October 15th, 2023

October 17th, 2023

COVID-19 Resources

COVID-19 Quick Reference (New Guidance)

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

July 11th, 2022

July 7, 2022 MCS COVID-19 Stakeholder Information Session

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

The audio from this session can be found here.

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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

May 8th, 2022

May 5, 2022 MCS COVID-19 Stakeholder Information Session

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

The audio from this session can be found here.

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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

April 10th, 2022

April 7, 2022 MCS COVID-19 Stakeholder Information Session

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

The audio from this session can be found here.

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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

January 9th, 2022

January 6, 2022 MCS COVID-19 Stakeholder Information Session

The audio from this session can be found here.

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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

December 30, 2021

COVID-19 Cases Rise – Guidance for LTC Providers

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

Please review the following guidelines and rules:

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

Find COVID-19 resources on:

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

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

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

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

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

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

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

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

December 30th, 2021

Dec. 13 ICF COVID-19 Webinar Recording Available

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

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

Listen to the webinar recording here.

Email LTCR Policy for the transcript.

December 29th, 2021

COVID RESOURCES FOR HCS/TXHML

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

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

Additional Guidance and Resources

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

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

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

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

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

Resources

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

November 5th, 2021

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

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

The audio from this session can be found here.

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

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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

September 15th, 2021

Oct. 4 ICF COVID-19 Webinar with HHSC LTCR

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

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

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

September 15th, 2021

Sept. 13 ICF COVID-19 Webinar Recording Available

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

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

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

August 30th, 2021

LTC Providers May Request COVID-19 Emergency Support

For Emergency Staffing Support:

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

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

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

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

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

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

The emergency plan must include:

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

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

Long-term care providers can request:

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

To Request Support:

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

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

HHSC LTCR staff may request supporting documentation to verify need.

August 15th, 2021

LTC Provider COVID-19 Resource Contacts Have Changed

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

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

LTC providers can now order COVID-19 therapeutics directly.

July 18th, 2021

August 2 ICF COVID-19 Webinar with HHSC LTCR

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

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

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

July 16th, 2021

July 6 ICF COVID-19 Webinar Recording Available

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

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

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

May 12th, 2021

Quality In LTC Conference Online

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

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

From HHSC May Newsletter

COVID-19 updated resources, see link below:

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

May 6th, 2021

APR 29 MCS COVID-19 Stakeholder Update

The audio from this session can be found here.

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

April 17th, 2021

March 18, 2021 MCS COVID-19 Stakeholder Information Session

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

The audio from this session can be found here.

• Email us for transcript

The presentation can be found here.

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

COVID-19 Provider Information

COVID-19 Client Information

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

April 17th, 2021

Reminder: Providers Can Request Free COVID-19 Testing Kits

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

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

March 28th, 2021

Free BinaxNOW COVID-19 POC Tests Available for LTC Providers

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

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

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

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

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

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

March 22 ICF COVID-19 Webinar with HHSC LTCR

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

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

ICF Provider Webinar

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

Helpful Vaccination Information

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

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

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

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

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

CDC   Coronavirus Disease 2019 (COVID-19)

Resources For Posters For The Facility For Staff & Individuals

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

AADMD Webinar Series to Return in January 2021

https://open.texas.gov/

HHSC COVID-19 Provider Information

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

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

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

The webinar will review the November 2020 updates.

Long-term Care Facility Webinar

November 24, 2020

10:00 – 10:45 a.m. CST

See Recording below

Register for the Webinar.

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

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

View the video training.

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

ANCOR’s COVID-19 Resource Center

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

CDC information for persons with IDD

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

Resources from HRS

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

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

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

December 22, 2020

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

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

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

Risk/Benefit Return to Activity Form

September 29th, 2023

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

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

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

DH & ISS Billing

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

Units:

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

· ISS is an hourly unit with a maximum of 1560

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

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

Prorating instructions:

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

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

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

Other areas discussed were:

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

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

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

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

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

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

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

January 28th, 2023

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

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

Click on link below for full report

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

Highlights from Vol. 17

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

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

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

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

In addition:

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

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

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

Approved 3rd party biller list

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

January 15th, 2023

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

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

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

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

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

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

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

· IMTs field 18: Location Code

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

· IMT LA Reassignment field 111: New Location Code

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

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

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

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

January 12th, 2023

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

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

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

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

December 16th, 2022

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

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

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

November 20th, 2022

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

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

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

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

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

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

October 17th, 2022

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

October 7th, 2022

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

September 11th, 2022

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

-Termination Forms Submitted by LIDDAs

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

Read more on the following items:

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

–Using the “Resubmit to SAS” Button

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

August 31st, 2022

Migration Trending Issue Support Vol 7:  

August 16th, 2022

HCS and TxHmL Waiver Programs:  Trending Issue Support Volume 6

–Individual’s residential address in Individual Search

–“Pending LA Review” status and action needed

–Using the correct IMT Form to update the service coordinator (SC)

–HCS and TxHmL call queue

For  info on these trending issues see the following link:

https://www.tmhp.com/news/2022-08-16-hcs-and-txhml-waiver-programs-trending-issue-support-volume-6

August 13th, 2022

HCS and TxHmL Waiver Programs: Trending Issue Support  Volume 5

Since May 2, 2022, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers, local intellectual and developmental disability authorities (LIDDAs), and financial management services agencies (FMSAs) that bill on behalf of consumer-directed services (CDS) have been submitting claims and forms to Texas Medicaid & Healthcare Partnership (TMHP). TMHP has received feedback from providers indicating that additional support is required.

Here are the latest resolutions to trending issues below:

HCS and TxHmL Call Queue

Status:  When contacting TMHP, providers need to select option 1 then option 7 to enter the HCS and TxHmL Waiver Programs queue.  The full number is 800-626-4117, Option 1, then Option 7.

Location Code Issue

Resolution:  LIDDAs submitting Individual Plan of Care (IPC) transfers for clients were receiving incorrect location codes. This issue has been resolved. Providers that received an incorrect location code need to resubmit the IPC transfer.

