes links, meeting invites, or file attachments that appear to be legitimate.

If you receive an unexpected or suspicious email, don’t click on the links, open the attachments, or accept the invite.

HHSC is actively working to resolve this issue and will communicate updates.

**Please know that several providers have reported receiving suspicious emails from HHSC yesterday.
One email is from Debasmita Bhakta related to  Revised HHSC Contract;
And another one is from Terry Flowers related to HCS Enforcement Review.
Both have attachments and both individuals work at HHSC.  

**Tip From Twogether Consulting:

If you are unsure and know the sender or sender’s email, or if you are expecting an email from HHSC, you may want to contact them by phone or contact them some other way directly to ensure they did actually send you an email, especially if it contains links or attachments.

TULIP: Unavailable Oct. 31st-Nov, 3rd, 2025!

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October 6th, 2025

TULIP System Updates

PLEASE BE ADVISED THAT HHSC WILL BE PERFORMING SYSTEM UPDATES TO TULIP.  

Don’t forget all EMR checks (Misconduct & Nurses Aids checks) are done through TULIP for HCS/TxHmL/ISS Providers

TULIP will be unavailable from October 31st, 2025 @ 5:00pm to November 3, 2025 @ 8:00am.

These updates are necessary to improve system performance and reliability.   More details on issues like password reset will be sent out as they approach the transition date.

DAHS and Individualized Skills and Socialization Provider Webinar with HHSC LTCR:: October 30th, 2025

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October 5th, 2025

HHSC Long-term Care Regulation will host a webinar for Day Activity and Health Services (DAHS) and Individualized Skills and Socialization providers

Date: October 30, 2025

Time: 11 a.m. to noon.

Place:  Webinar

DAHS and Individualized Skills and Socialization providers should attend this and all webinars with HHSC LTCR.

LTCR will provide the latest updates and answer questions from participants.

Register for the webinar.

Cross Agency Employment Conference – Thursday, November 13

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October 3rd, 2025

Save the date for the second annual Cross Agency Employment Conference on Thursday, November 13, 2025.

What: Cross Agency Employment Conference

When: Thursday, November 13, 2025

Where: Online

Registration: Registration will open in mid-October.

More Information

The Cross Agency Employment Conference will feature presenters from Texas HHS, the Texas Workforce Commission, and the Texas Education Agency.

The conference is open to agency staff, job seekers, providers, family members, and advocates who want to understand the job seeker’s journey to employment, and the services and support available to them through each life stage.

ASL/CART services will be provided for this event.

This conference is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $27.7 million with 100 percent funded by CMS/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.

HHSC Webinar: Advances in Trauma Informed Care- Oct. 10th, 2025

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Oct 3rd, 2025

HHSC is hosting a free webinar on World Mental Health Day, Friday, October 10, 2025, from 9:30 a.m. to 11 a.m. CST.

What: Webinar on Advances in Trauma Informed Care

When: Friday, October 10, 2025, 9:30 a.m. to 11 a.m. CST

Register Now: Register for the webinar.

Trauma is not just an event, it’s an experience that disrupts a person’s sense of safety, stability, and connection. It can alter brain development, behavior, and emotional regulation. For many people, trauma leaves invisible wounds that shape how they learn, relate, and navigate the world. We’ll unpack how trauma manifests across developmental stages and why people with intellectual or developmental disabilities face heightened risks. We’ll also share how professionals, caregivers, and advocates can foster environments of psychological safety, healing, and resilience

Payment Rates For Attendants-Information Letter 2025-24

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September 19th, 2025

The link for IL-2-25-24 is:  https://www.hhs.texas.gov/sites/default/files/documents/il2025-24.pdf
This IL replaces; i.e., IL 2025-17, and it does provide links to the Information Letters HHSC has previously posted regarding IPC and ISP changes in the HCS, TxHmL, CLASS and DBMD programs.
Based on questions many providers have asked about the wage rate, please note the statement on page 1 that states Rider 23 increases attendant wages to an average of $13/hour.   
From HHSC

“HHSC has published the Information Letter IL 2025-24 (Replaces IL 2025-17), regarding the approved payment rates for personal attendant services in various programs. The HHSC Provider Finance Department webpage has more information about the approved payment rates.
Review the IL for more information. If you have further questions, contact HHSC PFD, Long-term Services and Supports (LTSS), Center for Information and Training at PFD-LTSS@hhs.texas.gov or (737) 867-7817.Payment Rates”

Reminder about New Long-Term Care Regulation Training Registration From HHSC

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September 10th, 2025

“From HHSC”

HHSC has announced that registering for Joint Training will be easier and more efficient through our new Learning Management System (LMS), Learning Tree. Long-Term Care Regulation (LTCR) Joint Training began using the LMS for training registration on Sept. 1, 2025.

What is the Learning Tree LMS?
  • A user-friendly online platform designed to enhance your learning experience.
  • Centralizes course registration and access.

You’ll need an account to register for in-person trainings or virtual webinars. For those looking for modern therapeutic approaches, check out here for more info.

How do I register for an Account?

Step 1: Create an Account

  • Navigate to the Registration Link.
  • Fill in the required information:
    • First Name, Last Name – Formatted as it would appear on any training certificates.
    • Email Address – It’s important to obtain your certificates in your Completed Courses. We recommend using your personal email address. This will also be your username.
    • Cell Phone – This is not required.
  • Select the correct Affiliation for your account or role.
  • Select the Register button to create your account on our system.

Step 2: Create a New Password

After registering for an account, you will be taken to a new screen to reset your password. Passwords created in the Learning Tree LMS must include:

  • Minimum of 8 characters
    • Maximum of 12 characters
    • 1 uppercase letter
    • 1 lowercase letter
    • 1 number
    • 1 special character

Special Characters include: ~!@#$%^&*_-+=’|(){}[]:;”<>,.?/

Step 3: Register for Training

After you reset your password, you’ll be re-directed to your Learner Dashboard.

  • Select Register for Course on the left navigational pane.
  • Locate the course you are signing up for.
    • If you know the name of the training you’re looking for you can also type it in the search bar at the top. Press <Enter> on your keyboard or Find Course to search, and the course should appear.
  • Click Register.
  • Click Proceed to Checkout.
  • Click Confirm.
  • Click Go to Dashboard.

Courses are free of charge unless otherwise noted.

Register for an account.

Transition Support Teams: 8 LIDDA’s Provide These Resources

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September 3rd, 2025

Individuals that reside in institutions such as a nursing facility, state-supported living center (SSLC), or intermediate care facilities, who have IDD often have many significant medical, psychiatric, and behavioral needs that create challenges to living successfully in the most integrated community setting. Serving individuals who transition or divert from these institutions often requires specialized staff, intensive training, and expertise across several fields of study as well as ongoing support and technical assistance.  As these individuals transition to an HCS program, for example, providers and family members have a difficult time finding the needed support for their individual in the community, particularly in rural areas, to maintain the care they need.

The Texas Health and Human Services Commission (HHSC) secured Money Follows the Person (MFP) Demonstration funding to help individuals who have complex medical and behavioral needs and want to live or remain in the community to receive the services and supports they need.

Texas has 8 regional Transition Support Teams (TSTs), often referred to as Hubs, to serve all 254 Texas counties, including all 39 local intellectual and developmental disability authorities (LIDDAs) and the community waiver providers within a designated region. These interdisciplinary teams provide the following support services:

  • Educational and training activities and materials, such as webinars, videos, and other correspondence, are provided at least quarterly and focus on increasing the expertise of LIDDAs, providers, and community members in supporting individuals with complex needs.
  • Technical assistance provided to LIDDAs, program providers, and other community support services on specific disorders and diseases, emerging and best practices, and evidence-based services for individuals with significant challenges.
  • Case consultations and peer reviews are provided to service coordinators, crisis intervention staff, direct care staff, and other members of an individual’s service planning team who need assistance providing effective care for an individual.

A licensed professional, such as a clinical social worker, serves as each TST coordinator. TSTs include licensed medical staff such as physicians, physician’s assistants, nurse practitioners, and registered nurses as well as psychiatrists, psychologists, behavioral specialists, and other professionals who have expertise working with individuals with IDD. These interdisciplinary teams support the LIDDAs and service providers within their designated service areas.

TSTs are also designed to address unique regional and cultural issues and challenges as well as identify gaps in medical, psychiatric, and behavioral resources. They report information about these identified gaps to Texas HHSC.

 

Designated LIDDA Covered LIDDA Service Areas
Alamo Local Authority for IDD Alamo Local Authority for IDD
Camino Real Community Services
Gulf Bend Center
Hill Country MHDD Centers
Behavioral Health Center of Nueces County Behavioral Health Center of Nueces County
Border Region Behavioral Health Center
Coastal Plains Community Center
Tropical Texas Behavioral Health
Emergence Health Network Concho Valley Center for Human Advancement
Emergence Health Network
Permian Basin Community Centers
West Texas Centers
Integral Care Bluebonnet Trails Community Services
Central Counties Services
Heart of Texas Region MHMR Center
Integral Care
MHMR Authority of Brazos Valley
Metrocare Services ACCESS
Andrews Center
Burke
Community Healthcore
Denton County MHMR Center
Lakes Regional Community Center
LifePath Systems
Metrocare Services
Spindletop Center
Texoma Community Center
My Health My Resources of Tarrant County Betty Hardwick Center
Center for Life Resources
Helen Farabee Centers
My Health My Resources of Tarrant County
Pecan Valley Center for Behavioral and Developmental Healthcare
StarCare Specialty Health System Central Plains Center
StarCare Specialty Health System
Texas Panhandle Centers
Texana Center The Gulf Coast Center
The Harris Center for Mental Health and IDD
Texana Center
Tri-County Behavioral Healthcare

If you need help to locate offices that can help you with intellectual or developmental disabilities, aging, behavioral health, and other disability services, please visit Where Can I Find Services?

