July 30th, 2022

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

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

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

Read the PL details.

July 30th, 2022

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

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

Read the full alert.

July 30th, 2022

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

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

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

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

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

From HHSC:

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

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

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

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

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

Below is the full FAQ document

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

July 27th, 2022

American Rescue Plan Act HCBS & TxHmL Provider Retention Payments

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

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

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

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

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

Here are the 3 new ARPA reports are provided below:

Approved To Pay Report:          HC064110.TXT

Claims Detail Extract:               GC063979.TXT

Remittance and Status Report:  HC064112.TXT

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

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

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

July 18th, 2022

Monthly Reporting Required

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

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

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

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

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

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

January 9th, 2022

Reminder: SB 809 / Rider 143 COVID-19 Reporting

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

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

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

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

December 30th, 2021

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

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

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

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

December 14th, 2021

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

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

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

November 30th, 2021

November 14th, 2021

PROVIDER REPORT GRACE PERIOD

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

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

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

Read More….

October 3rd, 2021

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

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

Grace Period

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

Sept. 18th, 2021

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

Introduction:

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

Frequently Asked Questions (FAQ):

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

Reporting: 

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

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

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

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

Failure to submit:

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

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

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

List of Some Of The Providers Required to Complete Reports: 

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

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

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

September 18, 2021

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

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

Rider 143

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

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

July 14th, 2022

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

After Public Health Emergency Ends

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

PL-2022-39

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

July 10th, 2022

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

2022 AccessAbility fest & abilitySTRONG Parade

REGISTRATION IS NOW OPEN!

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

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

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

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

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

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

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

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

Juliy 11th, 2022

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

Staff Member and Service Provider Requirements

The session is a $275 per person.

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

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

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

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

TAC 9.177 (d) A program provider must:

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

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

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

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

July 11th, 2022

Thought this was great info. and wanted to share-

From IntellectAbility

Long-haul COVID in People with IDD

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

Read more

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

July 4th, 2022

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

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

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

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

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

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

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

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

July 5th, 2022

Use the following instructions to access these resources:

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

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

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

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

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

For more information, please visit the Provider Finance website.

July 5th, 2022

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

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

July 5th, 2022

 Information Validation on LTC Claims IL 2022-35

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

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

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

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

July 4th, 2022

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

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

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

The comment period ends July 13.

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

July 3rd, 2022

Overview

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

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

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

Texas Local IDD Authorities (LIDDA)

Click on link below:

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

HCS Group Home Vacancy Search

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

June 23rd, 2022

2022 Conference for Intellectual & Developmental Disabilities

Innovating, Developing & Defining the Future of Service Delivery

August 12, 2022

Norris Conference Centers – Dallas Northpointe Centre

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

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

Please click on this link for Exhibitor Information

June 23rd, 2022

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

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

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

This revised guidance applies to:

• Home and Community-based Services
• Texas Home Living

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

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

For questions, email one of the policy mailboxes below:

• HCS policy mailbox
• TxHmL policy mailbox

June 17th, 2022

Employment First Training Series

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

Cool new TWC provider locator tool

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

June 16th, 2022

June 12th, 2022

Potential Long-Term Care Remittance and Status Report Delays

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

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

From TMHP

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

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

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

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

June 6th, 2022

Register for June 8 HCBS ARPA Stakeholder Update Webinar

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

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

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

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

TMHP Migration Complaints-HHSC Responses-060222

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

May 25th, 2022

Tip

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

May 30th, 2022

LTC Online Portal Dashboard Accessibility Issue Resolved

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

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

From HHSC:

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

Read the full alert here.

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

May 30th, 2022

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

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

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

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

From HHSC:

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

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

May 29th, 2022

2022 Hurricane Season Emergency Preparedness with COVID-19

Long-term care providers in Texas are reminded to review their emergency preparedness and response plans before the Atlantic hurricane season begins, which runs June 1–Nov. 30. LTC providers should make updates, if necessary.

Providers should factor in COVID-19 contingencies when reviewing their preparedness plans. For example, as applicable:

• Are your receiving facilities and transportation contracts still viable?
• If your provider type is allowed to evacuate to a hotel and that is in your plan, are hotels open in your destination?
• How will you maintain infection control measures during evacuation or sheltering-in-place?
• If you have COVID-19 positive persons in your facility, how will that affect evacuation or sheltering-in-place?
• How will you make sure personal protective equipment is available in addition to food and medicine?

Providers affected by an adverse event, such as severe weather, or expects it will need to temporarily exceed capacity due to a disaster, should contact their HHSC LTC Regulatory regional office.

Please refer to your program’s rules for more important information regarding emergency preparedness.

Hurricane and Flooding Readiness for HCS/TxHmL
Wednesday, June 1
1:45–3 p.m.
Register for the training.

August 15th, 2021

August and September 2021 LTCR Provider Training Opportunities

Long-Term Care Regulatory providers are invited to attend the following trainings hosted in August and September. Visit the Joint Training Opportunities page to register and learn more about each of these events.

Emergency Preparedness in Long-Term Care Facilities
August 18
1:30 p.m.
Register for the webinar.

August 25
1:30 p.m.
Register for the webinar.

September 13
1:30 p.m.
Register for the webinar.

September 23
1:30 p.m.
Register for the webinar.

July 4th, 2021

Hurricane and Flooding Readiness Webinars for LTC Providers

Home & Community-based Services:

Wednesday, July 21
2 -3:30 p.m.
Register for the webinar.

Intermediate Care Facilities:

Wednesday, July 21
10 -11:30 a.m.
Register for the webinar.

July 2021 LTCR Provider Training Opportunities

Long-Term Care Regulatory providers are invited to attend the following trainings hosted in July.  Visit the Joint Training Opportunities page to register and learn more about each of these events.

Emergency Preparedness in Long-Term Care Facilities

July 21
1:30 p.m.
Register for the webinar.

July 28
1:30 p.m.
Register for the webinar.

July 3rd, 2021

CMS Provides Guidance on Full-Scale Emergency Preparedness Exercises

ICF Providers, please make sure you see this.

The Centers for Medicare and Medicaid Services issued Quality Safety & Oversight Memo QSO-20-41-ALL Revised (PDF). The memo gives more guidance to providers on full-scale exercise requirements that are part of CMS regulations for emergency preparedness.
The following provider types are exempted from completing a required full-scale exercise for the 2021 cycle based on a provider’s activation of their emergency plan.

• Nursing facilities
• ICFs-IID
• Home health agencies
• Inpatient hospice providers

This exemption does not apply to the exercise of choice.
Providers should still follow all other emergency preparedness guidance in the March 26, 2021 State Operations Manual, Appendix Z (PDF).

May 23, 2022

Very Important!

Please see information from TMHP below:

COVID-19 in Healthcare Relief Grants

Senate Bill (SB) 8, 87th Legislature, 3rd Called Session, 2021, appropriates funding for the Health and Human Services Commission (HHSC) to issue awards to support Texas healthcare providers affected by the COVID-19 pandemic. These awards include funding for Rural Hospitals, Nursing Facilities, Assisted Living Facilities (ALFs), home health agencies (HHA), Intermediate Care Facilities for Individuals with Intellectual and Developmental Disabilities or related conditions (ICFs/IID), and providers of Community Attendant Services.

HHSC has published new information regarding the COVID-19 in Healthcare Relief Grants for the competitive award processes (“TIER 2”) here. HHSC encourages prospective Request for Application (RFA) applicants to review this information outlining general eligibility criteria, RFA application requirements, and anticipated solicitation posting dates for each of the respective RFAs.

Eligible applicants should rely on the final information published in each RFA Solicitation. Each RFA may have additional or different information than what is provided on the website.

More Help Available For Persons Entering IPC’s Into TMHP!

More information about submitting and revising Individual Plans of Care is available in the Long-Term Care Online Portal User Guides for Home and Community-based Services and Texas Home Living Waiver Programs. These user guides are available for the following programs that submit IPC forms 3608 and 8582 in the Texas Medicaid and Healthcare Partnership LTC Online Portal:

• HCS and TxHmL providers.
• Local intellectual and development disability authorities.
• Financial management services agencies billing on behalf of Consumer Directed Services employers.

Read the full alert here.

May 8th, 2022

 HCS and TxHmL Must Submit Claims and Forms to TMHP Beginning May 2, 2022

April 28th, 2022

Claims Submission

Reminder: HCS and TxHmL Must Submit Claims and Forms to TMHP Beginning May 2, 2022

Reminder: HCS and TxHmL Programs can Submit 837P Professional and 837D Dental Claims Using EDI or TexMedConnect

For additional questions, providers can refer to the HCS and TxHmL Waiver Programs Frequently Asked Questions (FAQ), send an email to hcs_txhml@tmhp.com, or contact the TMHP EDI Help Desk at 888-863-3638.

May 5th, 2022

Please see the link below for updated Service Delivery Logs for 05/2022 in Billing Requirements Handbook on page 185.

Billing & Payment Billing Requirements For HCBS Waiver

For questions about HCBS Program Billing Requirements, please email:   hcspolicy@hhs.texas.gov

April 28th, 2022

Very Important!

Recorded Webinar For Claims Submission in TMHP

Below is the link to the recording of the claims submission webinar TMHP conducted.   Additional information about the migration will be sent under separate cover.

Note:  HHSC will not conduct another webinar on claims submission!

 https://tmhp.exceedlms.com/student/enrollments/create_enrollment_from_token/fEmzWuXLDuXzfc3jncsErHWU

March 1st, 2022

HCS and TxHmL Programs Forms and Claims Submissions to TMHP Available March 1, 2022

April 28th, 2022

• Attached are handouts from the November, 2021 and February, 2022 joint meeting of the IDD SRAC and STAR+PLUS Pilot Program Workgroup related to the pilot and decisions (including eligibility) made thus far.
  • See pages 52 – 102 of the February, 2022 document for information about the pilot.
• HHSC has created a webpage on the Pilot Program.
  • The link to this webpage is:  https://www.hhs.texas.gov/services/health/medicaid-chip/medicaid-chip-members/starplus-pilot-program-sp3

April 28th, 2022

April 28th, 2022

Details On Hearing

Date, Time & Location:  Thursday, May 5, 2022 at 10:00 a.m., Capitol Extension, E2.030

Purpose:  To receive invited testimony on several of its interim charges:  #1 related to Healthy Families and Healthy Texas Initiative. When looking at healthy aspects of families, everything from hygiene to food, especially food since lots of people ask is mazola corn oil healthy?  These are all related to the 1115 Waiver, and, the one of importance to PPAT members,  related to implementation of SB1, Rider 30 (HHSC) and recommendations for reducing the interest list for waiver services for Individuals with IDD and reducing associated staffing shortages. See end of this message for text of Rider 30.