See previous Volumes and info below:

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 4

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 3

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 2

HCS and TxHmL Waiver Programs: Trending Issue Support

Important Claims Submission Information for HCS and TxHmL Programs

LTC Online Portal Dashboard Accessibility Issue Resolved

IPC Forms 3608 and 8582 Issue Resolved

HCS and TxHmL FAQ Updates Available May 9, 2022, and May 23, 2022

Individual Plan of Care (IPC) Training Materials for HCS and TxHmL Waiver Programs

Now Available: HCS and TxHmL Programs Forms and Claims Submissions to TMHP

EVV Updates for the HCS and TxHmL Transition to TMHP for Claims Submission

September 28th, 2023

September 28th, 2023

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

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

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

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

September 4th, 2023

September 5th, 2023

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

Here are some of the improvements:

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

B.TMHP is adding direct transfers where applicable.

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

LONG Term Care 800-626-4117

Option 1 LTC Customer Service

Option 2 LTC Nurse

Option 3 EDI

Option 4 EVV

Option 5 Fair Hearing (Providers only)

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

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

Sub-Option 1 HCS/TxHmL Forms and Claims Inquiries

Sub-Option 2 MN

Sub-Option 3 Claims

Sub-Option 4 All Other Forms

Sub-Option 5 All Other Inquiries

August 24th, 2023

August 24th, 2023

August 16th, 2023

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

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

August 23rd, 2023

Person-Centered Training Opportunities

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

Staff Member and Service Provider Requirements

The session is a $275 per person.

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

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

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

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

HHSC Person-Centered Planning/Practice Training Information

What Training Is Required?

Online Introductory Course

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

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

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

Person-Centered Thinking Classroom Course

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

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

HHS Approved Full Training

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

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

Get Your Promotions for Becoming A New ADP Client:

 – 1st  3 months free 

 – Other Discounts Available!

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

August 21st, 2023

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

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

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

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

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

November 15th, 2021

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

WorldMarket Platform Overview-Youtube video

1099 Solutions

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

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

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

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

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

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

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

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

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

WorldMarket At A Glance PDF

September 13th, 2021

Attention:

Employees Returning From COVID-19

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

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

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

Click here for ADP’s COVID-19 Resource Center

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

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

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

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

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

August 16th, 2023

August 15th, 2023

Remediation & Validation Process

August, 15th, 2023

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

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

July 31st, 2023

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

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

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

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

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

For example:

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

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

July 25th, 2023

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

• HHSC Caregiver Webinar Series Starts August 16

July 6th, 2023

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

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

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

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

Cost:  $75

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

June 20th, 2023

June 26th, 2023

EVV Policies

Policy Handbook

• EVV Policy Handbook

Policy Handbook Revision Log

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

July 25th, 2023

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

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

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

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

June 19th, 2023

June 15th, 2023

New Portal Enhancement Training Information:

More Info and Registration

From the TMHP website:

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

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

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

For HCS and TxHmL Providers Webinar

Select one of the following dates to register:

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

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

Note: The webinars will not provide billing training.

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

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

June 14th, 2023

New!

May 13th, 2023

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

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

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

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

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

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

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

Download These Fact Sheets:

mySchedules

Integrating mySchedules with Kronos and Other Time and Attendance Systems

Client Scheduling

Integrating Maps and Mileage into Scheduling

Encouraging Employees to Request Extra Hours

UPCOMING EVENTS & WEBINARS

Managing Group Homes? Calculate Your Payroll Savings Opportunities

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

Use this spreadsheet to estimate your potential savings.

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

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

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

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

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

June 5th, 2023

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

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

June 5th, 2023

Just A Reminder About Consent For Synchronous Audio-Visual Technology

Revision 22-3; Effective Oct. 19, 2022

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

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

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

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

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

May 28th, 2023

When to Call the IDD Ombudsman

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

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

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

                                                                                                                  OR

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

Online: Submit your question or complaint online

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

Fax: 888-780-8099

.

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

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

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

Or click on the links below to download a copy

Resources for people with intellectual or developmental disabilities:

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

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

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

May 27th, 2023

 Attestation and Initial & Final Reports

May 10th, 2023

 

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

Wednesday, May 24, 1-2 pm EDT

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

Register Today

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

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

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

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

Presenters

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

May 15th, 2023

From HHSC

Resources on Aging

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

May 15th, 2023

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

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

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

HHSC does not play a role in the hiring process.

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

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

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

May 15th, 2023

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

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

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

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

Email questions to: update@hhs.texas.gov

May 14th, 2023

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

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

May 14th, 2023

May 14th, 2023

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

View the full alert here.

May 13th, 2023

Community Attendants & Direct Care/Support Workers:

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

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

Please take time to call:

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

 HCS and ICF/IID providers who attended the webinar from HHSC on 1/19/22.

• Recently HHSC re-issued and, in some cases, issued updated policies and guidance for all IDD COVID-related documents.(1/5/22 and 1/7/22 for HCS concerning guidance booklet updates).
• HHSC is working to reorganize the COVID-related information, including COVID flexibilities and Appendix K waivers, on the ICF/IID and HCS home webpages to facilitate ease in access. 
• HHSC did communicate the above and other changes and policy clarifications with providers via a webinar on January 19th, 2022, however many questions were still unanswered and attendees were told that questions that were not answered should be addressed in an FAQ from HHSC within 2 weeks of the webinar.