HHSC: HCS Amendment To Rates Effective Sept. 1, 2025-Update

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August 30th, 2025

CMS has approved the 1915 (c) waiver amendments with an effective date of September 1, 2025. This means that the rates funded by Rider 23 and posted by HHSC on August 19, 2025 will be effective September 1, 2025.

Copy of Information Letter 2025-17 and link to approved rates –  https://www.hhs.texas.gov/sites/default/files/documents/il2025-17.pdf

New Information Letters ILs):  Please read these letters very carefully, especially if you provide services to people using the CDS option.  Note also the increase in cost limits.
IL 2025-21 for HCS:   https://www.hhs.texas.gov/sites/default/files/documents/il2025-21.pdf
IL 2025-19 for TxHmL:   https://www.hhs.texas.gov/sites/default/files/documents/il2025-19.pdf
IL 2025-22 for DBMD:   https://www.hhs.texas.gov/sites/default/files/documents/il2025-22.pdf
Reimbursement Rule Amendments:  The rule amendments proposed earlier this summer will soon be published as adopted.

 

August 15th, 2025

In September 2025, Texas will see changes to HCS (Home and Community-based Services) rates, including the discontinuation of the Attendant Compensation Rate Enhancement program and increased rates for identified attendant services. These changes are tied to the 2026-27 General Appropriations Act, specifically Rider 23

  • Discontinuation of Attendant Compensation Rate Enhancement:

    .

    The current program will end, effective September 1, 2025. 

  • Rate Increases for Attendant Services:

    .

    HHSC will propose increased rates for certain attendant and attendant-like services, also effective September 1, 2025. 

  • Funding for Wage Increases:

    .

    The 2026-27 General Appropriations Act, Rider 23, provides funding for HHSC to increase the wage for personal attendants to $13.00 per hour and adjust related payroll costs. 

June 21st, 2025

HHSC is accepting comments on the amendment of the 1915(c) Home and Community-based Services Waiver. View the HCS amendment details.

Through this amendment, HHSC updated the attendant rates and increased the HCS individual cost limits. The cost limits were updated as described below:

  • Intermittent (LON 1), Limited (LON 5), and Extensive (LON 8)

    • The amount is going from $167,468 to 210 percent of the annualized cost of care in an Intermediate Care Facility for Individuals with an Intellectual Disability or Related Condition (ICF/IID) using the fiscal year 2026 non-state-operated small facility daily rate for Level of Need (LON) 8, rounded to the nearest dollar, which is estimated to be $169,182 pending finalization of the fiscal year 2026 rates for ICFs/IIDs.

  • Pervasive (LON 6):

    • The amount is going from $168,615 to 210 percent of the annualized cost of care in an ICF/IID using the fiscal year 2026 non-state-operated small facility daily rate for LON 6, rounded to the nearest dollar which is estimated to be $211,822 pending finalization of the fiscal year 2026 rates for ICFs/IIDs.

  • Pervasive plus (Level of Need 9):

    • The amount is going from: $305,877 to 210 percent of the annualized cost of care in an ICF/IID using the fiscal year 2026 non-state-operated small facility daily rate for LON 9, rounded to the nearest dollar which is estimated to be $392,318 pending finalization of the fiscal year 2026 rates for ICFs/IIDs.

Comments will be accepted until July 21, 2025.

Email comments to the Texas Medicaid Waivers inbox.

HCS Home Page, Provider Letters, Contacts and Resources (Update)

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July 28th, 2025

Home and Community-based Services (HCS)

HCS Home page

Provider Letters/Provider Communications!!!

Click here for news, information letters (ILs) & provider letters (PLs).

To receive provider letters & communications for HCS/TxHmL/ICF/ISS or other HHSC programs, please go to GovDelivery signup from Granicus at:

https://service.govdelivery.com/accounts/TXHHSC/subscriber/new

Remember to only sign up for the alert letters and communications for the programs that apply to you or that you would like to receive information about!

Receive Emails from HHS Every Sunday

The Texas Health and Human Services Commission contracts with a company called Granicus to provide email updates, called GovDelivery. In accordance with your contract, and contracting rules at 40 Texas Administrative Code §49.302(g), you must subscribe to receive HHSC email updates, using this GovDelivery signup, and select Information Letters, Provider Alerts and the contract program type(s).

When you sign up for email updates, you are giving your information to both HHSC and to Granicus. When HHSC has your information, it is subject to the HHSC privacy policy. When Granicus has your information, it is subject to the Granicus GovDelivery privacy policy.

Contact Program Staff

 Emergency Alert Communication System: AlertMedia

PL-2025-01

All  HCS Providers must complete the following steps:
• Register your AlertMedia account using 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.

Resources

Infection Control & Vaccine Resources

HB 3720

State Rules (Title 40 Subchapter D replace with Title 26 part I  Ch 263 & 565)

 Review Tools and Forms
Additional Resources (Updated)

 

**If you have any questions about any of these resources on this page or about the HCS program, email LTCR Policy and Rules or call (512) 438-3161.

PAT (Provider Applicant Test)-Update 2025 (HCS/TxHmL)

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July 22nd, 2025

From HHSC’s PAT  FAQ’s as of Jan. 1st, 2023

“Frequently Asked Questions for Providers Applicant Training (PAT) for HCS/TXHML”

-When is the Provider Applicant Training (PAT) and Test available?
This training is available online at this time (training modules). The PAT Test itself is being revamped and is not available to take until  September of 2025.

If you are trying to apply for an HCS/TxHmL contract at this time, you will not be able to submit HCS/TxHmL applications without the PAT Test Certificate of Completion (must have passing grade of 85%), until you can schedule the test in September of 2025.  

Beginning Sept. 1st, the training modules will still be available online, but applicants will no longer be able to take the test online!.  Applicants will need to take the practice modules online and then schedule a time to take the test “in person”.  We will keep you posted as to whether they will be available at various testing centers or at one specific location. 

The PAT training is one of the first steps for HCS/TxHmL applicants to obtain a contract with HHSC.

Please do not submit your application without the PAT certificate that reflects a passing score of 85% or above.

-Who can take the training and test?
Applicants listed on Form 3681, Section 8.a and 8.b must complete the online PAT training. The Program Manager noted on this form, must complete the training and pass the test with an 85% or above.
See Texas Administrative Code Title 40, Chapter 49, Rule §49.204. You must provide a copy of HHSC Form 3681 along with your certificate of passing by at least 85% to HHSC.  The program manager must be the person taking the PAT test.

-How can I access the HHS Learning Portal?
• HHS Learning Portal (texas.gov).
• Set up your new account. You will need to confirm your new account through the email address used.
• Find and select the Medicaid Long Term Services and Support Training under “Course Categories.”
• Select the Provider Applicant Training (PAT) link. Select “Enroll me” to access the Training and get access to the “Welcome” page.

The training is compiled in four different steps.

Step 1. Important to know Before you Get Started
 Fill out the Provider Applicant Training (PAT) Information form. This form must be completed to access the introduction and the training modules.

Step 2. Training Modules
 Complete each module must be completed to advance to the next module.

Step 3. Evaluation and Certificates
 Complete the mandatory survey

Step 4. Provider Competency Exam
 Schedule your test with HHSC, after you have completed training modules.  Please save your exam certificate upon completion of test.  HHSC will issue you your results. Submit the certificate along with your completed application

PAT FAQ’s read more

IMPORTANT:  You must take the PAT before you can apply to be an HCS Provider!!!.  You must pass the Test by 85 %  If you fail the test, you can’t retake the test for a period of 6 months, so please study the TAC before and pay careful attention to the PAT modules before answering test questions.

Note: If you do not pass on your first attempt, please DO NOT apply.

Statewise Provides Free EVV Compliance Checklist For Texas

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July 22, 2025

Statewise Logo

From our friends at Statewise:

7 essential steps to EVV compliance, as well as Pro Tips are provided in this free checklist from Statewise.

“At Statewise, we’ve made it easier for providers like you to stay on top of your responsibilities with a free EVV Compliance Checklist—designed specifically for Texas Medicaid agencies.”

Texas EVV Compliance Checklist Free 

For more info on Texas EVV from Statewise:

Discontinuation of Attendant Compensation Rate Sept. 1st, 2025

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July 22nd, 2025

Attendant Rate and Cost Limit Revisions Webinar on July 22

HHSC will be providing updates to Home and Community-based Services (HCS) and Texas Home Living (TxHmL) providers, and local intellectual and developmental disability authorities (LIDDAs) on the topic of attendant rate and cost limit revisions for the waivers. Attendant Rate and Cost Limit Revisions Webinar July 22, 2025 2–3 p.m.

Register here for the webinar. Run a test of your computer’s connectivity if you have never attended a webinar from your computer. You can run this test at any time before the date of the webinar. Perform this test early to allow time to address any technical issues.

Email tx_medicaid_waivers@hhs.texas.gov with any questions.

July 16th, 2025

PL-2025-11

 

The Health and Human Services Commission (HHSC) will be proposing increased rates for identified attendant services and discontinuing the Attendant Compensation Rate Enhancement (Rate Enhancement) program, effective September 1, 2025. These increases are pursuant to the 2026-27 General Appropriations Act, Senate Bill 1, 89th Legislature, Regular Session, 2025 (Article II, HHSC, Rider 23).

Please pay special attention to the cost reporting guidance in this provider letter.

* Public notices will be published in the Texas Register, which can be accessed on the Texas Secretary of State website.

The Proposed Rate Packet and other information will also be published on the HHSC PFD website.

Lastly, HHSC will be issuing GovDelivery alerts. To begin receiving these alerts, visit the GovDelivery site, select Medicaid Reimbursement Rates and Non-Medicaid Reimbursement Rates as preferences, and enter the requested information.