Organizations Invited to Testify: Though not inclusive, organizations invited to provide testimony include PPAT, the Texas Council of Community Centers, the Arc, Disability Rights Texas and PACSTX.  HHSC will also provide testimony.

April 20th, 2022

• HHSC will hold a public hearing on the rules this summer.  Date and time not shared by HHSC yet.
• Lengthy discussion regarding the proposed provision related to lease agreements and the potential for eviction if R&B payments are not received, has occurred.
  • A process is needed to ensure Providers receive R& B payments
    • However, It is clear that further discussion regarding the proposed process/requirement is needed.

April 16th, 2022

Effective April 16, 2022 the Public Health Emergency (Pancemic) has been extended another 90 days.  This means, that if not terminated during that 90-day period, it will either end July 15, 2022, or, if deemed necessary, will be extended for another 90-day period

April 13th, 2022

Texas Providers have been reminded that they can be surveyed at any time by a CMS/Federal Surveyor and will need to be in compliance if this occurs.

In short, at this time, HHSC Regulatory will not survey for compliance with the federal mandate.

The federal mandate and HHSC position apply to certified-only HCSSAs, Hospice, Nursing Homes and ICFs/IID. 

April 12th, 2022

• The program rules will go to MCAC on August 11, 2022. 
• The regulatory or license rules will go to the HHSC Executive Council but no date set yet.
• The program and regulatory rules will be published in the Texas Register for formal comment in late July, and HHSC will hold a public hearing on the rules.
• HHSC has decided to eliminate the on-site ratios.
• Though the off-site ratios have not been eliminated, HHSC is considering revisions to them and open to suggestions and ongoing dialogue.
• The current draft rules do not require any benchmark regarding time persons must engage in off-site activities, and at this time, there is no consideration to establish benchmarks.  According to HHSC, this is in great part due to the limited amount of appropriations received to implement the new service.
• No changes expected, at least for now, to the proposed rates.
• At this time, no changes to the DH rates for persons enrolled in an ICF/IID, yet who will attend an ISS facility are anticipated to occur.
• Based on comments received through the informal comment period, HHSC is restructuring and revising the draft regulatory/license rules.  Details were not provided.
• Stakeholders requested consideration of a separate meeting to discuss the draft rules.  No confirmation received as to whether HHSC will schedule a meeting.
• HHSC has created a webpage related to ISS.  To access, go to: https://www.hhs.texas.gov/providers/long-term-care-providers/long-term-care-provider-resources/individualized-skills-socialization

April 10th, 2022

Individualized Skills and Socialization

IDD Systems Redesign Committee (SRAC) Agenda from January 27th, 2022

See link below or read the section below.  The webcast recording is available below:

March 7th, 2022

 (See link below to FAQ’s)

Answers to Additional Questions related to the Migration

March 10, 2022

Draft of ISS Rules below:

• Texas Administrative Code, Title 26, Part 1, Chapter 559, Subchapters A and H, Individualized Skills and Socialization

Email comments before March 28th, 2022 to Long-term Care Regulation Policy and Rules.

March 9th, 2022

CARE Banner In CARE system for HCS/TxHmL providers:

March 7th, 2022

Public Comment Period for STP

HHSC will submit a Statewide Transition Plan to the Centers for Medicare and Medicaid Services. This is required by the federal Home and Community Based Services Settings Rule. The STP describes HHSC’s plan to meet the requirements of the HCBS Settings Rule.

HHSC invites members of the public, including HCBS recipients and their families, providers, and other stakeholders, to submit comments on the STP.

Comments will be accepted until 11:59 pm on April 4, 2022. Access the STP and instructions for submitting public comments here.

March 4th, 2022

If you attended the 2/9/22 Plans of Correction (POC’s) training webinar for HCS & TxHmL, here are the answers to some of the follow-up questions asked during the session: 

Q: I have experienced that the POC has a date that is 8 days in the past but the postage stamp would be 2 days ago. This leaves me with 6 days to complete the POC. Do I use the date on the letter or the postage date for the 14-day time period?

A: §9.183(f) states the program provider must submit the POC within 14 calendar days of receiving the final report for each violation identified in the plan of correction. The start date of the 14 days is when the program provider receives the final survey report, not the date of the letter or the postage date. The final report can be emailed to the program provider if the email address is on file.

If you have specific questions about the due date for the POC, please contact your regional program manager.

Q: Can we sign the 3724 electronically?

A: If the program provider has the capability to electronically sign, this is acceptable.

Q: Isn’t HHSC supposed to send the provider a pdf or word version of the violations that the provider can actually edit on the right side to enter in their POC’s?  That seems to be an issue some providers have had.

A: Form 3724s are e-mailed to program providers PDF format. A program provider should be able to edit the PDF to enter their POCs on the right-hand side. Please see Instructions for Electronic 2567/3724 for how to do this. If you’re still having trouble, you can contact your regional program manager.

Q: If the 3724 is mailed to the provider in a protected PDF format, how can the provider type the corrections on the form if they do not wish to hand write them?

A: Please contact your regional program manager.

Q: Can a POC be completed in the HCS portal?

A: No, the POC cannot be completed in the provider portal. The POC information needs to be entered on the final 3724 report that is submitted to the program provider.

Q: Are those letters certified to verify when the letter was actually received by the provider?

A: No, the letters are not required to be certified.

Q: I was told there are no debriefings during the survey process. Has this changed?

A: The surveyor will review Form 3701-A, Statement of Preliminary Findings during the survey exit conference to review each of the areas of noncompliance that were identified during the course of the survey, including findings that may result in a critical violation. Per §9.171(j), if HHSC identifies a finding that may be a critical violation not discussed during an exit conference, a new exit conference with the program provider will be held to discuss those additional finding(s).

Q: Is this Form 3724 that is used in the ICF Program as the CAP replacing Form 8581 that was previously used in the HCS and TxHmL Program as the CAP?

A: Form 3724 should be used for Plans of Correction for the HCS program. Form 3724 is the state form from ASPEN for the Statement of Licensing Violations and Plan of Correction.

Form 8581, Corrective Action Plan has been retired and removed from the HHSC website.

Q: Will HHSC surveyors provide a separate form for administrative penalties for any violations not corrected?

A: All violations must be corrected before the imposition of penalties. If violations aren’t corrected the provider will be decertified. Decertification triggers contract termination. 

Enforcement notifies the provider through certified and first-class mail of the imposition of penalties.

Q: Is the IDT the same as the SPT (service planning team) for HCS and TxHmL?

A: The concept is similar. Per 40 TAC 9.153(106), the definition of a Service Planning Team is

“One of the following:

(A) for an applicant or individual other than one described in subparagraphs (B) or (C) of this paragraph, a planning team consisting of:

(i) an applicant or individual and LAR;

(ii) service coordinator; and

(iii) other persons chosen by the applicant or individual or LAR, for example, a staff member of the program provider, a family member, a friend, or a teacher;

(B) for an applicant 21 years of age or older who is residing in a nursing facility and enrolling in the HCS Program, a planning team consisting of:

(i) the applicant and LAR;

(ii) service coordinator;

(iii) a staff member of the program provider;

(iv) providers of specialized services;

(v) a nursing facility staff person who is familiar with the applicant’s needs;

(vi) other persons chosen by the applicant or LAR, for example, a family member, a friend, or a teacher; and

(vii) at the discretion of the LIDDA, other persons who are directly involved in the delivery of services to persons with an intellectual or developmental disability; or

(C) for an individual 21 years of age or older who has enrolled in the HCS Program from a nursing facility or has enrolled in the HCS Program as a diversion from admission to a nursing facility, for 365 calendar days after enrollment, a planning team consisting of:

(i) the individual and LAR;

(ii) service coordinator;

(iii) a staff member of the program provider;

(iv) other persons chosen by the individual or LAR, for example, a family member, a friend, or a teacher; and

(v) with the approval of the individual or LAR, other persons who are directly involved in the delivery of services to persons with an intellectual or developmental disability.

Q: What do we do if the 45-day PoC completion date has already passed by the time we get the final report?

A: If you receive the final report near or after the 45-day PoC completion date, please contact your regional program manager for assistance.

Instructions for Documenting Your POC’s On Electronic Form 2567/3724 Received From HHSC

Provider:

1. Open the 2567/3724 document
2. Go to “Insert” on the toolbar
3. Select “Text” Box
4. Insert the “Text” Box where you want to write the PoC
5. Insert a second “Text” Box where you put the PoC date.
6. Right-click on the text box’s border, and choose “copy”.  (For copy and pasting)

7. Scroll down to the second page of 2567, left-click anywhere on the page, then press “Ctrl-V” on the keyboard

                           ( or right-click with the mouse and choose “paste” ) – the text box will paste in nearly centered into the POC field

                            ( to center, press two cursors spaces to the left and two cursor spaces up ).

Repeat on the remaining pages

Save the document.

Send the document back to the region.

LTC Providers May Need to Update Fire Alarm System Cellular Communication Services

In 2022 cellular companies will retire their older 3G technology. These companies include T-Mobile, Sprint, Verizon and AT&T.

LTC providers relying on fire alarm systems that utilize outdated cellular communicators operating on 3G networks must consider upgrading their fire alarm communication apparatus. The majority of these systems depend on cellular communication devices to dispatch signals to a 24-hour central monitoring station, which in turn, alerts the local emergency services to provide assistance. Should your system’s cellular communicator be based on 3G technology, and with cellular providers phasing out 3G support, your setup could fail to alert emergency services in the event of a fire. This highlights the critical need for ensuring your fire alarm system is up-to-date, not only for effective emergency communication but also for integrating seamlessly with Fire Watch Security in NYC, ensuring a comprehensive approach to fire safety and emergency response.