May 12th, 2023

Important Reminder:  Denial of Medicaid Eligibility

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

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

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

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

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

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

May 2nd, 2023

Infection Control Resources from HHSC

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

Resources Created by HHSC

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

Center for Disease Control and Prevention (CDC)

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

Statewide Program for Infection Control & Epidemiology (SPICE)

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

World Health Organization

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

Agency For Healthcare Research & Quality

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

National Association of County & City Health Officials  (NACCHO)

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

April 27th, 2023

In addition, see following webinar with handout

April 14th, 2023

April 12, 2023 town hall meeting

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

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

PDF handout

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

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

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

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

2022 Cost Reporting:

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

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

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

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

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

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

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

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

ISS Units

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

•260 DH days= 1560 ISS hrs

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

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

April 11th, 2023

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

Training Resources

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

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

Suggested training resources include:

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

For more information, email tmhptrainingsupport@tmhp.com

April 1th, 2023

Link to HCS/TxHmL TMHP Youtube Video Playlist

April 4th, 2023

New HCBS Rules (HCS and TxHmL)

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

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

March 30th, 2023

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

https://www.texasfoundationofhope.org/

 2845 Thousand Oaks Dr.

San Antonio, TX 78232

(210) 265-3351

txfoundationofhope@gmail.com

Office Hours:

Monday – Friday  9:00 AM to 5:00 PM

March 30th, 2023

Review of this important section in 9.174 Service Delivery

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

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

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

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

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

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

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

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

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

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

(i) is a single-action lock;

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

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

March 30th, 2023

Service Delivery Logs for Individualized Skills and Socialization

March 1st, 2023

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

February 21st, 2023

Service Delivery Logs Finally Available for Individualized Socialization Skills Services

March 29th, 2023

 Heightened Scrutiny Process For ISS (Individualized Skills and Socialization)

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

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

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

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

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

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

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

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

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

Questions

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

March 26th, 2023

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

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

March 15th, 2023

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

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

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

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

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

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

Handy Dandy List of Items In The Toolkit:

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

REQUEST TECHNICAL ASSISTANCE WITH HCBS SETTINGS CRITERIA

March 20th, 2023

​88th Legislative Session in Texas!

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

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

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

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

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

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

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

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

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

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

Feb 2023 HB’s

Feb 2023 SB’s

March 2023 HB’s

March 2023 SB’s 

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

March 5th, 2023

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

1915(c) Waiver Interest Lists by Legislative District

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

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

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

Clicking on each district with show more detailed information.

• State House
• State Senate
• Congress

February 27th, 2023

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

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

February 25th, 2023

February 22nd, 2023

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

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

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

February 22nd, 2023

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

February 21st, 2023

Update on Who Qualifies To Assess The Need For A Modification

According to HHSC (and the proposed rules that will now be under Chapter 263) modifications to the door lock requirement must be based on a documented, assessed need and brought to the SPT for review and documentation in one’s PDP

As to whom determines the assessed need, HHSC stated at recent training sessions in Lake Jackson and Austin I believe, that a licensed professional, defining such as a doctor, RN, behavioral health provider, or other therapist providing such determination is within the scope of their practice.

February 14, 2023

Protocol For Modifications to AccessTo Food, Locks on Individual’s Doors & Other CMS Regs HCBS Settings Rules

Please see the alert letter below for complete information discussed in this post:

IL-2023-05

“In 2014, CMS issued federal regulations for settings where Medicaid home and community-based services (HCBS) are provided. All settings where Medicaid HCBS are delivered must meet federal requirements by March 17, 2023.

HHSC is finalizing updates to the HCS Program rules at 26 TAC §263.502. The rules are expected to be adopted in early 2023 and will include the detailed requirements outlined below.
The federal regulations require that all individuals residing in a provider-owned or controlled setting must ensure certain requirements are met. These requirements include:

● Individual privacy in the bedroom;
● Choice not to share a bedroom;
● Choice of roommate if sharing a bedroom;
● A lock is installed on the bedroom door;
● Individual can furnish and decorate their bedroom;
● Individual has control over their schedule and activities that are not part of an implementation plan;
● Individual has access to food at any time;
● Individual has the ability to have visitors of their choosing at any time;

If a program provider becomes aware that a modification to one of these requirements must be implemented due to a specific assessed need of an individual, the program provider must notify the service coordinator as soon as possible. The program provider must provide the service coordinator with the following information:

● A description of the specific and individualized assessed need that justifies the modification;
● A description of the positive interventions and supports that were tried but did not work;
● A description of the less intrusive methods of meeting the need that were tried but did not work;
● A description of the condition that is directly proportionate to the specific assessed need;
● A description of how data will be routinely collected and reviewed to measure the ongoing effectiveness of the modification;
● The established time limits for periodic reviews to determine if the modification is still necessary or can be terminated;
● The individual’s or legally authorized representative’s (LAR’s) signature evidencing informed consent to the modification; and
● The program provider’s assurance that the modification will cause no harm to the individual.

If the service coordinator receives a notification from the program provider of a required modification(s), the service coordinator must convene a service planning team (SPT) meeting to update the person-directed plan (PDP) with the information above.

If the SPT agrees to the modification(s) and updates the PDP, then the program provider may implement the modification(s).

**Note that a family member/LAR’s request or preference to not comply with one of the requirements is not considered an individualized assessed need that justifies a modification to the federal requirement.”

Link to PowerPoint Handout From Austin Training on February 10th, 2023 for information discussed on this subject and other current issues (residential agreements, ISS, etc…)

February 14th, 2023

Repeal of HCS Rules under Title 40, Chapter 9 / Movement to Title 26, Chapter 565

February 10th, 2023

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

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

-When is the Provider Applicant Training (PAT) Online available?
This training is now available online. The PAT training is the first step for applicants to obtain a contract with HHSC. Please do not submit your application without the PAT certificate that reflects a passing score of 85% or above.

-Who can take the training?
Applicants listed on Form 3681, Section 8.a and 8.b must complete the online PAT training. The Program Manager listed must complete the training and pass the test with an 85% or above.
See Texas Administrative Code Title 40, Chapter 49, Rule §49.204.

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

The training is compiled in four different steps.

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

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

Step 3. Evaluation and Certificates
 Complete the mandatory survey

Step 4. Provider Competency Exam
 Download, and save your exam certificate upon completion. Submit the certificate along with your completed application

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.

March 2nd, 2023

Unwinding of Continuous Medicaid Coverage:  HHSC will stagger Medicaid Eligibility Determinations, separating into 3 groups.  IDD will be in the last group, meaning that packets will be sent in June with persons having 30 days to reply.  More information can be found at:  https://www.hhs.texas.gov/services/health/coronavirus-covid-19/coronavirus-covid-19-provider-information/end-continuous-medicaid-coverage-ambassador-toolkit

February 9th, 2023

The Biden administration plans to end the state of Public Health Emergency (PHE), due to the pandemic.  Many are warning that the shift will have major implications for people with disabilities that go far beyond COVID-19.