Please contact the HHSC PFD, Long-term Services and Supports Center for Information and Training Team, if you have questions regarding this provider letter at PFDLTSS@hhs.texas.gov or (737) 867-7817.

Note From Twogether Consulting:  From what we understand, essentially the increased rates will help those HCS providers who do not already receive the Attendant Compensation Rate Enhancement (ACRE), but it will be a “wash” for those who currently participate in this rate enhancement.  (Although it is not nearly the increase that was wanted and needed to support residential services in particular.)  So, what it sounds like, is that those providers who receive ACRE currently would make about the same amount without ACRE, when the increased rates go into effect Sept. 1st, 2025.  We have however, been hearing from many providers that they feel that from their calculations, they may actually lose money with the rate increase and loss of ACRE.

Discontinuation of the Attendant Compensation Rate Enhancement Program and Rate Increases for Attendant Services

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June 30th, 2025

HHSC Publishes IL-2025-11

HHSC will propose increased rates for identified attendant services and discontinue the Attendant Compensation Rate Enhancement program, effective Sept. 1, 2025.

These changes are pursuant to the 2026-27 General Appropriations Act, Senate Bill 1, 89th Legislature, Regular Session, 2025 (Article II, HHSC, Rider 23).

HHSC has published Information Letter (IL) 25-11, Discontinuation of the Attendant Compensation Rate Enhancement Program and Rate Increases for Attendant Services, effective Sept. 1, 2025. Review the IL for more information.

If you have further questions, contact the HHSC PFD, Long-term Services and Supports (LTSS), Center for Information and Training (CIT) at PFD-LTSS@hhs.texas.gov or (737) 867-7817.

Rate Packets Now Available: For HCS/TxHmL/ICF/CFC/HCBS-AMH Waivers

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June 30th, 2025

Rate Packets Now Available

The rate hearing packets were posted on the PFD website on June 23, 2025. The hearing is being conducted to receive public testimony on the proposed Medicaid Rates.

Public Rate Hearing on July 16, 2025

The HHSC Provider Finance Department (PFD) Long Term Services and Support (LTSS) will hold its Public Rate Hearing on July 16, 2025, to address proposed rates for the following:

  • Medicaid and Non-Medicaid Payment Rate Actions for Attendant Services in various programs, and
  • Medicaid Payment Rate Actions for Nursing Facilities (NFs) and Nursing Facility Special Reimbursement Class for Individuals with Intellectual and Developmental Disabilities (IIDs).

Session One: 9:00–10:45 a.m. CDT

Proposed Medicaid Payment Rate Actions for Attendant Services in CFC, HCBS-AMH, HCS, TxHmL, and ICF/IID Programs, Effective Sept. 1, 2025

Session Two: 11:15 a.m.–1 p.m.

Proposed Medicaid Payment Rate Actions for Attendant Services in CLASS, CFC, DAHS, DBMD, PCS, PHC, CAS, FC, RC, STAR Kids and STAR Health MDCP, STAR Kids and STAR Health state plan services, and STAR PLUS HCBS and Non-HCBS programs, Effective Sept. 1, 2025

Session Three: 2:00–3:45 p.m.

Proposed Medicaid Payment Rate Actions for NFs and NF Special Reimbursement Class for IIDs, Effective Sept. 1, 2025

This rate hearing will be conducted both in person and as an online event. Register for the hearing to attend this online meeting. After registering, you will receive a confirmation email containing information about joining the webinar.

You can also dial in on your phone. To do so, follow the link above to register. You will then be provided dial-in instructions, including an audio PIN. The audio PIN must be entered to speak over the phone audio during the hearing.

Public Notice and Testimony

The notice for the rate hearing was published in the June 20, 2025, issue of the Texas Register and posted to the HHSC website on June 11, 2025. Unless otherwise noted in the notice and the rate hearing packets, written comments regarding the proposed payment rates may be submitted instead of, or in addition to, oral testimony until 5 p.m. (CDT) on the day of the hearing. Written comments may be sent by U.S. mail, overnight mail, special delivery mail, fax, or email, as follows:

U.S. Mail:

Texas Health and Human Services Commission

Attention: Provider Finance, Mail Code H-400

P.O. Box 149030

Austin, Texas 78714-9030

Overnight mail or special delivery mail:

Texas Health and Human Services Commission

Attention: Provider Finance, Mail Code H-400

North Austin Complex

4601 Guadalupe St.

Austin, Texas 78751

Phone number for package delivery: (512) 730-7401

Fax:

Attention: Provider Finance at (512) 730-7475

Email:

Long Term Support Services – PFD-LTSS@hhs.texas.gov

Persons with disabilities who wish to participate in the hearing and require auxiliary aids or services should contact Provider Finance at (512) 730-7401 at least 72 hours before the hearing so appropriate arrangements can be made.

Preferred Communication

If possible, use email or phone for the quickest response to communicate with HHSC about this rate hearing.

Forward this information to providers and organizations in your programs as appropriate. If you have any questions about this rate hearing, email PFD LTSS.

Twogether Consulting’s Satisfied Customer Page

by

June 26th, 2025

We would greatly appreciate a quote from any of our clients who would like to write up a short paragraph on how we may have helped your organization or any recommendations you have for others about our services at Twogether Consulting that you may have used over the years. We are also happy to accept updates to previous satisfied customer quotes that are currently posted on the site.

 Link to Satisfied Customers Page

If you would like to send us a quote, feel free to email us at info@twogetherconsulting.com 

Note:  Please type Satisfied Customer Quote in the subject line.   Be sure to leave your full name, company name, and title.  You are also welcome to leave a website link or email if you would like.

TMP Merger With Cubhub: Rebranded as Statewise

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June 26th, 2025

What Providers Need To Know

“TMP has joined Cubhub as part of the Statewise family—but nothing’s changing for Texas providers. TMP remains your trusted platform for IDD services.”

Important:  What’s changing?

Just the name of the platform (From TMP to Statewise). With the support of Cubhub, TMP will get stronger and gain improved features, but it will continue to serve as the primary platform for Texas-based IDD and personal care providers.   You will continue using the TMP platform as you know and trust, and the support team will remain the same.

For more information: https://statewise.com/blog/what-providers-need-to-know-as-tmp-merges-with-cubhub

Press Release: In Dallas, Texas, as of June 16th, 2025

Following TaskMaster Pro Acquisition, Cubhub Rebrands as Statewise
Delivering A Unified Platform for Medicaid Providers in Pediatrics, IDD, and Personal Care Services
Cubhub, a leading EMR solution known for helping pediatric home care agencies streamline compliance, scheduling, documentation, and billing under complex Medicaid rules, today announced its rebrand to Statewise after acquiring TaskMaster Pro. The new name reflects the company’s expanded capabilities and deeper commitment to delivering powerful, state-specific solutions across the care continuum.
“The Cubhub name served us well, but honestly, it also caused some funny looks and confusion at times,” said Cole Ballweg, CEO of Statewise. “We have always had a pediatric focus, however most of our partner companies have expanded into adult programs. Our mission is to help expand access to care by offering the best tools possible for anyone serving a Medicaid population. Since so much of that work involves state-specific nuances we think the name Statewise captures what we do more clearly.”
More than a name change, the move to Statewise marks a bold step forward—focused on equipping Medicaid-based providers with the tools, insights, and support they need to deliver exceptional care across every state. The company has plans to expand features and refine modules alongside its partner companies to meet the challenges of a market that is undergoing seismic changes.
About Statewise
Statewise is the unified result of Cubhub and TaskMaster Pro—bringing together purpose-built software for Medicaid providers in pediatric, IDD, and personal care services. Designed to meet the complex, state-specific requirements of Medicaid programs, Statewise helps agencies streamline operations, ensure compliance, and deliver exceptional care. To learn more, visit www.statewise.com or follow us on LinkedIn at https://www.linkedin.com/company/statewise-solutions
Media Contact:
Meghan McParland
Director of Marketing
Meg@Statewise.com
803.370.9312

ICF Provider 2024 Conference Recordings Available For Viewing

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June 25th, 2025

In case you were not aware, and you missed last year’s conference, we wanted to make sure ICF providers knew they could still watch the sessions.  Great For your Q’s, Administrators, and QA staff.

HHSC Long Term Care Regulation has posted 4 recorded sessions from the 2024 ICF Conference “Embracing Change to Enhance Value” held Dec. 5, 2024.

No CEs or certificates of attendance are offered for viewing these recorded sessions.

Access the recordings here.

iCareManager EHR System Information

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June 25th, 2025

 

From iCareManager email received on June 25th, 2025

iCareManager Website

“We are thrilled to introduce you to the innovative & efficient iCareManager

All-In-One EHR Solution!

Whether you connected with us at a conference or online, you’ve just taken the first step towards smarter, simpler, and more efficient IDD service delivery.

To kick things off, we’re attaching our 2025 e-book. It will give you a complete overview of who we are, what we offer, and how our EHR system is built to make life easier for IDD service providers.”

Download e-Book For FREE

 

What Sets iCM Apart From Others?

  • A Completely User-Friendly Dashboard
  • SOC 2 & HIPAA Certification
  • Holistic Solution To All Service Provision Needs

This is just the beginning, and we’re here to support you every step of the way

 

iCareManager, 6103 Parkway Dr, Laurel, MD 20707, United States

You may unsubscribe or change your contact details at any time.

Free IDD Provider Resource Webinar Series

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Free Webinars!!