The major cellular companies gave the following dates for retiring their older networks:

• AT&T began retiring its 3G network on Feb. 22, 2022.
• Sprint will retire its 3G CDMA network on March 31, 2022.
• Sprint will retire its 3G LTE network on June 30, 2022.
• T-Mobile will retire its 3G UMTS network on July 1, 2022.
• Verizon will retire its 3G CDMA network on Dec. 31, 2022.
• T-Mobile has announced it will retire its 2G GSM network but has not set a date for that retirement.

After these dates fire alarm communication devices that connect to cellular communication systems using this older technology will not work.

LTC providers are responsible for ensuring their fire alarms systems function correctly. Providers with fire alarm systems monitored by a third-party monitoring company should contact their fire alarm service company. They need to find out if their fire alarm communication equipment needs upgrading.

Email LTCR Policy or call 512-438-3161 with questions.

March 1st, 2022

HCS and TxHmL Form Submission on LTC Online Portal Unavailable Until May 1, 2022

Due to Postponement, submissions of Home and Community-based Services and Texas Home Living forms using the Texas Medicaid and Healthcare Partnership Long-Term Care Online Portal are unavailable until May 1st, 2022. Data migration to the TMHP LTC Online Portal took place prior to March 1st, 2022.

FYI-Any HCS and TxHmL form submitted to the LTC Online Portal before March 1 could be removed and require resubmission May 1st, 2022.

Beginning May 1, submit HCS and TxHmL forms using the TMHP LTC Online Portal. All user guides to aid form submissions are published to TMHP’s Learning Management System. All users must create an LMS account to access the materials. There is a sign-up link on the LMS homepage. Contact TMHP Training Support if you need help.

Providers can refer to the article, “Reminder: Beginning March 1, 2022, HCS and TxHmL Programs to Submit Claims and Forms to TMHP” for more information about the transition to TMHP, which now applies to May 1st, 2022.

Email questions to TMHP.

February 27th, 2022

HCS and TxHmL Webinar Slated for March 3 moved to March 10th, 2022

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

Webinar topics include:

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

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

Email questions about the webinar to your program policy mailbox:

• • HCS Policy
  • TxHmL Policy

February 26th, 2022

If you missed part II of the LTC TMHP Migration HCS & TxHmL Waiver Webinar Training, you will have an additional chance on March 10th, 2022

10am-12:30pm Central

Please click here register here

The Long-Term Care (LTC) Online Portal Training for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs is a two-part webinar for providers and Local Intellectual and Developmental Disability Authorities (LIDDAs).

Attendees can register for any of the first sessions, and any of the second sessions; but are strongly encouraged to complete the first session before attending the second session.

Part 2 of this webinar will cover the following topics:

• Purpose and Workflow of the 3608/8582 Individual Plan of Care (IPC) Form

• Purpose and Workflow of the Individual Movement (IMT) Form

• Purpose and Workflow of the 3615 Request to Continue Suspended Services Form

• Purpose and Workflow of the 3616 Request for Termination of Waiver Program Services Form

• Purpose and Workflow of the HCS Provider Location Update (PLU) Form

• Navigation of the LTC Online Portal • Available HHSC and TMHP resources for providers and LIDDAs This webinar will not provide billing training.

***For more information about billing with TMHP, refer to the Learning Management System (LMS) at learn.tmhp.com, and search for TexMedConnect or Claims in the keyword search feature.

February 26th, 2022

Additional Training Resources From TMHP

It is highly recommended that program providers, LIDDAs, and FMSAs create a TMHP Learning Management System (LMS) account at learn.tmhp.com before the webinar 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, contact tmhptrainingsupport@tmhp.com

February 8th, 2022

For those of you who missed today’s training (part I) or who did not download the documents, I have provided them on this “Updates” post from Twogether Consulting

Link to Resource Document from Webinar on 2/8/22 (TMHP Training Part I)

Webinar Handout Part I Training 

LTC TMHP Portal Provider User Guide

TMHP Migration (HCS & TxHmL) FAQ’s

This webinar will be repeated on March 8th, 2022

---

The Long-Term Care (LTC) Online Portal Training for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs is a two-part webinar for providers and Local Intellectual and Developmental Disability Authorities (LIDDAs). Attendees can register for any of the first sessions, and any of the second sessions; but are strongly encouraged to complete the first session before attending the second session.

Part 1 of this webinar will cover the following topics:

• Management of waiver program assessments and forms in the LTC Online Portal

• Purpose and Workflow of the HCS/TxHmL Pre-enrollment Form

• Purpose and Workflow of the 8578 Intellectual Disability (ID)/Related Condition (RC) Assessment

• Purpose and Workflow of the 3608/8582 Individual Plan of Care (IPC) Form • Available HHSC and TMHP resources for providers and LIDDAs

February 13th, 2022

HCS/TxHmL Providers & LIDDA’s: Client Assessment, Review, and Evaluation (CARE) Report and Screen Crosswalks Now Available

The CARE report and screen crosswalks for HCS, TxHmL providers and LIDDAs are now available to assist with daily operations.

Click the following link to view the files:

Provider and LIDDA CARE Report Crosswalk

Provider and LIDDA CARE Screen Crosswalk

HCS and TxHmL providers will use these crosswalks to locate relevant individual and provider data needed for day-to-day operations beginning March 1, 2022.

If you have questions, contact the HHSC HCS TxHmL Form Migration mailbox at HCS_TxHmL_Form_Migration@hhs.texas.gov.

February 13th, 2022

HHSC Publishes Information on data migration from the CARE system to the to the TMHP LTC Online Portal (IL 2022-12)

HHSC has published IL 2022-12 that provides information to HCS and TxHmL Program Providers and FMSAs about the CARE screens that are unavailable from Feb. 9 (5:00pm) to March 1, as data is migrated from the CARE system to TMHP LTC online portal.

It also provides information about form submissions after Feb. 9, and HCS and TxHmL claims submission for services delivered prior to March 1, and on March 1, or later.

Submit question about HCS & TxHmL Forms and Claims Migration Project here.

February 13th, 2022

Inactive Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Provider Client Assignment and Registration (CARE) Screens

Due to the HCS and TxHmL migration to Texas Medicaid and Healthcare Partnership (TMHP), the following CARE screens will be inactive beginning 9 p.m. Wednesday, Feb. 9, until Monday, Feb. 14.

L01 — CONSUMER ENROLLMENT
L02/C02 — INDIVIDUAL PLAN OF CARE
L03 — ENROLLMENT PACKET CHECKLIST
L05 — PROVIDER CHOICE
L06 — CONSUMER TRANSFER
L23/C23 — WAIVER ID/RC ASSESSMENT
L30 — MRA ASSIGNMENT NOTIFICATION
L31 — HCS IPC MRA REVIEW (HCS)
L32 — ID/RC ASSESS MRA REVIEW (HCS)
C18 — INDIVIDUAL DISCHARGE
C29 — MODIFY PROVIDER SERVICE AUTH

Below are screens that will be inactive and retired as of Feb. 10.

Note: Providers will not be able to submit entries until effective Feb. 16. Effective Feb. 16, Wait List and SLOT will be entered into SLOT and CSIL.

A20 — AUTHORIZE LOCATIONS
A29 — SLOT TYPES
A30 — SLOT ALLOCATION
A31 — SLOT STATUS UPDATE
A32 — SLOT ALLOCATION REMOVAL
A40 — RATE OPT OUT
A58 — WAIVER ID/RC ASSESSMENT(E)
A71 — WAIVER SLOT AVAILABILITY
A73 — SLOT TRACKING

L20 — GUARDIAN INFORMATION UPDATE
L26 — CLIENT ASSIGNMENTS
L61 — WAIVER SLOT COUNTS
L62 — WAIVER SLOT DETAIL
L64 — IPC EXPIRATION
L65 — ID/RC ASSESSMENT EXPIRATION

C20 — GUARDIAN INFORMATION UPDATE
C24 — LOCATION
C25 — LOCATION TYPE MODIFICATION
C26 — CLIENT ASSIGNMENTS
C64 — IPC EXPIRATION
C65 — ID/RC ASSESSMENT EXPIRATION
C75 — PRIOR APPROVAL
C88 — CONSUMER HOLDS
W21 — INTEREST LIST UPDATE
W27 — TRAVIS QUESTIONNAIRE ENTRY
W28 — TRAVIS QUESTIONNAIRE SEARCH

For questions or information, see:

• Portal Security Manual — Explains how to access TMHP systems (PDF)
• TMHP Learning Management System (LMS) — Register for an account
• TMHP Learning Management System (LMS) — Register for an account
• Computer Based Training for:
  • Portal Basics
  • TexMedConnect Claims Entry System
• Provider User Guide for the LTC Online Portal published on tmhp.com.
• Item-by-Item Guides for each HCS and TxHmL form published on tmhp.com.

February 8th, 2022

CBT (Computer Based Training) For TMHP Billing of Services/Entering Claims

https://tmhp.exceedlms.com/student/path/181116-texmedconnect-for-long-term-care-ltc-providers

I recently received this response from HHSC and thought it might be helpful to some providers who may have this concern:

There is no rule or regulation that prohibits an HCS Program Provider from providing services to their own child or family member. You can pop over to this site to get in touch with the best lawyers who will help you to claim this scheme.

The program provider’s operations must prevent conflict of interest as required by 40 TAC §9.177(f):

§9.177 Certification Principles: Staff Member and Service Provider Requirements

(f) The program provider’s operations must prevent:

  (1) conflicts of interest between the program provider, a staff member, or a service provider and an individual, such as the acceptance of payment for goods or services from which the program provider, staff member, or service provider could financially benefit, except payment for room and board;

  (2) financial impropriety toward an individual including:

    (A) unauthorized disclosure of information related to an individual’s finances; and

    (B) the purchase of goods that an individual cannot use with the individual’s funds;

  (3) abuse, neglect, or exploitation of an individual;

  (4) damage to or prevention of an individual’s access to the individual’s possessions; and

  (5) threats of the actions described in paragraphs (2) – (4) of this subsection.