Under the public health emergency, which has been in place since 2020, states have been eligible for extra federal funding for Medicaid in exchange for agreeing not to drop most beneficiaries from the program. The federal government has also given HCS providers added flexibilities during this time.

Currently, it appears that President Biden plans to extend the public health emergency to May 11, at which point it will end.

I can’t stress enough, that people with disabilities and their families (or specific Medicaid contact person) make sure they respond to any mail or email from their Medicaid office, that their address is up to date at HHSC & Medicaid as well as being in compliance with the financial eligibility rules under Medicaid as well.  Be sure to fill out any annual Medicaid Status Reports on time as well.

If an IDD provider (HCS, TxHmL, etc..) is the contact person for Medicaid please have all available persons that are appropriate assist with this process to ensure your individuals do not lose their Medicaid. ( i.e. case managers/care coordinators, program managers, financial dept. staff, etc.) 

States can start the redetermination process as soon as this month and can terminate Medicaid coverage for individuals as early as April 1. Across the country, the process is expected to be complete no later than May 2024.

February 9th, 2023

Where can you find helpful Training Videos on the PEMS process? Check out the TMHP page with their Youtube videos for PEMS.

In addition, you will find information on removing TPI’s and a Video series on running and utilizing your R&S Reports

1915 (c) waiver page at TMHP For YouTube Training Videos

Specific link to R&S Report Video Series

Specific link to Removal of TPI From Forms Video

February 5th, 2023

Proposed HCS and TxHmL Billing Requirements

January 5th, 2023

IMT and IPC Form Enhancements and IBI Guide Updates Now Available

January 31st, 2023

Advocacy Toolkit from our friends at the ARC of Texas

https://www.thearcoftexas.org/wp-content/uploads/Advocacy-Toolkit.pdf

Common Nursing Violations:  Prevention & Correction 

February 23rd, 2023 10 AM-12:00 PM

(ICF/IID)

The HCS/TxHmL Interpretive Guidance Booklet: Nursing Focus

February 27th, 2023 11AM-12:30 PM

(HCS/TxHmL)

March 2023

Billing Requirement Changes In HCS-2023 Update 

March 29th, 2023  10AM-12:30PM

To Be Determined At A Later Date

Abuse, Neglect & Exploitation Allegation Follow-Up Requirements: (HCS/TxHmL Providers)

(This session is for:  Administrative Staff, Program Managers, Case Managers/Care Coordinators, Nurses, and Quality Assurance Staff)

Abuse, Neglect & Exploitation Allegation Follow-Up Requirements: (ICF/IID Providers)

(This session is for: Administrators, QIDPs, House Managers, Nurses, and Quality Assurance Staff)

Pre-recorded sessions are available for purchase!

To Purchase these Pre-Recorded Trainings:

Go to www.twogetherconsulting.com

Or

Contact us at Javasbja@gmail.com at Meghanjones.tx@gmail.com

Currently, we have the following pre-recorded sessions:

HCSTxHmL Pre-Recorded Webinar Sessions

Expectations of The Nurse: HCS/TxHmL

(includes: Delegation, CNA Training, Billable Services & Documentation as well) (4 Part Series)

Care Coordination (5 Part Series)

CARE COORDINATION  (5 Part Series)

Part I  

“Roles & Responsibilities: The LIDDA Vs. The Provider (For HCS/TxHmL providers)

Contact us at info@twogetherconsulting.com to purchase this training and the handouts.

Part II   Pre-recorded sessions available for purchase!

“Important Parts of The TAC In Relation To The HCS Handbook”  (For HCS/TxHmL providers)

Part III   Pre-recorded sessions available for purchase!

For HCS & TxHML Providers

“Developing The IP Using Person-Centered Practices” This is part 3 of 5 of our Care Coordination series.

Part IV   Pre-recorded sessions are available for purchase!

“ICAP/IDRC/LON” Webinar  This is part 3 of 5 of our Care Coordination series.

Part V  Pre-recorded sessions are available for purchase!

(Billable Services- HCS)    This session is split up into 2 parts!  Each section is 2 to 2.5 hrs long

General Billable Services (Day 1) & then Adaptive Aids/Minor Home Mods/Dental (Day 2)

Contact us at info@twogetherconsulting.com to purchase this training and the handouts.

January 27th, 2023

As of 1/27/23, there have been no new alert letters concerning the extension of temporarily waiving certain requirements for In-Home DH  due to the Public Health Emergency, past  January 31st, 2023. This was the date we were given in Letter No. 2022-55.

My understanding is providers would receive notice at least 30 days prior to ending the PHE.  I am assuming at this time that the PHE will extend through Feb. 28th, 2023.  In-Home DH billing will discontinue in TMHP as of March 1st, 2023, so the last day to bill In-Home DH will be Feb. 28th, 2023.  At this point, we move to In-Home ISS services. However, if the PHE does not end, I am unclear yet if In-Home ISS will allow for continuing to waive certain requirements temporarily due to the PHE.  I believe that due to the fact the allowance for anyone to qualify for In-Home DH during the PHE is not part of the In-Home ISS rules/ISS rules, that an addendum would have to be put in place to cover In-Home ISS due to PHE.  Not sure that will happen, so I would plan to be ready by March 1st.

Otherwise, come March 1st, 2023 all individuals wishing to receive In-Home ISS services will have to qualify in the following way:

In-home ISS must be provided in the individual’s residence.

Billing Requirements Section 49102.3

Requirement for Justification by a Licensed Professional or to be 55 Years or Age or Older
Revision 23-1; Effective January 1, 2023

An individual may receive in-home individualized skills and socialization only if:

(a) a physician has documented that the individual’s medical condition justifies the provision of in-home individualized skills and socialization; or

(b) a licensed professional or behavioral supports service provider listed in Section 4240(2), Qualified Service Provider, has documented that the individual’s behavioral issues justify the provision of in-home individualized skills and socialization; or

(c) the individual is 55 years of age or older and requests to receive in-home individualized skills and socialization.