All Recordings of Our Previous sessions of “Free IDD Provider Resource Webinars”  are posted on our “Gotostage” Channel

June 22nd, 2025

FREE WEBINAR: From Our “Free IDD Provider & Family Resource Webinar Series”
Date: June 30th, 2025
Time:  Noon to 1:00 pm
Cost: FREE

Twogether Consulting is pleased to have Rachel Hopkins, Program Director of Healthcare Services at Molina HealthCare of Texas as our guest presenter of our “Free IDD Provider & Family Resource Webinar” on June 30th, 2025, from noon to 1 pm.. Rachel is also a certified Person-Centered Thinking Trainer. Rachael will be discussing STAR+PLUS and how MCOs work with providers and LIDDAs during this webinar. This session provides information about the STAR+PLUS Medicaid program, including its healthcare benefits, value-added services, service coordination teams, and collaboration with IDD Providers and LIDDAs. In addition, she will answer questions from providers and address concerns.
For everyone who registers, you will receive a link to a copy of this recorded session if you miss it, and we will also be posting it on our “gotostage channel” as well as on my Linkedin page and Twogether Consulting FB pages.

Here Are Just Some Of Our Previously Recorded Free Webinars of Interest

Please see all recordings of previous webinars on our Gotostage Channel

Core-VA Solutions “Virtual Healthcare Assistants For LTC Programs”

Virtual Healthcare Assistants Services and Training for Long-Term Care Programs, including HCS, TxHmL, and ICF

 

Twogether Consulting is happy to have Brittney Russo-COO (Chief Operations Officer) from Core-VA Solutions to discuss her company’s “virtual assistant” services.
Core-VA Solutions provides virtual assistance for any type of long-term healthcare setting, whether it be for a small medical office or therapy office or HCS provider. All of our virtual assistants have a degree in nursing and/or health-related fields.

Core-VA is able to serve clients all over Texas and beyond. Some of the clients these virtual assistants work with are those in HCS, TxHmL, and also other IDD programs. This includes assisting with EVV and TMHP billing. Brittney’s team is able to provide appropriate training to her staff to cater to some of your specific needs, including persons with experience in the HCS/TxHmL programs providing some of that training and the IT solutions which they can learn to use using IT fundamentals here to learn for this. They have “virtual assistants” versed in the use of quite a few electronic health records software such as Taskmaster Pro, Focus, and other EHR and billing software. This is a wonderful resource for HCS/TxHmL providers for sure! This is especially true for some of you, who are brand-new HCS/TxHmL providers. Core-VA serves many different clients in other lines of Long-Term Health Services, but it is so nice to have help from a virtual assistant who understands the world of HCS/TxHmL!

-Core-VA team Solutions is part of our free webinar series for the month of January 2023!  Click on their postcard below for more information.  Services are available at $10-12/hr and no contracts.

core va post card

“Core-VA Solutions aims to positively change how your long-term healthcare facility operates with our virtual assistants with degrees in nursing and/or health-related fields. We understand that you may currently waste precious time and money completing tedious tasks such as medical reception, appointment scheduling, insurance authorization, receiving and submitting medical information, and so much more. Instead of hiring expensive employees to complete these much-needed tasks, hire our affordable virtual assistants instead, as we can provide you with the same level of service, at a fraction of the price. All you have to do is let us know how we can help, and our team will find the perfect assistant match for your facility!”

 

 “Support & Empowerment Program For Persons With IDD & Their Caregivers”

 

Twogether Consulting is happy to have Diana Chavarria from AACOG discuss an amazing program offered via a grant from TCDD (Texas Council For Developmental Disabilities).  This is a wonderful resource for IDD providers, Caregivers of persons with IDD and persons with IDD.  Dianne is part of our free webinar series for the month of January 2023!

The Program Provides Support & Empowerment For Individuals and Their Caregivers Concerning The Following:
-General Health and Aging
-Aging With Specific Syndromes (i.e. Down Syndrome)
-Nutrition & Physical Fitness
-Financial Wellness
-Benefits and Employment
-Planning For The Future
-Mental Wellness
-Coping With A Diagnosis
-Crisis Management

Here is a link to a short, introductory video about the HRST: https://hrstonline.com/video/index.php?id=410335893

Topic:  Health Risk Screening Tool

HRST  (Health Risk Screening Tool) is an assessment tool that can identify & detect health risks in vulnerable populations. This tool and other services offered by HRS are based on person-centered practices. Here is a little more information about HRS from their website. The Health Risk Screening Tool (HRST) identifies and tracks health risks in vulnerable populations, making it possible to design a plan tailored to meet the unique health and safety needs of each individual in the least restrictive setting. The instrument can objectively justify resources allocated both financially and in service intensity. Used by Case Managers, supervisors, and direct support professionals. HRS also helps the provider to comply with CMS Rules and assist with Person-Centered planning and continuity of care.  It is field-tested, reliable, and user-friendly

“Health Risk Screening, Inc.’s roots began in 1992. Along with training courses, webinars, and materials, HRS is the sole developer, producer, and distributor of the web-based Health Risk Screening Tool (HRST). The HRST is the most widely used and validated health risk screening instrument for people with intellectual and developmental disabilities.

HRS was established on the principles of person-centered practices. Our founder, Karen Green McGowan was a pioneer in the early formative days of the person-centered movement..  Our focus is on developing tools and training for the person-centered support of vulnerable populations. Through the education of government agencies and service providers, we have helped improve people’s lives. Along with training courses, webinars and materials, HRS is the sole developer and distributor of the web-based Health Risk Screening Tool (HRST). The HRST is the most widely used and validated health risk screening instrument for people with disabilities.”

For more information, please contact  Hillary Gaytan at:  Phone: 727.754.9539  Email: hilary@hrstonline.com
You can also go to their website:  www.hrstonline.com 

Check out this great page they have devoted to COVID-19 Resources:  https://hrstonline.com/covid-19-resources/

 

HRS Inc

Guest presenter:

Patrick Lane  (PCT Mentor & Trainer)

From:  HRS

Date: Thursday -November 12th, 2020  (Session ended)

Where:  See recorded link below:

https://attendee.gotowebinar.com/recording/1049673375643527182

Topic:  Person-Centered Services 

Patrick will be talking about some of the Person-Centered Services offered at HRS including software that helps the provider develop Person-Centered Descriptions. These can be used as a resource for making annual plans Person-Centered by using these same person-centered skills practiced in PCT sessions. 

“Person-Centered Planning Training is designed to help you approach support from a more holistic angle, with person-centered practices that respect the autonomy of those with intellectual and developmental disabilities while providing them with the highest possible level of care.”

Improve The Quality of Life

  • Balancing personal choice with personal responsibility by establishing and maintaining things that are important to the person with things that are important for the person
  • Being integrated in one’s community so that the person is known and respected for her or his contributions.
  • Being respectfully communicated with as a person, using language consistent with being a typical adult as opposed to using clinical or system language
  • Receiving support that is consistent so that new staff and others know and respect the person’s values and choices, as well as how others can help the person.
  • Being matches with staff, housemates, or others that the person making life more enjoyable.
You can contact Patrick at: patrick@hrstonline.com     For more info about HRS PCT services, please see the following link: https://hrstonline.com/person-centered-services/

Guest presenter:

Steve Cardie

From:     Abundant Health

Date: Tuesday -November 17th, 2020  (Session ended)

Where:  See link to the recorded session below:

https://attendee.gotowebinar.com/recording/5931551182568587528

Topic:  Cellular Blood Pressure Monitoring System   (Free To Medicare Patients!)  

Abundant Health is the distributor of a remote blood pressure monitoring system for Medicare patients that is the best on the market. It is the only FDA approved cellular blood pressure monitor. It makes it easy to report regular blood pressure monitoring to your physician with little to no effort and proving complete HIPPA compliance.  The system is much like your standard wrist BPM cuff, but it has a SIM card in it that reports all data instantly to your physician and can supply records that can be printed out by the client or facility for the individual’s records.  This would be a great system as well for individuals living in their own family home or in a host home setting that may want to be as independent as possible or may cut down on needing as much staff assistance and/or supervision.  Abundant Health works with providers, clinics, hospitals, and physicians across the country.   Here is a quote from one of them:

“Our new Cellular Blood Pressure Monitor System connects automatically to cell towers and transmits your patient’s information directly to your practice. This device makes it simple for seniors who tend to be more technology challenged to utilize Medicare’s RPM program without the difficulty of connecting to cell phones or the internet. No passwords, no Bluetooth, no internet connections required.

The rapid advance of medical device design plus an enormous upgrade in telecommunications makes Remote Patient Monitoring (RPM) suddenly possible for virtually everyone. Anywhere.  In November 2018 CMS officially approved three new billing codes for Remote Patient Monitoring (RPM).  The telehealth industry experts agree that this is the biggest financial incentive to date in the history of digital medicine.”

Register for the webinar at    https://attendee.gotowebinar.com/register/3642654945259750160

You can contact Ayshe at:

Registration is now open! Quality in Long-Term Care Conference-August 27th -28th, 2025 (Austin, Tx)

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June 23rd, 2025

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

The 2025 Quality in Long-Term Care Conference (QLTCC) will be held at the Renaissance Austin Hotel, Aug. 27-28, 2025.

This year’s theme is “Blazing a Trail to Quality Improvement in Long-Term Care.”

The QLTCC offers presentations from nationally and internationally recognized experts. The topics include caring for people with dementia; infection prevention and control; current heath care trends; and cutting-edge advances in long-term care, aging, and disabilities. Continuing education credits will be available for multiple disciplines. Both in person and virtual options will be available.

The Quality Monitoring Team (QMP) is committed to providing high quality information and research from top-tier speakers to those working in the long-term care community. To provide quality programming of this caliber and that our attendees have become accustomed to, including the offering of a multitude of continuing education units, we have found it necessary to begin charging a fee. We thank you for your understanding and the continued support of this program.

The QLTCC offers presentations from nationally and internationally recognized experts. The topics include:

  • Caring for people with dementia.
  • Infection prevention and control.
  • Current heath care trends.
  • Cutting-edge advances in long-term care, aging, and disabilities.

