DADS Provider News, Alerts & Bulletins —
Family Care (FC)
Take and Share this Important Survey on Disability Employment
The National Council on Independent Living (NCIL) is seeking broad support from the disability community in filling out their disability employment survey. Answers to the survey questions are intended to shape debate about disability policy, and the results will be shared with the White House, all 50 Governors, top media, and disability groups, among others.
A very large sample size is needed to ensure that the survey results are valid, so NCIL requests that you share the survey with your Twitter, Facebook and email networks. The survey takes about 10 minutes, and all survey respondents can be entered to win $500. For further information, please contact Jennifer Laszlo Mizrahi at firstname.lastname@example.org or 202-365-0787.
Click here to access the survey.(11/21/2013)
Refax Provider Investigation Reports Faxed to DADS between 5 p.m. on November 8, 2013 and 5 p.m. on November 12, 2013
Due to software technical difficulties experienced over the holiday weekend, DADS may not have received any faxed Provider Investigation Report, DADS Form 3613 or 3613-A. Please refax any Provider Investigative Report that was faxed to DADS between 5 pm on Friday, November 8, 2013 and 5 pm on Tuesday, November 12, 2013. We apologize for the inconvenience. Instructions for faxing Provider Investigation Reports continue to be found on the following DADS webpage: http://www.dads.state.tx.us/services/crs/incidentforms/index.html.(11/18/2013)
DRAFT Guidelines for Electronic Signatures Posted for Public Comment
The Department of Aging and Disability Services (DADS) is distributing the attached electronic signature draft policy letter for public comment. The comment period ends at 5 p.m. on November 25, 2013.
DADS has developed this draft electronic signature policy to be consistent with national and state standards for electronic signatures set by the Texas Health and Human Services Commission and the Texas Uniform Electronic Transactions Act.
When this policy becomes effective, DADS will begin accepting electronic signatures on documents that are necessary for the delivery of program services or to support service delivery. After electronic signature, documents must be printed and faxed or sent by U.S. mail to DADS by license holders and contracted providers.
Please send comments to PDO@dads.state.tx.us.(11/13/2013)
Notice of DARS Town Hall Meetings
The Texas Department of Assistive and Rehabilitative Services (DARS), in partnership with the Rehabilitation Council of Texas, is providing an opportunity for public comment through town hall meetings across the state. We want to learn more about the vocational rehabilitation needs of Texans with disabilities. We will use this information as part of a Comprehensive Statewide Needs Assessment that we conduct every three years.
The locations, dates, and times of the upcoming meetings are listed below.
Wednesday, October 16, 2013
American Foundation for the Blind
11030 Ables Lane
Dallas, TX 75229
Thursday, October 24, 2013
6487 Whitby Road
San Antonio, TX 78240
Thursday, October 24, 2013
Metropolitan Multi-Service Center
1475 W. Gray St.
Houston, TX 77019
Tuesday, October 29, 2013
RISE Center for Independent Living
755 S. 11th St.
Beaumont, TX 77701
Tuesday, October 29, 2013
Laredo Medical Center
Tower B, First Floor
1700 E. Saunders St.
Laredo, TX 78041
Wednesday, October 30, 2013
Criss Cole Rehabilitation CenterAuditorium
4800 N. Lamar Blvd.
Austin, TX 78756
Tuesday, November 5, 2013
True-Light Christian Fellowship
3001 N. "A" St.
Midland, TX 79705
Wednesday, November 6, 2013
Doctor's Regional Medical Center-Conference Center
3240 Fort Worth St.
Corpus Christi, TX 78411
Thursday, November 14, 2013
Easter Seals Rio Grande Valley, Extension Office
Tavarez Medical Center
801 S. Main St.
McAllen, TX 78501
Printed copies of questions that will be addressed during the town hall meetings will be available at the meetings. If you wish to have input and cannot attend a town hall meeting in your area, electronic or printed copies of questions are available at DARS.Inquiries@dars.state.tx.us or by calling 1-800-628-5115.
All comments must be received by 5:00 p.m. on December 10, 2013.