In addition, EVV will need to occur for In-Home ISS services.

Qualifications for Service providers of In-Home ISS are as follows (they don’t need to be licensed)

49102.8 Qualified Service Provider

Revision 23-1; Effective January 1, 2023

In addition to meeting the requirements in Section 3400, Qualified Service Provider, a qualified service provider of the in-home individualized skills and socialization service component;

• (a) must have: (1) one of the following:
• (A) a high school diploma or a certificate recognized by a state as the equivalent of a high school diploma; or
• (B) documentation of a proficiency evaluation of experience and competence to perform the job tasks that includes:
• • (i) a written competency-based assessment of the ability to document service delivery and observations of the individuals to be served; and
  • (ii) at least three written personal references from persons not related by blood that indicate the ability to provide a safe, healthy environment for the individuals being served; and

  (b) must not be the individual’s host home/companion care service provider

November 21, 2022

Letter No. 2022-55 (Replaces IL 2022-54)

This information letter (IL) replacesd IL 2022-54 In-Home Day Habilitation Information for Program Providers for COVID-19, previously released on October 31, 2022, to extend the temporary guidance through January 31, 2023, unless the COVID public health emergency ends sooner. HHSC will provide guidance if anything changes.
In response to COVID-19 and to provide access to needed day habilitation services, the Health and Human Services Commission (HHSC) is temporarily waiving certain requirements in Sections 4381.3, 3710, 4381.7(6) and 4381.7(7) of the HCS Billing Guidelines and the TxHmL Billing Guidelines.

Effective March 13, 2020, through January 31, 2023 unless the COVID PHE ends sooner:
● HCS or TxHmL program providers may provide day habilitation to an individual in the individual’s permanent or temporary residence without having the justification required by Section 4381.3. This includes individuals residing in their own homes or family homes.

For more info, please click on the information letter.

January 27th, 2023

HHSC Form Required for Fire Drills for ISS Providers

Click on link below

Form 4719

* Some providers have noted that this form seems a bit inappropriate for ISS providers as the form has locations that seem more appropriate for a “home” setting, as opposed to maybe a “building” used by a licensed ISS provider, but it does have a box for “other” locations.

January 16th, 2023

Statewide Transition Plan

January 16th, 2023

Adoption Date of HCS Rules and Status of Statewide Transition Plan (STP): 

gave HHSC preliminary approval of its STP on 12/21/2022.  The STP will be posted for public comment this Friday (Jan. 20th, 2023).

It is unclear when the HCS rules will be adopted.

See graph of draft rules below (pages 12-17 for HCS).  Includes CLASS, TxHML, MDCP, and DMDB programs as well.

Appendix A: Home and Community-Based Services (HCBS) Settings Statewide Transition Plan

January 15th, 2023

TMHP Recoupment Letters

December 12th, 2022

Avoiding HCS and TxHmL Overpayment of Services

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

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

Read the full alert.

Help With The New Residential Agreements

Have You Signed Up For CIMS (Critical Incident Management System)Yet? 

January 12th, 2022

From our good friends at the Texas Chapter of AAIDD, some important info about the Texas 88th Legislative Session

See actual TAAIDD link  

January 11th, 2023

RENEWAL OF DETERMINATION THAT A PUBLIC HEALTH EMERGENCY EXISTS

“As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19)  pandemic, on this date and after consultation with public health officials as necessary, I, Xavier Becerra, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective January 11, 2023, the January 31, 2020, determination by former Secretary Alex M. Azar II, that he previously renewed on April 21, 2020, July 23, 2020, October 2, 2020, and January 7, 2021, and that I renewed on April 15, 2021, July 19, 2021, October 15, 2021, January 14, 2022, April 12, 2022, July 15, 2022, and October 13, 2022, that a public health emergency exists and has existed since January 27, 2020, nationwide.”

From the HHSC ASPR website page, this is the alert concerning continuing PHE.  At this time we have no further information on how long this will be ongoing.

https://aspr.hhs.gov/legal/PHE/Pages/covid19-11Jan23.aspx

January 11th, 2023

 Revised Information Letter (IL) 2023-01 related to ISS Payment Rates (replaces IL 2022-56):  

December 06, 2022

Last Friday HHSC posted the ISS rates which may be viewed at the link below.

• The on and off-site ISS rates are effective January 1, 2023. It appears to be unlikely any of the licenses for ISS will be approved by that time.
• The current in and out-of home DH rates will remain effective through February 28, 2023.
• ACRE will not be available for the ISS service.
• This is because the current DH rate is a daily rate; the ISS rate is an hourly rate. 
• Restructuring this component of ACRE will necessitate additional funds which HHSC will be requesting from the 88th Texas Legislature. Unfortunately, once received access to funds will not be available until September 1, 2023 and which providers choosing to participate in ACRE can request during the July, 2023 enrollment period.
• Though the ISS rules have yet to be adopted (hopefully by no later than December 16th), the proposed rules allow persons with a medical or behavioral justification to receive in-home ISS.
• proposed rules also state that if requested, a person who is 55 or older may also receive in-home ISS. 
•  The provider of the in-home ISS service does not need to be a licensed ISS provider.
• Note:  As proposed, the rules do not address whether persons with the aforementioned justification or request can also participate in community activities and bill for off-site ISS.  Though assumed this will not be permitted, we are still waiting for a response.
• The off-site rates allow for two levels of enhanced staffing.  Though the proposed rules did not call for two levels of enhanced staffing, the adopted rules will.
• The adopted rules will also change the ratios at least for the ‘LON 1 and LON 5 without enhanced staffing’ category.

September 27th, 2022

Please see the newly proposed ISS (Individualized Skills & Socialization) rates.  The proposed rates would be effective January 1st, 2023, if accepted, at the following link:  https://pfd.hhs.texas.gov/sites/rad/files/documents/2023/01-01-2023-pmnt-rates-individualized-skills-socialization-%20srvcs.pdf

January 10th, 2023

Below are just some of the trainings offered by HHSC on their “Trainings Initiative” page. Some live and some via webinar.