Continuing education credits will be available for multiple disciplines. Both in person and virtual options will be available. Register for the conference here: 2025 Quality in Long-Care Conference

Email UT Steve Hicks School of Social Work for more information about this event

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

Renaissance Austin Hotel

9721 Arboretum Blvd.

Austin, TX 78759

 

New ICF Provider Training Available: Internal Investigations by Providers for ICFs-July 18th, 2025

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June 23rd, 2025

HHSC Joint Training is presenting a new webinar for Intermediate Care Facility (ICF) providers on the internal investigation process for ICFs.

This 1.5 hour webinar provides guidance for ICF providers on conducting a required internal investigation when notified of an incident.

The first presentation of this training will be held July 18, 2025.

Register for this training at HHS Provider Joint Training Opportunities.

Register for Long-Term Care Webinars for Nurses & Nursing Facility Administrators: June 25th, 2025

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June 22nd, 2025

The Quality Monitoring Program and The University of Texas at Austin School of Nursing are offering a free webinar for nurses and nursing facility administrators.

“Diving into Enhanced Barrier Precautions for Nursing Facilities,” will be hosted by epidemiologist Annie Nutt on June 25 from noon to 1 p.m. Central time.

The webinar aims to guide and improve the care of Texas residents using evidence-based best practices.

Learning objectives will include:
• Understanding the science behind enhanced barrier precautions (EBP).
• Defining and distinguishing standard precautions, contact precautions and EBP.
• Discussing best implementation practices for EBP.

This webinar provides one continuing nurse education credit for registered nurses, certified nurse aides and licensed nursing facility administrators.

For more information, email Jacki Hecht at jhecht@nursing.utexas.edu.

To register for the webinar, click here.

TxHmL Amendment on Rates Effective Sept. 1, 2025

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June 20th, 2025

HHSC Requests Comments on TxHmL Amendment Effective Sept. 1, 2025

HHSC is accepting comments on the amendment of the 1915(c) Texas Home Living Waiver. View the TxHmL amendment details.

Through this amendment, HHSC updated the attendant rates and increased the TxHmL individual cost limit from: $17,000 to 50 percent of the annualized cost of care in an Intermediate Care Facility for Individuals with an Intellectual Disability or Related Condition (ICF/IID) using the fiscal year 2026 non-state-operated small facility daily rate for Level of Need (LON) 1, rounded to the nearest dollar which is estimated to be $31,684 pending finalization of the fiscal year 2026 rates for ICFs/IIDs.

Comments will be accepted until July 21, 2025.

Email comments to the Texas Medicaid Waivers inbox.

Hurricane Season Training & Updating Emergency Preparedness Plans

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June 1st, 2025

Hurricane Season – Ready or Not! Preparedness for HCS/TxHmL/ISS

Tuesday, June 17
10–11:30 am

Register Here

Hurricane Season – Ready or Not! Preparedness for Intermediate Care Facilities

Friday, June 20
10–11:30 a.m.

Register here

Click on the following links for more training opportunities:

Joint Training

HCSSA Training

OASIS Training

HCS and TxHmL Training

Individualized Skills and Socialization Training

May 18th, 2025

Planning For Flooding & Hurricane Season

** Please remember to address tornadoes in your emergency and evacuation planning, if they apply to your area, as they often occur during or in conjunction with Hurricane Season.  Texas has already been hit by some severe storms, large hail, and tornadoes during the past few months.  Don’t forget that May is heating up now and that severe storms and tornadoes can leave many people in Texas without electricity in incredibly hot temperatures.

See HHSC Recommendations Below:

“HHSC reminds long-term care facilities and agencies to review and update safety procedures and emergency plans for extreme weather in the 2024 hurricane season. Emergency plans for extreme weather should include the provider’s plan to address:

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

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

Facilities with generators should perform any maintenance or needed testing. This will ensure the equipment functions in case of power loss.

It is important to review building integrity and identify any areas that may need repair, reinforcement or weatherproofing. Facilities in multi-story buildings should review any other needed measures as well. They should also have a plan in place for how to move residents around or out of the building if there is a loss of power or other identified need to move to a safer location.

Facilities should contact their local HHSC Regulatory Services regional office (RO) if they are impacted by an adverse event caused by severe weather — such as flooding, power loss, etc.

This communication is especially critical if a facility is projected to exceed its licensed capacity due to accepting residents that have been evacuated from another facility. All requests to exceed licensed capacity must be made through the RO and approved by the Deputy Associate Commissioner of Survey and Compliance.

Program rules require specific staff or a designee of each program to register with the emergency communication system and respond to requests through the emergency communication system. Please refer to PL 2025-01 (PDF) for instructions and more information regarding the emergency communication system requirements.

For training opportunities related to emergency preparedness for long-term care providers visit the HHSC Provider Training webpage.

Ensure Medicaid Continues To Support Individuals With IDD

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May 31st, 2025

Please help ensure Medicaid continues to support Individuals in Texas with IDD.  More than ever, we need everyone to focus their efforts on contacting our U.S. Senate representatives.

Call Senator John Cornyn (1-202-224-2934) and Senator Ted Cruz (1-202-224-5922) to continue to ensure we have Medicaid to support programs serving individuals with IDD, as well as directly support individuals with IDD in Texas.

The ARC of TEXAS has supplied a nice script for you, or your person with a disability to contact these senate representatives and share your concerns, issues, and need for Medicaid for services:

“Hi, my name is [NAME] and I live in [CITY]. I am a [Texan with a disability / family member of someone with an intellectual or developmental disability]. Medicaid is essential for [me/my family member] to live independently and access the services we need. Without Medicaid, [I/my family member] would not be able to receive critical support such as help with daily activities, therapies, job support, and community integration. Please do not cut funding for Medicaid. It allows [me/my family member] to live in the community, access education and employment opportunities, and fully participate in society. Thank you for your time, and please support Texans with disabilities like [me/my loved one].”

Bill Creating “Building Better Futures Program” Signed Into Law By Governor Abbott

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May 30th, 2025

Governor Abbott signed House Bill 2081, officially creating the Building Better Futures program into law on May 26th, 2025.

This will be a step toward a more inclusive and accessible future for all Texans, including those with disabilities.

Rep. John Bucy III authored the bill, and it was sponsored by Senator José Menéndez.  This law takes effect immediately and establishes a grant program within the Texas Higher Education Coordinating Board (THECB) to support colleges and universities in developing and expanding Comprehensive Transition and Postsecondary (CTP) programs across the state. CTP programs provide inclusive higher education opportunities for students with intellectual and developmental disabilities (IDD), and will ensure what is hopefully equitable access to postsecondary education and career pathways.

*As of now, only four CTP programs operate in the entire state.

Now that the bill has been signed into law, the THECB is charged with implementing the program and developing rules and policies necessary to administer this program effectively.  We hope to keep you posted on developments as they occur.

Greater Inclusion of Children with Disabilities in Early Education Program-Major Bill Passes

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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.

IDD Operations Portal Enhanced View Training: May 23rd & May 28th, 2025

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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 23rd IDD Operations Portal

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

OR

Register for the May 28th 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/.

Frequently Cited Deficiencies-HCS/TxHmL/ICF

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May 20th, 2025

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

Home and Community-based Services

Texas Home Living

Intermediate Care Facilities

Texas Parks & Wildlife Explore Webinar: New Initiatives Focusing on Accessibility & Inclusivity

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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.

QR Code for Event Registration

Maintaining Records: Your Responsibility As A Provider

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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.

IDD Conferences & Conventions 2025

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May 15th, 2025

National/International Conferences & Conventions:
  • AAIDD Annual Meeting- The American Association on Intellectual and Developmental Disabilities (AAIDD) will hold its 149th annual meeting from June 23-25 in 
    Washington D.C.  This conference will focus on mentorship, access, equity, and collaboration in the IDD field.
  • Texas State Chapter of AAIDD Convention- Takes place Sept. 29th-Oct. 2nd in Corpus Christi, Tx

 

  • CR Unite Autism and IDD Care Conference-Hosted by CentralReach, this conference for therapy providers, special educators, and supported employment agencies will be held October 20-22 in 
    Chicago, IL
  • One Voice Conference: Hosted by The American Academy of Developmental Medicine and Dentistry (AADMD) will host this conference June 5-8 in 
    Phoenix, Arizona  The theme is “Rising Phoenix: A New Era in IDD Health” and will cover topics like inclusive curriculum, intersectionality, brain & behavioral health, and clinical practice.

 

  • Pacific Rim International Conference on Disability and Diversity-Celebrating its 40th anniversary, this conference will be held April 15-16 in 
    Honolulu, Hawaii
  • National Centre of Excellence in Intellectual Disability Health Conference- This conference will take place in Sydney, Australia and online, with the theme “Working together every step of the way”.

 

  • Global Disability Summit- Co-hosted by Germany, Jordan, and the International Disability Alliance (IDA), this summit took place April 2-3 in , Germany.

 

  • International Conference on Intellectual and Developmental Disabilities (ICIDD)- Organized by the World Academy of Science, Engineering and Technology, this conference will be held September 20-21 in 
    Lisbon, Portugal

    .

  • DADD Conference- The Division on Autism and Developmental Disabilities (DADD) of the Council for Exceptional Children (CEC) will hold its 26th annual international conference January 22-24 in 
    Clearwater Beach, Florida

    .

  • IASSIDD Congress- The International Association for the Scientific Study of Intellectual and Developmental Disabilities (IASSIDD) will host its congress in 
    Singapore with the theme “Person-centricity as an approach to well-being of People with Intellectual and Developmental Disabilities”.
  • National Centre of Excellence in Intellectual Disability Health Conference- This conference will be held in Sydney, Australia and online. 
Other Conferences:
  • Aging and Developmental Disabilities Conference: The 34th annual conference will be held May 12-13 in St. Louis, MO
  • Developmental Disabilities Awareness Day Conference- This conference will take place on May 20 in Niagara Falls, NY.
  • Evidence for Success Disability Conference- This conference will be held June 22-24 in Chandler, Arizona

    . 