If you have communication or other accommodation needs and are planning to attend a public hearing, please contact the DARS Inquiries Line at 1-800-628-5115. Requests for accommodations should be made five business days before the date of the hearing.
Please distribute this information to all interested stakeholders.(10/2/2013)
DADS Statement on Federal Government Shutdown
The Texas Department of Aging and Disability Services (DADS) wants to reassure providers and consumers that service delivery and provider reimbursement processes will continue despite the federal government shutdown that began Oct. 1.
For the immediate future, our programs serving Texans who are older and those with intellectual, developmental or physical disabilities will continue uninterrupted. Texas health and human services agencies are monitoring the federal fiscal environment and will continue to assess the effects any federal decisions may have on our programs or consumers, and will keep you updated as the situation changes.(10/1/2013)
Information Letters Retired as of Sept. 12, 2013
The Department of Aging and Disability Services is in the process of reviewing all Information Letters (IL) posted on its website. The ILs listed in this alert have been determined to have no further informational value and are being retired and removed from DADS website.
For questions about any of these letters, please send an email message to email@example.com.
|IL 2006-59||Remittance and Status (R&S) Reports||6/30/2006|
|IL 2006-66||New Fiscal Year -- Reminder||7/20/2006|
|IL 2006-81||New Fiscal Year -- Year End Closing||8/11/2006|
|IL 2006-82||New Fiscal Year -- Year End Closing||8/11/2006|
|IL 2007-42||Revised Notice of Fiscal Year 2007 Cutoff Dates (ICF/MR SG6 - Revises Information Letter 07-34)||8/07/2007|
|IL 2007-51||Remittance and Status (R&S) Report Information||5/18/2007|
|IL 2007-60||Increase in Payment Rates for Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR), Home and Community-based Services (HCS), Texas Home Living (TxHmL) and Community Living and Assistance Support Services (CLASS) and Associated Increases in Fiscal Accountability Requirements for ICF/MR and HCS and in Spending Requirements for CLASS Providers Participating in the Attendant Compensation Rate Enhancement||6/26/2007|
|IL 2007-110||National Provider Identifier (NPI) Contingency Period Ends March 1, 2008||11/27/2007|
|IL 2007-111||Initial Notice of Planned Payment System (Health and Human Services Administrative System) Downtime||11/12/2007|
|IL 2007-112||Second Notice of Tentative DADS Payment System (Health and Human Services Administrative System) Downtime for All Payments including those to Long Term Care (LTC) Providers||12/20/2007|
|IL 2007-126||Final Notice of Tentatively Planned DADS Payment System Downtime for All Provider Payments||1/11/2008|
|IL 2008-23||Posting of Models Used by the Texas Health and Human Services Commission (HHSC) to Evaluate Cost Reports||2/20/2008|
|IL 2008-27||DADS NPI Implementation||3/07/2008|
|IL 2008-65||TMHP Remittance and Status (R&S) Report Information||5/30/2008|
|IL 2008-67||Cutoff Dates for Miscellaneous Claims and Year-end Closeout Processing (ICF/MR Providers, Service Group 5)||8/06/2008|
|IL 2008-68||Cutoff Dates for Miscellaneous Claims and Year-end Closeout Processing (ICF/MR Providers, Service Group 6)||8/06/2008|
|IL 2009-74||Cutoff Dates for Miscellaneous Claims and Year-end Closeout Processing||8/03/2009|
|IL 2009-76||Cutoff Dates for Miscellaneous Claims and Year-end Closeout Processing||8/03/2009|
|IL 2010-52||Use of the TMHP Remittance and Status (R&S) Report Information for Fiscal Year (FY) End||6/09/2010|
|IL 2010-55||FY10 Miscellaneous Claims Cutoff Notice||7/21/2010|