For more information, please go to: https://www.hhs.texas.gov/providers/provider-training/training-initiatives

SSI/SSDI Benefits Overview

The SSI/SSDI Benefits Overview web-based training provides a basic foundation for understanding Supplemental Security Income and Supplemental Security Disability Insurance and provides contact information for people who can help you further understand these programs. The training has a corresponding quiz.

• SSI/SSDI Benefits Overview Training
• SSI/SSDI Benefits Overview Quiz

Employment First

The Employment First web-based training covers Texas’ new Employment First policy. The training has a corresponding quiz.

• Employment First Training
• Employment First Quiz

Visit the HHS Employment First website.

HCS and TxHmL

There are two Home and Community-based Services and Texas Home Living trainings in this series:

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

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

Each training has a corresponding quiz.

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

Direct Service Workers

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

• Direct Service Workers Training
• Direct Service Workers Quiz

January 2nd, 2023

Effective January 2023, the open enrollment application process to get a provisional contract to provide Home and Community-based Services (HCS) and Texas Home Living (TxHmL) services will change.

1. You must be enrolled as a Texas Medicaid provider through the Texas Medicaid & Healthcare Partnership (TMHP) Provider Enrollment System (PEMS) before applying.

2. To apply, you must complete the Provider Applicant Training (PAT). The PAT is now available on the HHS Learning Portal. Do not take the PAT if you aren’t applying for an HCS and TxHmL waiver contract.

• You must get a score of 85% or higher to pass the exam. Lower scores will not be accepted.
• After completing the PAT, you can apply using Form 5873 Waiver and Community-based Programs and Services. Your PAT exam certificate must be included with your application packet. Do not apply without a PAT exam certificate showing your passing score.

PAT FAQ’s.  Please read before taking the PAT! 

You must pass this test by 85% and if you fail the 1st x will have to wait 6 months to retake it!

Mail Your Application to the Waiver Program Enrollment Team

Send to this address:

HHSC

Contract Administration and Provider Monitoring

Mail Code W-359 P.O. Box 149030

Austin, TX 78714-9030

Applicants can also submit applications by email: IDDWaiverContractEnrollment@hhsc.state.tx.us or fax: 512-206-3916.

More resources can be found on the HHSC website, including guidance on how to apply and manage your contracts. If you have any questions about the application process, please email us.

January 2nd, 2023

HHSC published an alert on Dec. 21, 2022, informing long-term care providers that expedited delivery is available for a limited time for personal protective equipment through the Texas Division of Emergency Management.

This resource is available to all long-term care providers, including:

• Nursing Facilities
• Assisted Living Facilities
• Intermediate Care Facilities
• Home and Community-based Services
• Home and Community Support Services Agencies, including Community Living Assistance and Support Services, Deaf Blind with Multiple Disabilities, and Medically Dependent Children Program
• Texas Home Living
• Prescribed Pediatric Extended Care Centers
• Hospice
• Day Activity Health Services

Long-term care providers who have a current need for these specific resources can submit requests by visiting star.tdem.texas.gov and selecting the “Expedited PPE” button. The generic passcode for the inventory listed above is: 112518.

Items are available on a first-come, first-served basis. This system is only to be used on a one-time basis for expedited PPE only. If a provider needs these resources, please include the amount needed in your request.

January 1st, 2023

LTC Winter and Extreme Freezing Weather Preparedness

HHSC encourages long-term care facilities and agencies to review and update emergency plans for freezing temperatures and snow. Emergency plans for extreme weather should include the provider’s plan to address:

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

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

Facilities with generators should perform any maintenance or needed testing while the weather is mild. This will ensure the equipment functions in case of extreme cold or power loss.

It is important to review building integrity and identify any areas that may need repair, reinforcement or weatherproofing. Multi-story buildings should review any other needed measures should evacuation be required and have a plan in place for how to move residents around or out of the building if there is a loss of power.

Preparing for disaster is the most important step in protecting our most fragile Texans and reducing the risk for loss of life.

May 26th, 2022

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

Memorandum Summary

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

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

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

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

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

Read more……

September 13th, 2021

Very Important Updates on Emergency & Disaster Preparedness During the Pandemic

Resources Listed Are From CMS & HHSC 

See Info For ICF Facilities Below

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

Emergency Preparedness Participant Workbook

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

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

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

Out-of-Hospital Do-Not-Resuscitate Order

Out-of-Hospital Do-Not-Resuscitate (OOH DNR) order.

Both the English and Spanish versions can be downloaded on the EMS and Trauma Systems website, along with “Frequently Asked Questions About OOH DNR,” also in both languages.

For questions related to OOH DNR orders, email EMSInfo@dshs.texas.gov.

December 18th, 2022

 HHSC Long-term Care (LTC) Regulation has retired the COVID-19 Response for ICF for Individuals with an Intellectual Disability or Related Conditions Response Plan and the ICF Frequently Asked Questions documents, effective Dec. 13, 2022.

Facilities can obtain guidance along with resources for infection prevention, control measures, and Personal Protective Equipment (PPE) through the Infection Prevention and Control Measures for Common Infections in LTC Facilities (PDF) and Infection Control Basics & Personal Protective Equipment for Essential Caregivers (PDF) documents published by HHSC.

These resources can also be found on the ICF Provider Portal page.

Program providers may reach out to LTCR Policy with questions at LTCRPolicy@hhs.texas.gov.

December 11th, 2022

The provider self-reporting voicemail option will be transitioned out of service on Dec. 31, 2022. Effective Jan. 1, 2023, provider self-reported incidents must be submitted using one of the methods indicated below:

This does not apply to HCS or TxHmL, only ICF and other LTC programs such as ALF’s, SNF’s, DAH’s…

• Online via Tulip
• Email ciicomplaints@hhs.texas.gov
• Call 800-458-9858 (available Monday–Friday, 7 a.m.–7 p.m.)

Please ensure that all initial self-reported incidents include the relevant information detailed in Provider Letter 18-20.