And, the program provider must ensure they are not disqualified from being a service provider as described in Section 3420(b)-(d) of the HCS Billing Requirements:

3420 Service Provider Not Qualified

Revision 21-3; Effective September 1, 2021

(b) Spouse Not Qualified as Service Provider

A service provider is not qualified to provide a service component or subcomponent to the service provider’s spouse.

(c) Relative, Guardian or Managing Conservator Not Qualified as Service Provider for Certain Services

A service provider is not qualified to provide case management, residential support, supervised living, behavioral support services or social work services to an individual if the service provider is:

(1) a relative of the individual (Appendix II, Degree of Consanguinity or Affinity, explains who is considered a relative for purposes of these requirements);

(2) the individual’s guardian; or

(3) the individual’s managing conservator.

(d) Parent, Spouse of Parent or Contractor Not Qualified as Service Provider for Minor

A service provider is not qualified to provide a service component or subcomponent to a minor if the service provider is:

(1) the minor’s parent;

(2) the spouse of the minor’s parent; or

(3) a person contracting with DFPS to provide residential child care to the minor, or is an employee or contractor of such a person.

According to Section 3430 of the HCS Billing Requirements:

3430 Relative, Guardian or Managing Conservator Qualified as Service Provider

Revision 21-1; Effective January 1, 2021

If a relative, guardian or managing conservator is not otherwise disqualified to be a service provider as described in Section 3420, Service Provider Not Qualified, or in Section 4000, Specific Requirements for Service Components Based on Billable Activity, the relative, guardian or managing conservator may provide audiology services, dietary services, occupational therapy, physical therapy, speech and language pathology services, day habilitation, in-home day habilitation, registered nursing, licensed vocational nursing, specialized registered nursing, specialized licensed vocational nursing, transportation as a supported home living activity, host home/companion care, respite, in-home respite, employment assistance or supported employment if the relative, guardian or managing conservator is a qualified service provider for the particular service component or subcomponent being provided.

February 1st, 2022

HCS/TxHmL Writing Acceptable Plans of Correction Webinar

“WHAT IS A POC? 42 CFR §488.401 defines a Plan of Correction to mean a plan developed by the facility and approved by CMS or the survey agency that describes the actions the facility will take to correct deficiencies and specifies the date by which those deficiencies will be corrected.Apr 19, 2021″

Program providers can register for the Writing Acceptable Plans of Correction for HCS and TxHmL webinar. This webinar covers the process for writing an acceptable plan of correction for HCS and TxHmL program providers. No CE is awarded for this webinar. However, a certificate of attendance will be provided.

This will be an ongoing offering posted on the HHCS HCS/TxHmL Joint Training website.

Wednesday, Feb. 9
1 – 4 p.m.
Register for the webinar.

Email questions to Joint Training.

February 1st, 2022

HHSC Publishes Information on Delivery of PT, OT, and ST Services (IL 2022-08)

HHSC is issuing interim guidance allowing telehealth delivery of physical therapy, occupational therapy, and speech therapy services. Access Information Letter No. 2022-08, HB4: Physical Therapy, Occupational Therapy, Speech Therapy Services Delivered by Synchronous Audio-Visual. The letter notes which therapies are not allowed to be delivered through telehealth modalities because the service requires in-person delivery.

This guidance applies to the following programs:

• Community Living Assistance and Support Services Providers
• Deaf-Blind with Multiple Disabilities Providers
• Home and Community-based Services Program Providers
• Texas Home Living Program Providers

Email the LTSS policy mailbox with questions about this alert.

February 1st, 2022

Guidance for LTC Providers

COVID-19 cases continue to increase 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 rules, guidelines, and policies:

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

All provider types must continue to screen residents, clients, staff, and visitors for signs and symptoms of COVID-19.

Staff for all provider types must continue to use appropriate personal protective equipment (PPE).

Where required by rules for your provider type, providers must continue effective cohorting of residents based on COVID-19 status.

Find COVID-19 resources for your provider type online:

• The COVID-19 Resources section of your provider portal
• The HHSC Coronavirus (COVID-19) Provider Information page

Your maintaining vigilance in following infection control requirements makes a difference in protecting vulnerable Texans.

LTC providers are always required to provide services to residents before, during, and after any emergency. Your organization’s emergency plan or policy must include:

• Planning for staff shortages
• Back-up plans to ensure operations and care of residents or clients continues

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

• Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions
• Home and Community-based Services
• Texas Home Living

The U.S. Department of Health and Human Services has developed a COVID-19 Healthcare Planning Checklist (PDF) that you can use to assist you in creating a plan for dealing with an outbreak of flu or COVID-19.

For questions, email LTCR Policy.

HHSC has published ICF and HCS Emergency Staffing Requests – Jan. 10

HHSC has published ICF and HCS Emergency Staffing Requests (Provider Letter 2022-02). This letter provides information for Intermediate Care Facilities for Individuals with an Intellectual Disability (ICFs) or Related Conditions and Home and Community-based Services (HCS) program providers facing staffing shortages related to the COVID-19 public health emergency.

January 14th, 2022

January 10th, 2022

When was Omicron Variant First Found in Texas and What is This Variant of COVID-19?  (Please see article below)

Texas Identifies Case of COVID-19 Omicron Variant

HHS  

Corona Virus Testing and Testing Information  (Includes videos and information about finding testing locations near you and home-testing as well)

Booster Shot Information 

DSHS

Below are frequently asked questions (FAQs) about the variants of COVID-19, including the Delta and Omicron variants.

How can I tell if I have the Delta or Omicron variant? Do labs report that to the state?

That information may not be readily available. The viral tests that are used to determine if a person has COVID-19 are not designed to tell you what variant is causing the infection. Identifying COVID-19 variants requires a special type of testing called genomic sequencing. Due to the volume of COVID-19 cases, sequencing is not performed on all viral samples. However, because the Omicron variant now accounts for the majority of COVID-19 cases in the United States, there is a strong likelihood that a positive test result indicates infection with the Omicron variant.

Are the symptoms different for the Delta or Omicron variant? If so, what are they?

Because Delta and Omicron are variants of the same virus—SARS-CoV-2, the virus that causes COVID 19—the symptoms and the emergency warning signs are the same. However, some variants may spread more easily or may cause more severe symptoms and illness. Because of this, scientists are actively monitoring and studying new variants to learn more about how easily they spread, whether they make people more or less sick, and how well they respond to existing vaccines, treatments, and tests.

Is Texas tracking variants of COVID-19?

Yes. Public health officials at the federal, state, and local levels continue to study variants, monitor their spread, develop strategies to slow their spread, and test how variants may respond to existing therapies, vaccines, and testing. For information on variants of concern in Texas, see the Variants and Genomic Surveillance for SARS-CoV-2 in Texas section of the DSHS website.

Who is most at risk of contracting a variant of COVID-19?

Unvaccinated people are most at risk of contracting COVID-19, including any of its variants. The Delta and Omicron variants are more aggressive than other known variants and spread most rapidly in communities with fewer fully vaccinated people.

The absolute best protection for yourself and those close to you is getting fully vaccinated. The vaccine is proven to safely protect you from COVID-19’s worst effects and lowers your chances of spreading the virus. Greatly increasing the number of fully vaccinated Texans is the only way to prevent a devastating rise in the spread of the pandemic virus.

Are the newer variants worse than the early COVID-19 strains? Will a variant make me sicker than previous strains?

Omicron appears to spread much more easily than other known variants, which means it’s more contagious than other variants. We are still learning whether Omicron may put infected people at higher or lower risk of hospitalization than other variants.

What’s the treatment for patients with the Delta or Omicron variant?

There are different treatment options available for all COVID-19 variants, but some treatments may be more effective for certain variants. In many cases, treatments are reserved for certain high-risk groups. If you or a loved one is sick, check with your healthcare provider about your specific case.

What is the current travel guidance?

Travel recommendations may vary depending on whether you are fully vaccinated or not. Some travel destinations may have different requirements for vaccinated and unvaccinated travelers.

Keep in mind that travel and other guidance may change as we learn more about the virus variants and breakthrough cases. Stay up to date with CDC travel recommendations by visiting the Travel page of the CDC website.

Are people of certain ages at higher risk for infection with the newer variants?

Yes. Anyone who is not fully vaccinated is at greater risk of getting COVID-19. Children up to 5 years old are not yet eligible to receive the COVID-19 vaccine. Anyone who is old enough and able to get the vaccine should do so to protect those who are unable to get it, as well as those for whom the vaccine is less protective. That includes children under age 5 and people with certain medical conditions. It’s also important for those people who qualify to get the booster dose, too.

How many known variants are there?

There are many. Because viruses constantly change through mutation, new variants occur all the time. Sometimes they disappear, and sometimes they persist. Variants are classified in four ways, from least to most severe: Variants Being Monitored, Variants of Interest, Variants of Concern, and Variants of High Consequence.

Public health officials are currently studying two that are classified as Variants of Concern: Delta and Omicron. These are variants that show evidence of an increase in transmissibility, more severe disease (increased hospitalizations or deaths), and/or reduced effectiveness of tests, treatments, or vaccines.

In the U.S., there are currently many Variants Being Monitored, but no Variants of Interest or Variants of High Consequence.

To learn more about variants in the U.S., visit the About Variants of the Virus, Variant Classification, and Variant Surveillance pages on the CDC website.

What are the differences between the variants?

Variants vary by their genetic markers. These differences in genetic markers may affect how easily the virus is spread, the severity of illness, how well existing tests can detect the virus, the effectiveness of treatments and vaccines, and more.

Each variant is slightly different. Think of variants like branches on a tree. Each branch is slightly different than others on the tree, but they have similarities, too. Scientists study the differences in COVID-19 variants, so they can label and track them according to those differences.

Do the vaccines protect against the Omicron variant?