Interagency Reportable Conduct Search Engine: Informal Comments Deadline For Draft Rules

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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.

Cost Report For 2024 & 2025 Accountability Report Training Information

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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.

Local Intellectual and Developmental Disability Authority Handbook (LIDDA) 24-4 Revision

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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.

 

12000 Protocol for Offering an HCS Crisis Diversion Slot Updates language for clarity.
12100 Purpose Updates reference to Section 12300.

Updates language for clarity.
12300 Qualifications for the HCS Reserved Capacity Group for Crisis Diversion Changes title to Criteria for Requesting an HCS Reserved Capacity Group Crisis Diversion Slot.

Changes language in first paragraph about how a person meets the criteria for the LIDDA to request an HCS Reserved Capacity Group Crisis Diversion slot.

Removes language in fourth bullet about ICF/IID LOC I criteria, replaces it with how a person meets the criteria for LIDDA priority  population per Title 26 Texas Administrative Code (TAC), Section 304.102, Diagnostic Assessment.

Updates the Note to require persons to meet the diagnostic and financial criteria specified in 26 TAC Section 263.101, Eligibility Criteria for HCS Program Services and CFC Services to enroll in HCS.

Updates language for clarity.
12400 Process Removes language about ICF/IID LOC I criteria and adds language that requires a person to meet the criteria for LIDDA priority population per 26 TAC Section 304.102, Diagnostic Assessment.

Adds information about Form 1058 and submission.

Removes requirements to submit a packet with a Determination of Intellectual Disability (DID) and Inventory for Client and Agency Planning (ICAP) booklet/scoring sheet.

Updates HCS Program TAC reference to 26 TAC Section 263.104.

Updates language for clarity.

“Caytlin Handley Act”-House Bill 1188

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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

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

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April 18th, 2025

Job Position

Lone Star HCS (Conroe, Tx)

 

 

Job Position:  Host Home/Companion Care Service Provider

Please see information below and contacts to respond.

Looking for Host Home/Companion Care provider who wants to care for 3 young men, 2 of which are fairly independent. The 3rd individual needs a bit more help with hygiene and meal preparation. The host home is located in the Woodlands, Texas area near Conroe and Houston. If you are interested in the position, please contact Rhonda Wilson for more details.

Note: You would not be using your own home. The home would be provided by one of the individual’s family members, for the host home/companion care provider to rent along with the individuals they are caring for.

 

Rhonda Wilson (Program Director/Provider Coordinator)

rhonda.wilson@lonestarhcs.org

936-777-2028 (Phone)  936-228-7641 (Fax)

 

March 1st, 2025

The Harris Center for Mental Health and IDD

Job Position Now Available: Program Director V, Residential & Day Services.

Please see information about the position below.  We have also provided a link you may click on to apply.

**Note, this position is on page 2. 

The Harris Center is now accepting candidates and will begin scheduling interviews this week. If you know any interested parties, please feel free to share.

I believe this position will be with their internal ICF/IID program

Apply Here

 

 

Based on the many phone calls, emails, and contacts through our social media pages concerning employment needs and job openings in the HCS/ICF/ISS programs, we will continue to use our “Updates” page as a platform to assist providers in posting these openings and opportunities.

If you contact Meghan Jones at meghanjones.tx@gmail.com and let her know where you are posting a position and who to contact, we can also just put a link and the contact person’s name, # and/or email for free at no cost.  For example, you are posting on Indeed, Linkedin, BenefitMall, Facebook, PACSTX job postings, an online newspaper, etc… If you would like to post an opening with a complete job description (or longer than a few paragraphs), the cost is $15 for a one-time fee. We will continue to run this post until you notify us otherwise.  All current updates are also noted in our bi-weekly newsletter.

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

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

Julie Blacklock/ Owner

Texas Council on Developmental Disabilities News This Week

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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

April 11, 2025

HB 1936 would strengthen the enforcement of accessible parking violations. It was authored by Rep. David Cook.

Read More »

 

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

Updates on Budget Proposals For IDD Services

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April 10th, 2025

Resource Links: 

Consideration of the budget as well as HB 500, the supplemental budget, by the House will occur today at 9:00am, Thursday, April 10th.

HB 500 (supplemental):  https://www.capitol.state.tx.us/tlodocs/89R/billtext/pdf/HB00500H.pdf#navpanes=0

 

House Rules Adopted related to Consideration of the Budget:  To view the rules adopted by the House on April 2, 2025 related to consideration of the budget (SB 1), see pages 2 – 4 at the following link:

https://journals.house.texas.gov/hjrnl/89r/pdf/89RDAY37FINAL.PDF#page=2

 

Link to Watch Today’s Debate:  Though the House proceedings on the budget and HB 500 will make for a long day, interested persons may view at:   https://house.texas.gov/videos

Representative Donna Howard’s Proposed Accountability Amendment to Rider 23:

This amendment adds the provision below to Rider 23 which parallels the same provision in the Senate Rider.  However, unlike the Senate Rider 23 which requires HHSC to create list of providers whose calculated direct care staff wage and benefits expense ratio is less than 0.95 and submit to certain legislative offices, Howard’s amendment sets it at less than 0.90.

(c) Out of funds appropriated in Strategy B.1.1, Medicaid & CHIP Contracts and Administration, HHSC shall continue to collect biennial cost reports from providers to monitor the average hourly wage and associated payroll costs, taxes, and benefits.

HHSC shall calculate for each provider the total amount that was paid to the provider that is attributable to the direct care wages, payroll costs, taxes, and benefits, the amount expended by the provider for that purpose, and the ratio of expenses to revenue to determine a direct care wage and benefits expense ratio. HHSC shall report to the Legislative Budget Board, the Lieutenant Governor, the Speaker of the House of Representatives, and the Office of the Governor on an annual basis by November 1 of each year on the findings, including a list of providers whose calculated direct care staff wage and benefits expense ratio is less than 0.90.

Gofundme Fundraiser Link For Our Friend Marie “Lynn” Palmares

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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

Previous Temporary Exception Now A Permanent Policy Change in HCS/TxHmL For Respite and CFC PAS/HAB

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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.

Overview Presentation of Specialized Telecommunications Assistance Program (STAP) For Deaf and Hard of Hearing

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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

 

HCS/TxHmL Providers & FMSAs: Technical Assistance Session For TMHP on April 2025

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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.

Employability Status Check Changes For All LTCR Providers

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March 12th, 2026

Employability Status Checks:  March 2026 Update

HHSC LTCR Publishes Provider Letter 2026-03: Employability Status Checks

LTCR has published PL 2026-03 regarding Employability Status Checks.

This provider letter provides guidance to Assisted Living Facilities (ALF), Day Activity Health Services (DAHS), DAHS- Individualized Skills and Socialization, Home and Community-Based Services (HCS), Home and Community Support Services Agencies (HCSSA), Intermediate Care Facilities (ICF), Nursing Facilities (NF), Prescribed Pediatric Extended Care Centers (PPECC), and Texas Home Living (TxHmL) facilities. The letter notifies providers about the transition of Employability Status Check searches to the Texas Unified Licensure Information Portal (TULIP) and provides instructions to conduct Employee Misconduct Registry (EMR) and Nurse Aide Registry (NAR) searches.

For questions contact LTCRPolicy@hhs.texas.gov.

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.

Documentary “Into the Spotlight” Released To The General Public

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February 27th, 2025

 Into the Spotlight has been released to the general public, as of February 21, 2025.
You can find it on YouTube Movies, Google Play, Apple TV and through other streaming and on-demand services.
This documentary follows a group of Dallas area theatre performers with intellectual and developmental disabilities and their amazing director who are part of the “Spotlight” program. They wrote, developed, and performed their own play. This program Spotlight Academy of The Arts, still continues today and it is sponsored by Highland Park United Methodist Church of Dallas through their Belong Ministry.  This is a must-see documentary and I was lucky enough to have seen it this past year at the AAIDD Texas Chapter Convention.
Here’s the link to the official trailer.  Into The Spotlight
Enjoy!

Utilization Review Department News!

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February 20th, 2025

HHSC Publishes Information on Waiver and Community Services Utilization Review Process

HHSC has published Information Letter 2025-02 Waiver and Community Services Utilization Review Process.

This letter provides a summary of the authority for conducting field utilization reviews in the Community Living Assistance and Support Services (CLASS), Deaf Blind with Multiple Disabilities (DBMD), Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Programs.

There is also a link included in the letter, to the document that describes the Waiver and Community Services Utilization Review Process.

You can also click on the link to the summary of this field UR Review process here:  https://www.hhs.texas.gov/sites/default/files/documents/field-ur.pdf

April 30th, 2020
Last Friday HHSC posted the following CARE banner:  Due to the 09/01/2019 HCS rate increase, service authorizations are being updated to ensure they are in line with their corresponding IPCs. This will not cause any payment changes.
Upon inquiry as to what this meant, Holly Lindsey, UR, HHSC provided the explanation below.  Hopefully the explanation and guidance will be of assistance to you should an action (revision, renewal or transfer) be taken on an IPC which prompts a notice that the IPC exceeds the cost cap.
Message from Holly Lindsey:  Since the effective dates of the rate increases, providers have been paid at the appropriate rate for the corresponding service. However, the C62 and C72 screens do not update until a provider takes an action on the IPC that was effected. This can be a revision, a renewal, or a transfer. That is why providers are suddenly seeing “Exceeds” messages in CARE for the same services that were under the 100% capitation rate ($83,734) previously. The services cost more so the total cost is higher. This actually occurred months ago with the rate increase, however, it takes an action on the IPC for it to update.
Any IPC that is over the $83,734 level requires a packet to be submitted (TAC 9.160(d). However, since we are removing flags to allow for billing during COVID, it is not necessary to send a packet at this time. The next time an action is taken on the IPC, however, an “Exceeds” message will occur again, and CARE will prompt them to send a packet.
Removing the flag is currently a manual process, so providers can contact me (Holly Lindsey) directly through this email for flags related to cost.
Note from Twogether Consulting: If you have tried to enter a renewal on an IPC or IDRC into CARE and you are having problems, remember that IPC’s and IDRC’s are automatically renewed through April 30th, 2020.
For Assistance with either issue:
They can call the main UR # 512-438-5055 or
Holly Lindsey:  512-438-5704;  holly.lindsey@hhsc.state.tx.us

Employment Readiness Rates

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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

Letter To The Providers From Twogether Consulting: February 15th, 2025

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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.