December 11th, 2022

The Health and Human Services Commission (HHSC) created the Regulatory Services Division in 2017 as regulatory functions consolidated from the Department of Family and Protective Services, the Department of Aging and Disability Services and the Department of State Health Services. As part of this consolidation effort, effective Jan. 30, 2023, HHSC will retire the Provider Investigation policy mailbox at PIPolicy@hhs.texas.gov.

For questions about investigations, please use the Long-term Care Regulation Policy and Rules mailbox at LTCRPolicy@hhs.texas.gov.

December 10th, 2022

Know that effective December 22, 2022, all HCS/TxHmL providers will need to have migrated to Palo Alto VPN for billing claims!

December 06th, 2022

Please see this alert that was just sent to the 3 IDD associations from HHSC 

Recording of Individualized Skills and Socialization- Provider Licensing Application Process Webinar

December 06, 2022

If you were not able to listen to the November 30th webinar on navigating TULIP/applying for an ISS license, the recording of the webinar and the presentation are now posted.  See below for details.  Though assumed that persons who listen to the recording will also be able to download a certificate, HHSC has yet to confirm that

Listen to the webinar recording.

Recording of Individualized Skills and Socialization Provider Webinar

December 1st, 2022

Home and Community-based Services and Texas Home Living waiver program providers that enrolled through the Texas Medicaid and Healthcare Partnership Provider Enrollment and Management System will be subject to a pre-enrollment site visit from TMHP. Read the full alert.

December 1st, 2022

Texas Health and Human Services Commission (HHSC) updated the following information regarding the Determination of Intellectual Disability (DID):

• DID Best Practice Guidelines website
• DID Best Practice Guidelines (PDF)
• Become a Certified Authorized Provider to Conduct a DID website

For more information, email the IDD Services Team.

December 1st, 2022

Overview of Upcoming LTC Online Portal Enhancements for HCS and TxHmL Waiver Programs

On December 12, 2022, the Texas Medicaid and Healthcare Partnership will implement several enhancements to the TMHP Long-Term Care Online Portal. After the enhancements are implemented, existing information and training materials will be updated. Read full alert.

-IPC Forms

-Termination Forms

-Pre-Enrollment Forms

-Individual Movement (IMT) Local Authority (LA) Reassignment Forms

-Provider Location Update (PLU) Forms

Other System and Form Enhancements

The Inactivate and Correct this Form buttons on the 8578 Intellectual Disability/Related Condition (ID/RC) Purpose Code (PC) 2 and Initial Enrollment IPC forms will be available only to HHSC staff.

This will decrease the potential for pre-enrollment and enrollment forms to get out of sync, as well as decreasing unnecessary form inactivations.

Account Preparation and Additional Resources

To prepare for these changes, HCS and TxHmL providers and LIDDAs that do not have an LTCOP account need to create an administrator or user account. Providers and LIDDAs can find instructions for creating an account in the TMHP Account Setup for HCS and TxHmL Waiver Programs Quick Reference Guide (QRG).

Additionally, providers and LIDDAs are encouraged to visit the TMHP 1915(c) Waiver Programs web page for recent news, reference materials, education, and bulletins.

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

October 23rd, 2022

LTC Portal Enhancements: Coming Soon!

Beginning in December 2022, several enhancements will be implemented for the Texas Medicaid & Healthcare Partnership (TMHP) Long-Term Care (LTC) Online Portal. The enhancements will improve form submission and portal functionality. Information about these upcoming changes will be available in future articles on the TMHP 1915(c) Waiver Programs web page.

Account Preparation and Additional Resources

To prepare for these changes, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) providers and local intellectual and developmental disability authorities (LIDDAs) that do not have an LTC Online Portal account need to create an administrator or user account. Providers and LIDDAs can find instructions for creating an account in the TMHP Account Setup for HCS and TxHmL Waiver Programs Quick Reference Guide (QRG), which is available in the TMHP Learning Management System (LMS), and on the TMHP website.

Note: To access the LMS, register for the LMS by clicking the Don’t Have an Account? Sign Up Here button beneath the login field.

(FYI-This includes HCS/TxHmL provider applicants who are going to have their contracts approved soon to begin services.  If you haven’t signed up for the LTC Portal yet, please do so!) 

Additionally, TMHP encourages providers and LIDDAs to visit the TMHP 1915(c) Waiver Programs web page for recent news, reference materials, education and bulletins.

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

November 14th, 2022

Don’t forget: HHSC has extended the time for any providers eligible for these ARPA payments to complete the attestation, so that the initial and final reports are not due, until 30 calendar days after the end of the COVID Public Health Emergency (PHE).

July 4th, 2022

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

Initial report is now due by August 15, 2022.

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

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

Providers who may be eligible to receive funds are:

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

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

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

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

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

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

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

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

June 2nd, 2022

Don’t Forget!

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

Initial report is due by July 1, 2022.

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

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

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

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

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

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

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

May 19th, 2022

HCS/TxHmL providers:

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

See rates and new codes listed in link below:

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

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

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

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

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

Q: What are the ARPA HCBS Provider Retention Payments?

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

Q: What Services are eligible for Provider Retention Payments?

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

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

November 11th, 2022

TMHP Enhancements

According to HHSC the enhancements (improvements) planned for release this month will most likely be posted later this week or early next week.  These posted enhancements will not be effective until Dec. 12, 2022.

HHSC will go over these enhancements in depth at the December 8th, 2022 Migration Webinar

September 23rd, 2022

There are 2 sets of HHSC and TMHP ‘enhancements’ (or ‘fixes’ or ‘improvements’ to the system) to be released in the near future.  HHSC has said that the first set of ‘enhancements’ will be released November 4, 2022, and the second set will be released in June of 2023.

November 11th, 2022

At this time, according to HHSC the PHE is set to end on January 11, 2023.  Currently, it is not known whether it will be extended beyond January 11th, 2022.  It is possible providers will be notified this week in some alerts if PHE will be extended beyond January 11, 2023.

Why is this important?