Early data suggest that the available vaccines are effective against severe disease and hospitalization caused by the Omicron variant. The best protection against any COVID‑19 variant is getting fully vaccinated. And a booster dose of vaccine is a proven way to maximize the protection against infection and severe disease.

Which vaccine provides better protection against the virus?

In mid-December 2021, CDC updated their vaccine recommendations with a preference for mRNA vaccine (Pfizer and Moderna) over the Johnson & Johnson (J&J) vaccine. However, public health experts continue to say that getting any vaccine is better than being unvaccinated. J&J vaccine will remain available for people who are unable or unwilling to get an mRNA vaccine.

Read CDC’s media statement to learn more about the updated vaccine recommendations.

Keep in mind that guidance may change as we learn more about the virus variants. DSHS will update information as it becomes available.

LTC Regulatory Services

Incident Reporting

HHS regulated providers can self-report incidents affecting resident health/safety, including issues related to COVID-19, online to the Health and Human Services Commission or by calling 1-800-458-9858.

• Incidents Submission Portal for Long-term Care providers
• Incidents Submission Portal for Health Care Quality providers

Intermediate Care Facilities (ICF/IID)

• ICF/IID Provider COVID-19 Vaccination Data Reporting Rule (PDF)
• ICF/IID COVID-19 Expansion of Reopening Visitation Emergency Rule (PDF)
• ICF/IID COVID-19 Response Emergency Rule (PDF)
• COVID-19 Response for ICF/IIDs (PDF)
• Frequently Asked Questions for ICF/IIDs (PDF)

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)

Revised Guidance on Staff Work Restrictions and Return to Work

HHSC has issued revised guidance for long-term care providers experiencing staffing shortages due to COVID-19. The requirement to contact LTCR before implementing CDC guidance on staff work restrictions and return-to-work has been removed.

“Guidance and Protocol for Long-Term Care Facilities Experiencing Staffing Shortages due to the COVID-19 Public Health Emergency.

This checklist provides guidance for long-term care facilities and residential providers facing staffing shortages related to the COVID-19 public health emergency.

This checklist incorporates CDC guidance with state and federal staffing requirements.

Facilities facing staffing shortages must use this checklist before requesting emergency staffing resources. The CDC’s mitigation strategies are meant to be implemented sequentially (i.e., contingency strategies before crisis strategies). The conventional strategies must be followed when the facility has adequate staffing.

As a reminder, facilities are required to cohort residents based on their COVID-19 status: COVID-19 negative (COVID-negative), COVID-19 positive (COVID-positive), and unknown COVID-19 status (COVID-unknown).1 Healthcare personnel (HCP) are considered “boosted” if they have received all COVID-19 vaccine doses, including a booster dose, as recommended by CDC.”

For more….  Read the updated guidance.

HCS and TxHmL program providers, Local Intellectual and Developmental Disability Authority agencies, and Financial Management Services Agencies billing on behalf of Consumer Directed Services employers can register for webinars starting next month. These webinars will cover information about the Long-Term Care Online Portal and forms that HCS and TxHmL program providers will use.

The webinars will:

• Include a live Q&A session
• Begin in February 2022

Details, including dates, times, and registration links will be in a future article on the Texas Medicaid & Healthcare Partnership website. Providers should check the Recent News section of the LTC webpage often for current information.

HCS and TxHmL program providers, LIDDAs, and FMSAs will begin submitting claims and forms to TMHP on March 1, 2022. Program providers, LIDDAs, and FMSAs should set up the following accounts, if not yet done:

• One of the following for Claims Submission Account:
  • TexMedConnect
  • Electronic Data Interchange
• LTC Online Portal
• TMHP Learning Management System

Failure to set up the necessary accounts can lead to payment delays after March 1, 2022. Program providers, LIDDAs, and FMSAs can find resources for creating the necessary accounts and the time frames it could take to create those accounts linked below.

• TexMedConnect allows users to submit claims and can take up to 10 days. LTC Online Portal allows users to submit, view, and manage forms. Account setup can take up to three days. The TMHP Account Setup for HCS and TxHmL Waiver Programs (PDF) is the available resource.
• EDI allows users to submit claims through a third-party submitter or a provider’s own software. Account setup can take up to 30 days. Access the updated 837P LTC Companion Guide Now Available for HCS and TxHmL Program Claims Submission Practice.
• TMHP LMS allows users access to important TMHP training materials and that takes one day. LMS Registration and Navigation Job Aid for Providers (PDF) is the resource.

Providers can refer to the HCS and TxHmL Waiver Programs Frequently Asked Questions (FAQ) or contact the TMHP EDI Help Desk at 888-863-3638 with questions.

December 20th, 2021

Check LEIE/OIG and check With the implementation of FBI-based fingerprinting in 2021, Long-term Care Regulation (LTCR) also implemented Occupations Code (OC), Chapter 53, related to the consequences of a criminal conviction, specifically the 2019 legislative update to OC §53.023 concerning additional factors for licensing authorities to consider after determining a conviction directly relates to the occupation.

Policy Details & Provider Responsibilities Long-term care facilities and agencies must check and continue to check an applicant’s criminal history, Nurse Aide Registry status, and Employee Misconduct Registry. Use the HHSC Employability Status Search at https://emr.dads.state.tx.us/DadsEMRWeb/ (link is external), which includes information regarding Sanctions. OC § 53 requires an employer to consider only convictions directly related to the occupation.

PL 2021-44 

With this new implementation, it is possible for an individual to receive a license, permit, or certification who is not employable or only employable in limited settings according to Health and Safety Code (HSC) §250.006.

Beginning December 20, 2021, long-term care facilities and agencies must also check the Excel document linked below to determine if an individual is licensed/permitted/certified but is unemployable in one or more long-term care settings licensed by LTCR. This file contains the names of nursing facility administrators, nurse aides, and medication aides that have active licenses/permits/certifications but are unemployable according HSC §250.006 in one or more long-term care settings.

https://www.hhs.texas.gov/sites/default/files/documents/active-unemployable.xlsx

HHS is updating the Employability Search with information on active but employable individuals. Until this update is complete, providers will be required, in addition to checking the Employability Search, to check the Active but unemployable Excel File in the resources section of this Provider Letter.

Resources Active but unemployable Excel File

Contact Information

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

December 17th, 2021

The link doesn’t inform providers about current information but will provide future information about ARPA funds, and will be available on the newly created HHSC Grants webpage.

Press Release: Governor Abbott, HHSC Announce $128 Million To Support Staffing Needs At Rural Hospitals, Nursing Facilities | Office of the Texas Governor | Greg Abbott

According to the HHSC Provider Finance representative- Ms. Ellison at LTCR Dec. 7th meeting with the IDD workgroup, this is the information on how the state-controlled ARPA funds appropriated via SB 8 (3rd Special Session) will be distributed.  [Remember: These funds are separate from the HCBS 10% FMAP funds.]

December 12th, 2021

ISS (Individualized Skills and Socialization)  

Changes to Day Habilitation (DH) programs are coming for HCS/TxHmL!  The link below contains a discussion concerning the implementation of a recommendation in the Rider 21 Report (General Appropriations Act for FY 2020-2021, 86th Session) related to the monitoring of DH programs which will transition to the provision of ISS.

To view, the report go to:  https://www.hhs.texas.gov/sites/default/files/documents/laws-regulations/reports-presentations/2021/rider-21-transition-day-habilitation-services-jan-2021.pdf

• Current DAHS providers who want to also provide ISS.
• HCS/TxHmL providers operating a DH and serve persons eligible to receive ISS.
• Independent DH providers serving persons eligible to receive ISS.
• ICF/IID providers who operate a DH and only serve persons receiving ICF/IID services will not be required to obtain the license. However, if the ICF/IID provider opens its DH program to serve persons eligible to receive ISS, such as persons enrolled in HCS/TxHmL, it will need to obtain the license.

November 4th, 2021

HCS and TxHmL Annual Vendor Submission Timeframe

The timeframe to submit for annual vendor approval is Nov.1, 2021 through Jan. 31, 2022. Required documentation for annual vendor requests are in the HCS and TxHmL Billing Guidelines, Section 6160(b)(2), Approval of Annual Vendor. Email packet submissions to Billing and Payment with the subject line: Annual Vendor Approval. Submissions sent to any other email addresses may not be received.

If you are unable to meet the deadline to submit, please request an extension by emailing Kaliope Schmidt, the Provider Fiscal Compliance manager. or Email Provider Fiscal Compliance or call at 512-438-5359  with your questions.

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

Email packet submissions to Provider Fiscal Compliance with the subject line: Annual Vendor Approval.

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

New & Current HCS/TxHmL Providers, Please Take These Trainings

These are the courses that are really applicable to HCS/TxHmL providers below and they are all free.  Click on them to go directly to these pages:

November 23rd, 2021

 While most of the suspensions related to COVID-19 have ended, the following HCS suspensions are still in place.

• HHSC will still allow an HCS four-person residence to add up to two additional individuals temporarily if the residence has the space to accommodate them and has been approved as a four-person residence by HHSC. (Rule: 40 TAC §9.153(39)(B))
• Suspension of the requirement for HCS providers to ensure at least one complete staff shift change per day for individuals receiving residential support. (Rule: §9.174(a)(38)(C))
• Suspension of the requirement for day habilitation to be provided in accordance with the individual’s person-directed plan, individual plan of care, implementation plan, and Appendix C of the HCS Program waiver application. (Rule: §9.174(a)(28))
• In Relation To a recent alert from HHSC concerning “Background Checks”: 40 TAC 9.177(n) states “The program provider must comply with §49.304 of this title (relating to Background Checks).” This rule has not been waived and is still required.
• Concerning IPC’s & IDRC’s and signatures, I have verified with LTCR (Long-Term Care & Regulatroy) policy department the following:                                                                      The policy letter you will need to reference is  IL 2020-45  and it is currently still valid.

  According to HHSC, a service coordinator or program provider is not required to obtain signatures of the individual or LAR on an IPC renewal/revision or on supporting documentation. However, the program provider or LIDDA service coordinator must obtain an oral agreement from the individual or LAR about the IPC renewal/revision and supporting documentation and document the oral agreement in the individual’s record.  A program provider or LIDDA service coordinator must obtain the signature of a person, other than the individual or LAR, who is required to sign the IPC renewal/revision or supporting documentation.