 Please feel free to e-mail us or contact Meghan Jones to schedule an appointment for consultation.  We have consultants available to provide consultation for HCS, TxHmL, ICF, (some CLASS as well) and we also provide some consultation for AMH-HCBS and YES Waiver.  Please contact us directly for your care coordination, QIDP, and nursing needs at info@twogetherconsulting.com or you may contact our assistant Meghan Jones at meghanjones.tx@gmail.com
We are happy to say that we will continue to provide whatever assistance we can with questions you may have, especially concerning HCS/TxHmL Care Coordination, Nursing, or general survey requirements from LTCR department in these programs.  We continue to assist those working with the ICF/IID program as well. We are currently providing on-site live training at this time and live training is open to the public as well.
FYI-We do still provide “mentoring” assistance for program managers, case managers, and especially for nurses.  We continue to provide nursing trainings and we can refer you out to our partner RN consultants, Nursing Innovations, who provide IDD nursing consultation, mentoring and/or training for HCS, TxHmL and ICF.  If you have new staff or nurses who need training quicker than classes posted on the calendar, please let me know and we do offer some of our previously recorded sessions for a low cost which includes the handouts.   We are happy to schedule one-on-one training sessions and mentoring with one of our consultants.  We can also refer you to another resource, if more appropriate.  Twogether Consulting also continues to provide assistance with applying to become an HCS/TxHmL waiver provider and we can assist with applying to become an AMH-HCBS or YES Waiver provider.
For HCS Providers who want to purchase specific services and/or specific forms we have on our website, may go to the following link “purchase services” page. If you are having issues downloading forms, please feel free to contact us at info@twogetherconsulting.com and I will be happy to send them to you.
Thank you,
Julie Blacklock/ Owner & IDD Waiver Consultant

Medical Care Advisory Committee (MCAC) met Thursday, February 13, 2025

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February 15th, 2025

The Medical Care Advisory Committee (MCAC) met Thursday, February 13, 2025.  The following items of interest were on the agenda.
These items were:
~  Status of Medicaid Eligibility Unwinding
~   Discussion on CMS’ guidance regarding ensuring continuity of coverage for individuals receiving Home and Community-based Services
~  Employment Readiness (new service as result of HB 4169 (Price, 88 R).  View HB 4169 at:  https://www.capitol.state.tx.us/tlodocs/88R/billtext/pdf/HB04169F.pdf#navpanes=0
The committee received oral and written testimony on these topics above and other items on the agenda.
Twogether Consulting would like to thank all who provided oral and written testimony this past Thursday.  I know that many of you took time off your busy schedules to come down to the capitol in Austin for this testimony and some of you had extremely long wait times to provide testimonials.  
Link to view the agenda.
https://www.hhs.texas.gov/about/communications-events/meetings-events/2025/02/13/medical-care-advisory-committee-mcac-agenda

Spotlight Musical Theater Presentation in Dallas February 22nd, 2025

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February 14th, 2025

Belong Disability Ministry celebrates 15 years of Spotlight Musical Theater with a new production, “I’m on My Way” on Saturday, February 22 from 5:00 – 7:00pm at Highland Park United Methodist Church. This comedic, yet touching musical shares captivating stories of what it’s like to live with a disability through a series of DART rides. Join us in a theatrical display that features real-world scenarios, upbeat original music, and a journey in finding courage during the tough times of life. Purchase tickets HERE.  For more about Spotlight Theater, please click on this Youtube link, for a newscast story about their documentary:  https://www.youtube.com/watch?v=tf4lAoBuhNY

 

5-Year Children’s Behavioral Health Strategic Plan

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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.

HHSC Publishes PL 2025-01: New Emergency Communication Tool For Long-Term Care Providers-AlertMedia

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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.

Letter To The Providers From Twogether Consulting: January 16th, 2025

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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.

 Please feel free to e-mail us or contact Meghan Jones to schedule an appointment for consultation.  We have consultants available to provide consultation for HCS, TxHmL, ICF, (some CLASS as well) and we also provide some consultation for AMH-HCBS and YES Waiver.  Please contact us directly for your care coordination, QIDP, and nursing needs at info@twogetherconsulting.com or you may contact our assistant Meghan Jones at meghanjones.tx@gmail.com
We are happy to say that we will continue to provide whatever assistance we can with questions you may have, especially concerning HCS/TxHmL Care Coordination, Nursing, or general survey requirements from LTCR department in these programs.  We continue to assist those working with the ICF/IID program as well. We are currently providing on-site live training at this time and live training is open to the public as well.
FYI-We do still provide “mentoring” assistance for program managers, case managers, and especially for nurses.  We continue to provide nursing trainings and we can refer you out to our partner RN consultants, Nursing Innovations, who provide IDD nursing consultation, mentoring and/or training for HCS, TxHmL and ICF.  If you have new staff or nurses who need training quicker than classes posted on the calendar, please let me know and we do offer some of our previously recorded sessions for a low cost which includes the handouts.   We are happy to schedule one-on-one training sessions and mentoring with one of our consultants.  We can also refer you to another resource, if more appropriate.  Twogether Consulting also continues to provide assistance with applying to become an HCS/TxHmL waiver provider and we can assist with applying to become an AMH-HCBS or YES Waiver provider.
For HCS Providers who want to purchase specific services and/or specific forms we have on our website, may go to the following link “purchase services” page. If you are having issues downloading forms, please feel free to contact us at info@twogetherconsulting.com and I will be happy to send them to you.
Thank you,
Julie Blacklock/ Owner & IDD Waiver Consultant

Letter To Providers From Twogether Consulting-January 7th, 2025

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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.

 Please feel free to e-mail us or contact Meghan Jones to schedule an appointment for consultation.  Please contact us directly for your care coordination, QIDP, and nursing needs at info@twogetherconsulting.com or you may contact our assistant Meghan Jones at meghanjones.tx@gmail.com
We are happy to say that we will continue to provide whatever assistance we can with questions you may have, especially concerning HCS/TxHmL Care Coordination, Nursing, or general survey requirements from LTCR department in these programs.  We continue to assist those working with the ICF/IID program as well. We are currently providing on-site live training at this time and live training is open to the public as well.
FYI-We do still provide “mentoring” assistance for program managers, case managers, and especially for nurses.  We continue to provide nursing trainings and we can refer you out to our partner RN consultants, Nursing Innovations, who provide IDD nursing consultation, mentoring and/or training for HCS, TxHmL and ICF.  If you have new staff or nurses who need training quicker than classes posted on the calendar, please let me know and we do offer some of our previously recorded sessions for a low cost which includes the handouts.   We are happy to schedule one-on-one training sessions and mentoring with one of our consultants.  We can also refer you to another resource, if more appropriate.
For HCS Providers who want to purchase specific services and/or specific forms we have on our website, may go to the following link “purchase services” page. If you are having issues downloading forms, please feel free to contact us at info@twogetherconsulting.com and I will be happy to send them to you.
Thank you,
Julie Blacklock/ Owner & IDD Waiver Consultant

Promoting Independence Plan: 2024 Report

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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

ISS (Individual Socialized Services) FAQ’s

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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

 

Question 1: May an Individualized Skills and Socialization (ISS) provider charge families for after-hour care?  Many times families cannot get off work at the time the program closes/services stop.  Some providers will keep their doors open until 5 or 6 (with staff present of course), until families get off work.  In these cases, the ISS providers charge families for that service.

HHSC’s Response: If the individualized skills and socialization provider is also the program provider, the program provider would not be allowed to charge additional fees outside of the established HCS Waiver Program Payment rates, located here. According to 40 TAC §9.178(o):

(o) The program provider must not assess charges against the individual’s personal funds for costs for items or services reimbursed through the HCS Program or through CFC.

 

Additionally, according to 26 TAC §263.2015:

The service limit for the combined total of on-site, off-site, and in-home individualized skills and socialization is:

  (1) 1560 hours during an IPC year;

  (2) six hours per calendar day; and

  (3) five days per calendar week.

 

If the individualized skills and socialization provider is a contractor of the program provider, the provider’s costs must be considered reasonable and necessary in regard to the Medicaid cost/accountability reports. Unless the program provider agrees to pay a higher amount, the individualized skills and socialization provider must provide the service at or below the direct services portion of the applicable HCS Program rate.

According to 40 TAC §9.177(b):

(b) The program provider must employ or contract with a person or entity of the individual’s or LAR’s choice in accordance with this subsection.

  (1) Except as provided by paragraph (2) of this subsection, the program provider must employ or contract with a person or entity of the individual’s or LAR’s choice to provide an HCS Program service or CFC service to the individual if that person or entity:

    (A) is qualified to provide the service;

    (B) unless the program provider agrees to pay a higher amount, provides the service at or below:

      (i) for any service except CFC ERS, the direct services portion of the applicable HCS Program rate; and

      (ii) for CFC ERS, the reimbursement rate; and

    (C) is willing to contract with or be employed by the program provider to provide the service in accordance with this subchapter.