*This is important as COVID-19 flexibilities may end and Medicaid status may be lost for those individuals in our waiver  and ICF programs where provider has not responded to previous warning letters from CMS that their Medicaid status will not automatically be renewed without reapplying.

Previous Webinars Hosted ByTwogether Consulting:  Therap during our free resource webinar series below.  Just click on the links and register.

October 2022

https://attendee.gotowebinar.com/recording/2347988816141652494

August 2022

https://attendee.gotowebinar.com/recording/1388286687336697103

If you need assistance with your current Therap services or with information on getting these services, please contact:

Calvin Christensen(Business Development Consultant at Therap Services, LLC)

 Here is his LinkedIn page

https://calendly.com/calvin-christensen/system-demonstration?back=1&month=2022-10

Overview of GER Reports (Incidents, Injuries, Med Errors…)

Data-Driven:

Person-centered solutions your organization can use to support agency workflows, communication, compliance, organizational outcomes, and revenue management

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October 31st, 2022

Previous Webinars Hosted ByTwogether Consulting:  TaskMaster Pro (TMP) during our free resource webinar series below. 

Just click on the links and register.

October 20th, 2022

https://attendee.gotowebinar.com/recording/1488497278022599682

We couldn’t find an innovative IDD Practice Management software that focused on delivering better care, so we built one!

Software features for Service Providers

Our IDD software is designed by Service Providers and built for Service Providers. Every day we face the same challenges you do in providing care to the people in our IDD community. So that delivering the best care possible can be the focus, we designed TMP to be easy to use, intelligent, and robust.

Care professionals are led quickly through documentation processes with platform-assisted data completion. No repetitive entry of information, it’s fast and accurate. Compliance data is gathered and tracked simultaneously. This means compliance reporting can be completed at the push of a button. Thus, caregivers spend more time giving care and less time on paperwork.

January 15th, 2023

Jan. 11th TMHP LTC Migration Webinar

October 23rd, 2022

Oct. 5 TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar Recording Available

A recording of the Oct. 5 TMHP LTC Portal for HCS/TxHmL Providers and FMSAs Webinar is available for those who could not attend.

The webinar recording and slides have been posted to the HCS and TxHmL Webinars & FAQs webpage.

Listen to the Webinar here.

For questions, email TxHmL Policy.

October 13th, 2022

Monthly Meetings/Webinars On Migration To TMHP LTC Portal for HCS/TxHmL/FMSA’s 

Medicaid and CHIP Services (MCS) will begin hosting monthly meetings for Providers and Financial Management Services Agencies (FMSAs) who use the Long-Term Care (LTC) Online Portal for the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) waiver programs, beginning in October will be held to discuss trending issues, share solutions established to address barriers providers and LIDDAs are experiencing, answer questions, etc.

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

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

Save the Dates

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

• October 2022: Wednesday, Oct. 5, 1–2 p.m. Register for the webinar.
  • Here is a copy of the handout from October 5th, 2022, if you missed the webinar.  The recording of that session will be posted in the near future.
• November 2022: Wednesday, Nov. 9, 10–11 a.m. Register for the webinar.
• December 2022: Thursday, Dec. 8, 1–2 p.m. Register for the webinar.

Standing Meeting Agenda

• Trending issues – discuss trending issues and solutions to increase successful processing of forms.
• Updates on LTC Online Portal for HCS and TxHmL – provide relevant updates.
• Questions and Answers – HCS and TxHmL Providers and FMSAs will have the opportunity to ask questions* regarding LTC Online Portal for HCS and TxHmL.

*To comply with HIPAA requirements, questions that include any identifying information for a specific individual will not be allowed during the monthly meetings.

Email Questions to TxHmL Policy.

October 16th, 2022

Register for Texas Culture Change Coalition Conference

The Texas Culture Change Coalition will host their in-person fall 2022 conference, “Texans Coming Together for Residents, for Staff, for All!”

This year’s theme is “A Day Focused on Person-Centered Senior Care.”

Nov. 3
8 a.m.–5 p.m.
Commons Conference Center (J.J. Pickle Research Campus)
10100 Burnet Road, Bldg. 137
Austin, TX 78758

Continuing education credit for multiple disciplines will be provided for this event.

Register for the conference.

For more information, visit the Texas Culture Change Coalition website.

October 17th, 2022

HHSC HCS Program Provider Response to COVID-19 Emergency Rule Expired Oct. 14

The emergency rule for Home and Community-based Services waiver program providers that contain the HCS Program Provider Response to COVID-19 Emergency Rule expired Oct. 14.

The following rule expired Oct. 14:

• 40 Texas Administrative Code Section 9.198 – Program Provider Response to COVID-19 Emergency Rule

HCS program providers must continue to comply with visitation requirements for essential caregivers and clergy in a disaster located in TAC Chapter 570 as well as all other applicable rules and certification principles.

See Section 9.198 below:

July 11th, 2022

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

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

Read PL 2022-13, Version 2 here.

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

July 5th, 2022

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

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

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

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

May 7th, 2022

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

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

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

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

February 20th, 2022

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

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

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

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

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

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

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

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

The rules became effective Feb. 17, 2022.

January 7th, 2022

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

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

September 23rd, 2022

HCS COVID-19 Mitigation & Expansion of Visitation Rules: 

Revision Response Plan

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

Update:   April 17th, 2021

HHSC Publishes HCS Expansion of Reopening Visitation Rules

Original Published:  March 25th, 2021

3.0 HCS Expansion of Reopening Visitation Rule

To read more, please click on the link below: 

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

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

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

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

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

Visitor Limitations: (Indoor and Outdoor)

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

3.3.1 Indoor Visitation

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

3.3.2 Outdoor Visitation

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

3.3.3 Limitations for Visitation

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

Limited Visitation Designation and Attestation

4.0 Limited Visitation Designation and Attestation Requirements

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

4.1 Essential Caregiver Visits

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

4.2 Limited Visitation without Attestation Form

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

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

HHSC Publishes HCS Expanded Visitor Attestation Rules & Guidance Letter

September 25th, 2020

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

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

HCS Emergency COVID-19 Mitigation Rules 

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

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