For more information regarding the End of Temporary Suspension of Certain LTCR Requirements During COVID-19 Outbreak please see Provider Letter 2021-29.

November 10, 2021, HCS, TxHmL, CLASS, DBMD Webinar Recording Available

As some of you may know, Twogether Consulting does not work for Taskmaster Pro, but we do have quite a bit of experience with their software and I love the benefits of this “cloud-based” program.  In the past, I have also used the software for my own HCS program as we had HCS contracts in over 32 counties.  Electronic Records were a must for us with that many counties to keep track of and service providers to monitor!  No matter who you choose to provide those services.  I do, however, highly recommend that if you currently do not have any type of electronic records system that you might want to start thinking about it, especially if you do have lots of area to cover or a large number of individuals in your program.  There are a couple of other programs out there I like and we help providers regardless of what they have chosen to put in place  I am no longer an HCS provider myself, as I am so busy with Twogether Consulting, lol but I certainly enjoy helping our clients using TMP. 

Currently, we do provide quality assurance to providers in Texas and some out of state. Twogether Consulting often provides additional webinars, training, and assistance for providers who are receiving services from TaskMaster Pro software to help them implement their nursing programs more efficiently with TMP’s great tools. We can also assist providers with getting the most out of your TMP software for facility quality assurance. Typically quality assurance plans are quarterly and/or as needed for example.  We provide mentoring for new Case Managers, Q’s, and Nurses, using the TMP software. This can be done off-site and therefore is more cost-effective for the provider.  

November 16th, 2021

Starting August 2021, HHSC has begun the transition to one system for Provider Enrollment Management which will move to 1 “smart system” if you want to become a Medicaid vendor/Medicaid provider, re-enrollment every 5 years, and the forms/application will be uniform.  They will go directly into TMHP system, not to HHSC.  The current paper application forms will not be required.  They have begun the process with existing providers.

One system=PEMS
One NPI-based enrollment
One dynamic smart application (no paper)
One dynamic smart provider agreement
One standardized set of enrollment forms
One provider message board

In Summary:

Providers will be enrolling through PEMS online application, no more paper applications. You will no longer enroll  through HHSC, the application will go directly to TMHP

IDD providers may recall that in 2015 legacy DADS issued a notice that Medicaid providers had to enroll or re-enroll in Medicaid by March 24, 2016, and every 5 years thereafter.  At the time, the process required payment of an application fee that was sent to legacy DADS.   Providers were informed, that as a result, the PHE, revalidation was postponed, and that changes to the process were forthcoming (in particular, that the application process would be completed through a TMHP portal).

Effective February 28, 2022 HHSC is ending the flexibility that extended revalidation dates due during the PHE.

• Providers that were due for revalidation effective March 1, 2020 through February 28, 2022 will be given a post-PHE grace period to complete the revalidation process.  TMHP will notify providers in January 2022 of their recalculated enrollment end date and again 120 days prior to their enrollment end date.
• A webinar to review the process will be held December 7, 2021. See registration link below.
• The system/portal will go live December 13, 2021.

• Link to PHE info: Provider Enrollment Revalidation Extensions to End on February 28, 2022 | TMHP

  Register for the December 7^th webinar: https://www.tmhp.com/news/2021-11-05-register-now-pems-provider-webinar

• Other Resources/Notices:

  https://www.tmhp.com/news/2021-11-05-coming-soon-tmhp-provider-enrollment-and-management-system-pems-0

  https://www.tmhp.com/news/2021-10-29-coming-soon-tmhp-provider-enrollment-and-management-system-pems

  https://www.tmhp.com/news/2021-10-13-coming-soon-tmhp-provider-enrollment-and-management-system-pems

  https://www.tmhp.com/news/2021-09-24-coming-soon-tmhp-provider-enrollment-and-management-system-pems

November 6th, 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.

• Link to Interim Final Rules and FAQs (scroll to bottom of page): https://www.cms.gov/newsroom/press-releases/biden-harris-administration-issues-emergency-regulation-requiring-covid-19-vaccination-health-care
• CMS is hosting national call/webinar Nov. 4th at 2:00 ET:  https://cms.zoomgov.com/webinar/register/WN_7IlEgLznTIm3sqAsv3nHZw

• Link to interim rules:  https://public-inspection.federalregister.gov/2021-23643.pdf
• Link to webinar on YouTube:  https://www.youtube.com/watch?v=ixxkn3Y8z6g&ab_channel=USDepartmentofLabor
• Link to FAQs:  https://www.osha.gov/coronavirus/ets2/faqs

HHSC Publishes Acceptable Documentation for a Criminal History Check for Contractors (IL 2021-48)

HHSC has published IL 2021-48 (PDF).

This letter is provided as a companion letter to PL 2019-01 (PDF) which describes acceptable documentation a contractor may use to demonstrate the contractor conducted a criminal history check of an employment applicant or an employee. Licensed contractors must continue to follow the guidance outlined in PL 2019-01. Unlicensed contractors must follow the guidance in this information letter.

For questions about this information letter, please contact LTSSpolicy@hhs.texas.gov

HHSC Publishes Information to Assist People with Terminated SSI (IL 2021-47)

HHSC has published IL 2021-47 (PDF).

It assists people with terminated Supplemental Security Income. In Texas, people who get Supplemental Security Income benefits are eligible for Medicaid. Under normal circumstances, termination of SSI benefits results in losing Medicaid coverage.  When the continuous Medicaid coverage period ends, these individuals will lose their Medicaid coverage unless their SSI benefits are reinstated they are found eligible for Medicaid under other criteria. If Medicaid coverage ends for an individual enrolled in a waiver program, their waiver program services will also end.

Following the declaration of a federal PHE (public health emergency) on Jan. 27, 2020, federal guidance allows HHSC to maintain Medicaid coverage for people who lose their SSI benefits.

●Applying to have SSI reinstated by the SSA .  ●Applying for Medicaid for the Elderly and People with Disabilities using Form H1200 and Form 1746-A.

Service coordinators and case managers should also encourage individuals to report changes in their circumstances to HHSC, even during the PHE, to ensure contact and eligibility information remains accurate. These changes may include changes of address, phone number, or pregnancy status. Individuals may report changes online at www.yourtexasbenefits.com, by calling 2-1-1, or by contacting a local HHSC benefits office

October 18th, 2021

• Pages 3-24 contain the committee report in bill language.  To view bill language related to the one-time direct care recruitment and retention payments, see Section 33, pages 22-24.
• Pages 25 – 75 reflect the conference committee decisions.  To view decisions specific to retention and recruitment payments, see Section 15, beginning at the bottom of page 45.  The first column reflects the Senate’s version of SB 8; the middle column the House’s version; the last column the conference committee decisions
• Pages 76-77 provide the bill’s fiscal note.

October 3rd, 2021

HHSC Announces HCS and TxHmL Interpretive Guidance Page

HHSC Long-term Care Regulation created the HCS and TxHmL Interpretive Guidance page. This page connects program providers with relevant tools for rule interpretation. It includes the Interpretative Guidance booklet and Certification Principle training.

October 3rd, 2021

Twogether Consulting highly recommends you read through the HCS/TxHmL Interpretive Guidance Booklet and keep this PDF downloaded on your desktop for reference in preparation for survey and for addressing Plans of Corrections after your survey.  This guidance is meant to give you information on what surveyors expect to see when coming to your facility as well as examples of critical vs. non-critical scenarios to help you identify the type of Administrative (monetary) penalties you may incur due to violations (previously citations) made concerning the HCS/TxHmL TAC rules and regs. It is extremely helpful (especially concerning nursing requirements and expectations).

September 30th, 2021

CAP Update: Administrative Penalties for ICFs (PL 21-34)

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

September 21st, 2021

Updated CDC Guidance for LTC Facilities on Accessing COVID-19 Vaccine – Sept. 2021

The Centers for Disease Control and Prevention has recently updated resources for long-term care facilities on how to help residents and staff access COVID-19 vaccines:

• Vaccine Access in Long-term Care Settings
• Care Administrators and Managers: Options for Coordinating Access to COVID-19 Vaccines
• Jurisdictions Can Ensure COVID-19 Vaccine Access for Staff and Residents in Long-term Care Settings

September 21st, 2021

COVID-19 Vaccine Status Not a Requirement for Services

In accordance with Governor Abbott’s Executive Order No. GA-39, providers must not require clients to provide documentation of their COVID-19 vaccine status as a condition to receive any Texas Medicaid service.

September 15th, 2021

Update: Getting COVID-19 Vaccines-ICF/IID

Nursing, assisted living, and intermediate care facility staff and residents who want to receive the first, second or third dose of the COVID-19 vaccine may use the options below.

Contact the HHSC LTCR Regional Director in the region where the facility is located. Request a mobile vaccination clinic at your facility. The mobile vaccination clinic can administer first, second, or third doses of the COVID-19 vaccine to residents and staff. Facilities may need to make alternate arrangements for staff and residents to receive any more doses after the vaccination clinic.

Enroll as a DSHS COVID-19 Vaccine Provider. Once registration is complete, vaccine providers can request vaccines. Email COVID-19 Vaccination Enrollment or call the DSHS COVID-19 Vaccine Provider hotline at 877-835-7750 with questions. Read the DSHS Vaccine FAQs for more information.

Contact the pharmacy or vaccine supplier. Coordinate directly with your COVID-19 vaccine supplier to schedule vaccine administration for those who want the vaccine.

Use the following to locate vaccines:

• COVID-19 local health entities or DSHS region
• DSHS COVID-19 Vaccine Home page

CMS Adds COVID-19 Vaccination to ICF Rules (QSO-21-21-ICFIID)

August 27th, 2021

The Centers for Medicare and Medicaid Services issued Quality Safety & Oversight Memo QSO-21-21-ICFIID (PDF). The memo announces the addition of COVID-19 vaccine immunization-related requirements. This includes:

• New requirements for educating a person or their representatives as well as staff on the benefits and potential side effects with the COVID-19 vaccine.
• Offering the vaccine.