As part of agreeing to provide the HCS Program service at the direct services portion of the applicable HCS Program rate, the individualized skills and socialization provider would not be allowed to charge an individual or family additional charges outside what is reimbursed through the HCS Program.  (This means, the provider can pay all of the direct and indirect portions of the rate to the ISS provider if they want to or more, but they don’t have to pay more than the direct portion of the rate if they don’t want to.  Many HCS/TxHmL providers choose to pay all of the rate amount, the direct and indirect side both, but most likely are not paying more than the total rate as this would not be feasible or affordable for many HCS providers.)

 

Question 2: According to the rules, a person may receive in-home ISS assuming certain criteria are met/justifications secured.  Provision of the service does not require a license.  If the person wants to also engage in off-site activities, such must be provided by a licensed ISS.  In these cases,

~Can (as an example) the HH provider obtain a license for off-site only and provide the service as long as the HH provider was not the person delivering the service?

HHSC’s Response: In accordance with the HCS Billing Requirements, Section 43102.7 a host home/companion care provider is prohibited from being the service provider of in-home individualized skills and socialization. There is no prohibition on the host home/companion care provider being a service provider of on-site or off-site individualized skills and socialization but those services cannot be provided in the individual’s residence. The host home/companion care provider would need to either be employed by an individualized skills and socialization provider or obtain an individualized skills and socialization license.

~  Can the individual (again one who has a justification for in-home ISS) attend an ISS just to participate in off-site ISS only, or must that service be provided in an off-site only licensed ISS ?

HHSC’s Response: Yes, an individual who has a justification to receive in-home individualized skills and socialization may choose to also receive off-site individualized skills and socialization at a facility that provides both on-site and off-site individualized skills and socialization. It is not required that they receive off-site through an off-site only licensed individualized skills and socialization facility.

~  Can the program provider for an individual obtain an off-site only ISS license so the individual can participate in off-site ISS activities as long as the service provider of such is not the HH provider?  And if so, could the person providing the in-home ISS work for or contract with the provider to provide off-site ISS to the individual?

HHSC’s Response: Yes, a program provider may become a licensed off-site only individualized skills and socialization provider so that an individual can participate in off-site individualized skills and socialization activities. The service provider providing in-home individualized skills and socialization would be allowed to become an employee or contractor of the program provider owned off-site only individualized skills and socialization provider, as long as they met all other service provider requirements outlined in program rule and in the HCS Program Billing Requirements.

 

Question 3: Concerning ISS notes, it’s been reported by some providers that some HHSC or TMHP reviewers have told them that the ISS notes cannot be handwritten rather must be electronic.  Is that true?  And if so, where is that stated?

HHSC’s Response: There is no requirement that service delivery logs for on-site, off-site, or in-home individualized skills and socialization must be electronic over handwritten. HCS Policy does not specify the modality of service delivery log notes, only that the written documentation must be legible. According to Section 3810 of the HCS Billing Requirements:

3810 General Requirements

Revision 23-2; Effective April 1, 2023

(a)        Legible A program provider must have written, legible documentation to support a service claim.

 

January 13th, 2023

ISS FAQs:  Updated January 13th, 2023

HHSC posted updated FAQs for the new service. Read the FAQ here.
If the above link does not work, the FAQs may be accessed at:  https://www.hhs.texas.gov/sites/default/files/documents/individualized-skills-and-socialization-faq.pdf

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

Reminder: Revalidation Period Extension Through May 31st, 2025

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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.

New Review Process regarding Critical Incident Reports

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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!

These changes will entail a review of the critical incidents submitted by providers by the LTCR Regional Offsite Review (ROR) Team. The ROR Team is tasked with ensuring resolution of critical incidents reported into CIMS are effective to prevent future similar incidents to the extent possible.
HHSC has provided a high level overview of the new process and related provider responsibilities.  One item of interest pertained to HHSC’s statement that providers would have 24 hours to produce any supporting documents requested by the ROR Team.  Providers expressed concerns about the short time frame requesting HHSC consider allowing additional time.  HHSC has stated that providers will be able to request reasonable extensions.
As a reminder, there is a December 23, 2024 webinar on the new process and its plans to publish a Provider Letter and FAQ.  Further details are provided below.
PL 2024-22:  The attached Provider Letter was shared with HHSC IDD Coordination Workgroup members earlier today and will be posted and distributed by HHSC in the next few days.
FAQ:   HHSC stated it was working on the FAQ’s
December Webinar:  See registration information below.  While HHSC urges HCS and TxHmL providers to participate in the Dec. 23rd webinar, it will host another webinar on January 15, 2025 at 2:00 p.m.  Registration information for the January webinar will be posted soon.

Long-Term Care Regulation staff and program providers are invited to attend the Regional Offsite Review Process for Critical Incidents Reported into the Critical Incident Management System for HCS/TxHmL training webinar.

Regional Offsite Review Process for Critical Incidents Reported into the Critical Incident Management System for HCS/TxHmL
Monday, Dec. 23
10–11 a.m.
Register for the webinar.

Deadline For Stakeholder Comments For Proposed HCS and TxHmL Billing Requirements-Dec. 16th, 2024

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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

TxHmL

Email stakeholder comments to TxHmL Policy.

HHSC Retraction To Be Posted Concerning: TMHP LMS Knowledge Management Bulletin on Surety Bond

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December 13th, 2024

Subject: TMHP LMS Knowledge Management Bulletin

HHSC has stated that an email was sent in error and that a retraction notice will be published concerning Surety Bond Requirements.  This is not a requirement for HCS providers for those of you asking. 

 

Here is what the message sent out stated:

“You have been enrolled and must complete KMB OCM 8383761 Surety Bond PDC60 Batch Process Removal 12/13/2024.”

Course Instructions:

1. Open a Microsoft Edge browser and log into the Learning Management System at https://learn.tmhp.com/.

2. Click the Plan icon in the navigation bar to view the training.

3. Select KMB OCM 8383761 Surety Bond PDC60 Batch Process Removal 12/13/2024 and complete the training.

Employment Assistance & Supported Employment Training Options From HHSC

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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.

Register Now

 

November 11th, 2024

The Texas Health and Human Services Commission (HHSC) is pleased to host a free in-person Employment First / Employment Services training on December 2, 2024 at the HHSC North Austin Complex (NAC), 4601 W. Guadalupe Street, Austin, Texas 78751, Rooms 1.401–1.404.

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

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.

Register Now

June 28th, 2021

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

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

Each training has a corresponding quiz.

 

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

“Embracing Change To Enhance Value”-2024 Conference for ICF Surveyors and Providers- Dec. 5th, 2025

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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

Comments on Proposed Rule Changes for HCS & TxHmL Have Ended

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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. 

Adverse Childhood Experiences (ACES) and Trauma Informed Care (TIC) Conference Online-12/05/24

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November 16th, 2024

 

From HHSC Weekly Digest Bulletin:

Adverse Childhood Experiences (ACES) and Trauma Informed Care (TIC) Conference Online, December 5, 2024
CPSO CS ACEs & TIC Conference 2024 - Poster

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
Register Now

TMHP: Important Reminder Concerning Client Movement Forms

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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.

Webinars & CBT’s Available For LTC Providers (HCS/TxHmL) on TMHP Learning Management System

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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.

IPC Revisions to Add ISS/Renewal & IPC Revisions/Enrollment & Transfer IPC’s

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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.

Assistance With Eligibility Issues Due To The End of Continuous Medicaid Coverage

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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

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 18th 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.

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

 

Email Addresses for Rachel Patton and Melissa Panzarella:
Rachel.Patton@hhs.texas.gov
Melissa.Panzarella@hhs.texas.gov

 

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

Save the Date: Annual Intermediate Care Facility Conference Webinar Dec. 5

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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.

 

Don’t Forget Annual Vendor Submission Due (Nov.1st-Jan31st) HCS/TxHmL!

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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.

Time To Vote: Ensure Your Individuals Are Educated and Have The Opportunity To Vote

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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
Absentee ballot deadlines
Voting deadlines
Important Action You Can Take With Your Individuals

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

HHSC Moves News and Information and Provider Letter Content

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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.

Annual EVV Policy Training Webinars for CDS Employers

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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.

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.

Resources for IDD Providers: Organizations & Associations

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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

Office of Inspector General (OIG) Recommends Updating ER/Evac Plans

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October 12th, 2024

From OIG: Update emergency plans

Providers should take stock of emergency preparations, acknowledging that a disaster is best prepared for well ahead of time. In Texas, long-term care facilities, including assisted living, nursing and intermediate care facilities, hospices and group homes, are responsible for maintaining emergency response plans for the residents in their care.

To verify that providers comply with federal and state requirements, OIG inspectors can review these facilities’ response plans, equipment and staff training. Most facilities were prepared during the most recent inspections, but inspectors found a few common errors. Specifically:

  • Not documenting initial employee training on emergency preparedness.
  • Not ensuring the emergency preparedness plan identifies how alternate energy sources should be used to maintain the power needs of key systems.
  • Failing to maintain a printed copy of the current emergency preparedness plan at each workstation assigned to a personnel supervisor who had responsibilities under the plan.
  • Failing to document the required contact information for the state licensing and certification agency in its communication plan.
  • Not sharing the emergency preparedness and response plan with residents and residents’ legally authorized representatives.
  • Failing to request an annual fire marshal inspection.

Emergency preparedness is vital for care facility residents’ ongoing health and safety during local incidents, like power outages or widespread natural disasters. Providers can find helpful preparedness resources at the DSHS Texas Ready website, including sample plans, disaster supply checklists and more information on preparing for hurricanes and other emergencies.

Preparing for a disaster includes planning for evacuation, transportation, communication, staff responsibilities and continuing resident care and treatment. In an emergency, providers can visit Texas HHS Disaster Services for up-to-date regulatory support for health care facilities, long-term care facilities and special waivers for Medicaid providers and clients as needed.