From DSHS website July 19th, 2021

How to Become a COVID‑19 Vaccinator

. Any facility, organization, or healthcare provider licensed to possess or administer vaccines or provide vaccination services is eligible to enroll through DSHS.

The first step to becoming a COVID‑19 vaccine provider is registering through EnrollTexasIZ.dshs.texas.gov.

Only providers registered through this site can receive and administer COVID‑19 vaccine in Texas.

For questions about registration, please call the DSHS COVID‑19 Vaccine Provider hotline at (877) 835-7750, 8 a.m. to 5 p.m., Monday through Friday or email COVID19VacEnroll@dshs.texas.gov.

Watch a joint video message from TMA President Dr. Fite and DSHS Commissioner Dr. Hellerstedt on COVID‑19 vaccine provider enrollment.

Registration Process 

Each facility or location, including those that are part of a hospital system or clinic network, must register at EnrollTexasIZ.dshs.texas.gov, complete the Centers for Disease Control and Prevention (CDC) COVID‑19 Vaccination Program Provider Agreement and list the healthcare providers at that location that would be responsible for vaccination.

It is recommended to use the Google Chrome internet browser to complete the COVID‑19 Provider Agreement.

For example, each hospital in a hospital system must complete a registration separately and list vaccine providers there.

More information on the CDC requirements is below.

• COVID‑19 Vaccine Provider Frequently Asked Questions
• Patient Population Adjustment Form
• Texas DSHS Immunization Portal Registration Guide
• Tips and Tricks for Enrolling for COVID‑19 Vaccine Program
• Best Practices for Data Loggers
• COVID‑19 Vaccine Management Resources

After Registration

After completing enrollment, you will receive an email confirming your registration. Once approved, you will receive another email confirming your status as a COVID‑19 vaccine provider.

August 15th, 2021

COVID-19 Vaccination Data Reporting Rule:  ICF

HHSC Long-term Care Regulation has published a revised version of the COVID-19 Vaccination Data Reporting Rule (PDF). The rule now includes Emergency Communication System Enrollment for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions.

The rule requires facilities to report COVID-19 vaccination data within 24 hours and enroll in an emergency communication system. HHSC will inform facilities when they can begin enrollment.

The rule became effective Aug. 11.

February 23rd, 2021

IDD Vaccine Plan Approved (HCS/TxHmL/ICF)

February 12th, 2021

HCS/TxHmL:  

Today DSHS reported it has finalized its presentation of the Tarrytown Expocare vaccine plan that the three IDD associations, Tarrytown and DSHS have been working on for many weeks.  DSHS says the plan will be presented to DSHS Vaccine Leadership and the Commissioner today and also the Expert Vaccine Allocation Panel (EVAP) at its next meeting Monday morning.  They expect to present this plan to the Governor’s Office Monday evening at which point DSHS feels it will have a final answer as to whether the plan is approved. Currently, we are not sure when it will be approved.

**This plan was developed using data the three IDD associations obtained from their respective members which include number of vaccines needed in both ICF/IID and HCS/TxHmL programs.  Thank you for all the work our IDD associations do for providers and individuals in the program!)

• HHSC has not made a decision whether this same reporting requirements ICF requires, will be established for the HCS/TxHmL program.

February 12th, 2021                                                                 

ICF/IID:

HHSC will soon release emergency rules and a Provider Letter related to the process it will use to identify which facilities (staff and residents) have already received the vaccine.

A stand-alone webinar on the requirement will also be held.  Here is the link to draft Provider Letter and draft emergency rules 

(So remember to update your policies and procedures for COVID-19 /infection control policies and procedures!!!)

ICF/IID providers will be required to complete a survey indicating how many residents and staff have received the vaccine (1st, 2nd, or both doses).  The survey will be open for at least the duration of the emergency rule, requiring providers to add any new information about the status of the vaccines given  This will allow providers to report 2nd doses given if such was not reflected in a provider’s first data entry (that is provided the individual received a 2-dose vaccine.  Some vaccines will only have 1 dose- i.e. Astrozenica), or to report receipt of newly first-doses given.

After this three week period, HHSC will reconcile the data to identify where gaps exist. This process will include contacting providers as needed to confirm the information reported through the survey.  HHSC anticipates the reconciliation process taking 2 or 3 days.

The data will then be sent to DSHS to be used to link providers still in need of the vaccine (whether 1st or 2nd dose) for the individuals they serve and their staff.  This process will take about 2 weeks.  The full process should take 5 weeks total, assuming HHSC completes its reconciliation process in a timely manner and DSHS is able to link providers to a vaccine entity in a speedy and efficient manner.

• Providers will not be cited on the rule, but it is possible to receive a citation from a desk audit (HHSC did not elaborate on this).
• The survey does not capture (and is not intended to capture) data on individuals who have opted not to receive the vaccine.
• Recognizing that not all providers are aware of or are tracking the vaccination status of their staff, providers only need only to report the number of staff of which they are aware have received the vaccine.

.

HHSC has revised the Updated HCS and TxHmL COVID-19 FAQ (PDF)  in response to the revised HCS and TxHmL COVID-19 Mitigation and Visitation rules.

September 21st,2021

COVID-19 Response Plan Revised HCS/TxHmL

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

9/21/21
Updated to reflect changes in response to GA-38 regarding facemasks and updated CDC guidance

The Table of Contents on pages 4 and 5 of the Response Plan will tell you what changes were made, each time the plan was revised, and the date.

February 22nd, 2021

COVID-19 FAQ’s From HHSC for HCS/TxHML

https://hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/provider-portal/long-term-care/hcs-txhml-general-covid-faq.pdf

January 7th, 2021

Texas Medicaid CHIP COVID-19 Information 

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

December 2, 2020

Reminder: Requirements and Protocol for COVID-19 Emergency Staffing Requests

HHSC LTCR offers emergency staff for facilities facing severe critical shortages. Emergency staffing is only approved for facilities that can’t provide necessary care to residents due to staffing shortages. Emergency staffing is temporary while facilities get alternative staffing resources.

Facilities must have staffing contingency plans in place to address potential staffing shortages due to COVID-19. (42 CFR §483.73(b)(6)).

Facilities are required to have separate staff assigned to each COVID-19 cohort and not share staff between cohorts unless necessary to maintain adequate staffing (40 TAC §19.2802(i)).

Facilities may only request emergency staffing from HHSC if all the following contingency strategies have been exhausted.

• Share staff between unknown COVID-19 status and positive COVID-19 cohorts (see CDC guidance).
• Contact staffing agencies, nearby health care facilities, partners, or local colleges or health care centers to identify supplemental staff. (40 TAC §19.2802(j))
• Identify alternate facilities with adequate staffing to care for residents with COVID-19.
• Note: Nursing facilities must contact their LTCR Regional Director and local health department before using staff who are asymptomatic and have, or may have, COVID-19. This is generally only allowed in emergencies. Implement or attempt all other staffing contingency strategies listed above before this step.

If a facility has implemented or attempted each item listed above and still does not have adequate staff to meet critical staffing levels, the facility must contact the Regional Director for their LTCR Region to request emergency staffing.

If approved for emergency staffing, facilities must submit a transition plan for addressing shortages that includes the following.

• Forecasted timeline for when COVID-19 positive staff will return to work, using the CDC’s Return to Work criteria, and when emergency staff can be released.
• Acquiring temporary staff or recruiting new hires.
• All other strategies for ensuring critical staffing shortages are fulfilled as soon as possible.

December 2, 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

Reminder to LTC Facilities about Death Reporting Requirements

July 22, 2020

The following are HHSC’s requirements for care facilities to report residents/individuals’ deaths to HHSC, including deaths from COVID-19.

• Intermediate care facilities must report all deaths to Complaint and Incident Intake within one hour. See:
  • PL 17-02 (licensed facilities)
  • PL 17-03 (non-licensed facilities).
• Home and Community-based Services and Texas Home Living Program Providers must report all deaths of people receiving HCS or TxHmL services to HHSC by the end of the next business day following the death or the program provider’s learning of the death. See IL 12-28.

***Note: If the death may have been from abuse, neglect or exploitation, more reporting requirements may exist.

LTC Providers Required to Report COVID-19 to HHSC

Effective immediately, a provider must report every confirmed case (only confirmed cases) of COVID-19 in staff and individuals receiving services from the provider as a self-reported incident. A presumptive or confirmed case is considered a critical incident.

Providers (other than HCS and TxHmL providers) must notify HHSC through TULIP or by calling Complaint and Incident Intake (CII) at         1-800-458-9858.

HCS and TxHmL providers must notify HHSC at waiversurvey.certification@hhsc.state.tx.us

For FAQ’s For Covid-19

Contact Information For Questions:

• 512-438.5359
  schmidt@hhsc.tx.us.state
• 
  Policy Specialist for HCS/TxHmL
• hcspolicy@hhsc.state.tx.us

Guidance for LTCR Providers on Coronavirus

LTCR urges all providers to review the Centers for Disease Control’s new guidance on strategies to prevent the spread of COVID-19 in long-term care facilities. To ensure you have the most current information on COVID-19, visit the CDC and DSHS websites. For questions or guidance, call one of the DSHS hotlines:

• 888-963-7111
• 877-570-9779

All providers must continue to follow all laws, regulations, guidance and their own internal policies and procedures related to infection control.

From The CDC website:

HHSC and Money Follows the Person Demonstration Grant

Bringing webinar series to health care professionals.

It discusses the work of Dr. Montessori and the Montessori Method when working with older adults with dementia. Dr. Cameron Camp provides this series.

The series will also focus on understanding the application of Montessori principles to improving staff engagement. Discussions includes specific principles and techniques.

Montessori Inspired Lifestyle: Montessori Based Dementia Programming
Sept. 28, 2021
9 a.m. – 4 p.m. CST
Register for the Montessori Based Dementia Programming webinar.

Applying Montessori Principles for Home Care Workers
Oct. 5, 2021
9 a.m. – 4 p.m. CST
Register for the Applying Montessori Principles for Home Care Workers webinar.

Applying Montessori Principles for Leadership and Staff Engagement
Oct. 26, 2021
9 a.m. – 4 p.m. CST
Register for the Applying Montessori Principles for Leadership and Staff Engagement webinar.

Applying Montessori Principles for Families and Loved Ones of Persons with Dementia
Oct. 28, 2021
9 a.m. – 4 p.m. CST
Register for the Applying Montessori Principles for Families and Loved Ones of Persons with Dementia webinar.

This course is for everyone. The focus is on direct care professionals, certified nursing assistants, attendants, social workers, nurses, administrators and activity professionals, recreation therapists, rehabilitation staff and other health care professionals.

HHSC and CHIP Services plans to offer 1.5 continuing education credits to:

• Licensed social workers, marriage and family therapists, psychology professionals and professional counselors
• Certified nurse aides
• Long-term care ombudsmen guardianship
• Assisted living facility managers
• Occupational therapists and assistants
• Qualified intellectual and developmental disability professionals
• Day activity and health services managers and home health and hospice managers

Nurses can receive CEs. CEUS provided by CEU Network have an added fee paid to CEU Network. The information will be provided in class. Other credentialing bodies are still pending.

CMDCP Certified Montessori Dementia Care Professional Certification:

Participants can apply for the Montessori certification, CMDCP Certified Montessori Dementia Care Professional with ICCDP, after attending one of the above seminars. The discounted price for the CMDCP application is $35 versus $135. Applications must be completed online within 30 days of completing the seminar. Visit www.iccdp.net or contact the International Council of Certified Dementia Practitioners at iccdpcorporate@iccdp.net for information about CMDCP Certified Montessori Dementia Care Professional certification. Obtain the handout as part of the webinar. It explains the steps to apply online and receive the discount.

Visit cen4ard.com for information about the courses.

HHSC Publishes Guidance for Ending of the Temporary Suspension of Certain LTCR Requirements During COVID-19 Outbreak (PL 2021-29)

Updated September 15th, 2021  (Originally posted on August 15th, 2021)

HHSC has published Provider Letter 2021-29 (replaces PL 2020-21 and 2020-26) – End of Temporary Suspension of Certain LTCR Requirements During COVID-19 Outbreak (PDF).

The letter describes the rule suspensions that ended, the rule suspensions that are still in place, and the rule suspensions that will be ended in the future.

See below specifics for HCS & ICF Only  (link above takes you to guidance for all LTC types of providers)

Suspension of Therapeutic Leave ends August 4th, 2021

• ICF/IID:
• Therapeutic Leave. (Rule: 26 TAC §261.226(a)-(f)); Statute: HSC §252.203(2))

The suspension of license application and renewal timeline requirements ends on October 3, 2021.

ICF/IID:
• Rules: 26 TAC §551.15(a), (d), and (e) and §551.21(a), (c), and (e)

The following rules will no longer be suspended effective November 2, 2021:-Fire Marshall Approval Documentation

ICF/IID: 26 TAC §551.12(a)

Suspensions Still in Place

• HCS:
• Updated September 15th– HHSC will now allow an HCS four-person residence to add an additional 2 individuals temporarily if the residence has the space to accommodate and has been approved as a four-person residence by HHSC. (Rule: 40 TAC §9.153(39)(B))

•The program provider must notify HCS Survey Operations of the additional individual(s) by emailing the following information to WaiverSurvey.Certification@hhsc.state.tx.us.

•Provider Name and Contract Number

•Name and CARE ID of the individual moving

•Location code and address of permanent residence•Location code and address of temporary residence

Other Suspensions for HCS In place.

• Suspension of the requirement for HCS providers to ensure at least one complete staff shift change per day for individuals receiving residential support. (Rule: §9.174(a)(38)(C))

• Suspension of the requirement for day habilitation to be provided in accordance with the individual’s person-directed plan, individual plan of care, implementation plan, and Appendix C of the HCS Program waiver application. (Rule: §9.174(a)(28))

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

September 5th, 2021

HHSC Publishes In-Home Day Habilitation Information for Program Providers for COVID-19 (IL 2021-39)

The Texas HHSC is temporarily waiving certain requirements in Section 3710, 4381.3, 4381.7(6) and 4381.7(7) of the Home and Community-based Services Billing Guidelines and the Texas Home Living Billing Guidelines.

This is in response to COVID-19 and to provide access to needed day habilitation services.

HHSC has published a revision to this guidance, IL 2021-39 In-Home Day Habilitation Information for Program Providers for COVID-19 (PDF), replacing IL 2021-33.

It extends the temporary guidance through September 30, 2021.

Email questions to HCSPolicy@hhsc.state.tx.us

May 3rd, 2021

HHSC Publishes In-Home Day Habilitation Information for Program Providers for COVID-19 (IL 2021-20)

The Texas HHSC is temporarily waiving certain requirements in Section 3710, 4381.3, 4381.7(6) and 4381.7(7) of the Home and Community-based Services Billing Guidelines and the Texas Home Living Billing Guidelines.

This is in response to COVID-19 and to provide access to needed day habilitation services.

HHSC has published a revision to this guidance IL 2021-20 In-Home Day Habilitation Information for Program Providers for COVID-19 (PDF) which replaces IL 2021-16. It extends the temporary guidance through
May 31, 2021.

Email questions to HCS Policy.

April 17th, 2021

Revisions to Guidance For Day Habilitation Providers Coming!

HHSC and DSHS are working on revisions to the DSHS Guidance for DHs.  Once revisions are finalized HHSC will notify providers.

March 25th, 2021

Program Provider Response to COVID-19 and Visitation Expansion-

Day Habilitation Off-Site

2.1.8 Day Habilitation and Outside Employment
Individuals receiving HCS or TxHmL services can choose to attend off-site day habilitation that is in compliance with DSHS Checklist for Day Habilitation Sites or outside employment with documented informed decision-making.
• The program provider’s infection control policy must include provisions specific to those attending off-site day habilitation, employment, or any other community activity to ensure the health and safety of individuals.
• The program provider must screen individuals for fever and other signs and symptoms of COVID-19 upon their return to the residence.
• If program provider staff does not provide transportation, the program provider should arrange for pick-up and drop-off to occur outside the residence when possible. If transportation staff must enter the residence to prepare individuals for transportation, they must be screened and wearing a face mask.
• Program providers must provide oversight of day habilitation settings to ensure compliance with their contract. They must request documentation (e.g., policies, plans, procedures) from the day habilitation site that demonstrates how it plans to comply with DSHS guidance. For outside employment, the program provider must request from the employer information on how the employer is responding to COVID-19 to protect its employees.
PL 21-09 March 25, 2021 Page 5 of 20

• The program provider must ensure individuals are supplied with masks or cloth face coverings and encourage their appropriate use, unless contraindicated. The provider cannot charge individuals for facemasks or face coverings.
Providers are responsible for ensuring the health and safety of the individuals in their care. In the context of deciding whether to attend outside day habilitation sites, the program provider fulfills this responsibility by participating in the informed decision-making process, which includes:
• Providing a full list of available options and alternatives, including in-home day habilitation, if available;
• Assessing the risks of attending day habilitation;
• Providing training on PPE, hygiene, and physical distancing;
• Except for individuals in host-home and own home/family home settings, ensuring that individuals have access to PPE.
For individuals in a host home and own home/family home settings, the program provider must encourage individuals to wear a facemask or face covering over the nose and mouth and use any other required PPE necessary to safely attend the day habilitation site.
The program provider must only contract with a day habilitation site that agrees to comply with DSHS guidance. As part of its contractual oversight of the day habilitation site, the HCS or TxHmL program provider should set up a system to monitor compliance with DSHS guidance.
In addition, the program provider must include in its contract a requirement for the day habilitation site to inform individuals, program providers, staff, and family when it is aware of probable or confirmed cases of COVID-19 among staff or the individuals it serves. However, a day habilitation site must not release personally-identifying information regarding confirmed or probable cases.

September 5th, 2021 

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

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

.

The Informal Dispute Resolution (IDR) process gives nursing facilities, assisted living facilities, intermediate care facilities, Home and Community-based Service and Texas Home Living waiver providers the opportunity to informally dispute regulatory survey findings. (Texas Government Code §531.058 and Human Resources Code §161.0892).

In accordance with Senate Bill 304, 84th Texas Legislature, 2015, and House Bill 2590, 85th Legislature, 2017, the Texas Health and Human Services Commission has contracted with Michigan Peer Review Organization (MPRO) to perform IDR reviews and make a recommendation of compliance or non-compliance.

To request an IDR, facilities must submit via email a fully executed IDR Request Form to the HHSC IDR Department within 10 calendar days of receiving the official Statement of Deficiencies (Forms 2567/3724) or Final Report. If a timely request is made for an IDR, HHSC will forward the request to MPRO. Facilities/providers are then required to submit a rebuttal letter and supporting documentation directly to MPRO within the required timeframes.

Request Forms

• IDR Request Form for NFs, ALFs, and ICFs (PDF)

Due Dates

Supporting documentation due dates are as follows:

• For NFs, ICF and the HCS/TxHML waiver providers the due date is the 5th calendar day after submitting the IDR Request form to HHSC on time.

Note: If the due date falls on a Saturday, Sunday or legal holiday, the due date becomes the next business day.

Where to Submit Your Supporting Documentation

All rebuttal information may be submitted via MPROs IDR Secure Application. Find instructions and link at www.mpro.org/texas-idr, or by mail to the address below:

MPRO – IDR Department
22670 Haggerty Road, Suite 100
Farmington Hills, MI 48335
www.mpro.org/texas-idr

For questions or problems with submitting supporting documentation, contact MPRO:

Aris Rhodes-Bond, IDR Project Specialist
248-465-7405

Charlene Kawchak-Belitsky, IDR Senior Manager
248-465-1038

Email: iidrgroup@mpro.org

Texas Administrative Code rules for IDR

• SNFs/NFs and ICF/IIDs

For questions or problems with submitting the IDR Request Form, contact IDR:

HHSC IDR Department
IDR@hhsc.state.tx.us
512-706-7268