|IL 2010-92||Training Sessions for Attendant Compensation Rate Enhancement||6/16/2010|
|IL 2010-98||Correction to Telephone Contact Number for Fiscal Accountability Short-Period (FASP) Cost Report for ICF/MR Rate Analyst||7/01/2010|
|IL 2010-103||FY10 Cutoff Dates for Year-end Closeout Processing||7/29/2010|
|IL 2010-113||Per Diem Rates Effective September 1, 2010, for the Non-State Operated Intermediate Care Facilities for Persons with Mental Retardation Program||8/23/2010|
|IL 2010-154||2010 Cost Report and Cost Report Training Requirements||12/31/2010|
|IL 2010-157||Proposed Intermediate Care Facility for Persons with Mental Retardation Rate Reductions||12/27/2010|
|IL 2011-19||Per Diem Rates Effective February 1, 2011, for the Non-State Operated Intermediate Care Facilities for Persons with Mental Retardation Program||1/24/2011|
|IL 2011-28||Revised Direct Care Staff Rate Enhancement and Attendant Compensation Rate Enhancement Enrollment Worksheets||2/08/2011|
|IL 2011-32||2010 Cost Report Training Requirements and New Web-based System for Cost Report Submission||2/24/2011|
|IL 2011-42||2010 Cost Report Notification and Cost Report Training Reminders||4/01/2011|
|IL 2011-46||Preparing for FY11 Claims Billing Closeout||7/15/2011|
|IL 2011-48||Critical Notice: Upcoming Change Will Require Physical Addresses Instead of Post Office Boxes to be on File with DADS for TMHP Claim Processing||6/02/2011|
|IL 2011-49||Maximization of Federal Matching Funds Prior to June 30, 2011, Expiration of the American Recovery and Reinvestment Act (ARRA) - LTC Provider Billing Opportunity Deadline||5/04/2011|
|IL 2011-60||Delayed Implementation of the Federal Tax Increase Prevention and Reconciliation Act until January 1, 2013 (Replaces IL 11-44)||5/25/2011|
|IL 2011-66||June 27, 2011, Replacement of Procedure Code Qualifier ZZ||6/14/2011|
|IL 2011-75||Follow-up Request for LTC Provider Billing to Maximize DADS Federal Match Prior to 6/30/11 ARRA Expiration||6/14/2011|
|IL 2011-84||Fiscal Year 2011 Miscellaneous Claims Cutoff Notice: ICF/MR Community/State (Service Group 5) Providers||7/19/2011|
|IL 2011-83||Fiscal Year 2011 Miscellaneous Claims Cutoff Notice||7/19/2011|
|IL 2011-87||Planned Change to Support Only Electronic Claims Submitted to TMHP for Payment of LTC Services||9/19/2011|
|IL 2011-90||FY11 Cutoff Dates for Year-end Closeout Processing||8/05/2011|
|IL 2011-91||FY11 Cutoff Dates for Year-end Closeout Processing||8/05/2011|
|IL 2011-106||Per Diem Rates Effective September 1, 2011, for the Non-State Operated Intermediate Care Facilities for Persons with Mental Retardation Program||8/26/2011|
|IL 2011-161||2011 Cost Report and Cost Report Training Requirements||12/30/2011|
|IL 2011-145||Important April 1, 2012, EDI 5010 Compliance Deadline Information -- affects Provider Claim Payment for ANSI Claim Submitters Only||12/20/2011|
|IL 2012-40||Important July 1, 2012, EDI 5010 Compliance Deadline Information -- affects Provider Claim Payment for ANSI Claim Submitters Only||5/15/2012|
|IL 2012-57||Important Reminder of July 1, 2012, EDI 5010 Compliance Deadline Information: affects Provider Claim Payment for ANSI Claim Submitters Only||6/12/2012|
|IL 2012-62||Preparing for the Upcoming Fiscal Year 2012 Claims Billing Closeout||6/27/2012|
|IL 2012-66||Fiscal Year 2012 Cutoff Notice for Miscellaneous Claims||7/30/2012|
|IL 2012-67||Fiscal Year 2012 Cutoff Notice for Miscellaneous Claims||7/30/2012|
|IL 2012-69||FY12 Cutoff Dates for Year-end Closeout Processing||7/31/2012|
|IL 2012-70||FY12 Cutoff Dates for Year-end Closeout Processing||7/31/2012|
|IL 2012-82||Status of the implementation of the Cost Avoidance Project||10/26/2012|
Texas Department of Aging and Disability (DADS) providers in Regions 2, 3, 4, 5, 6, 7 and 9 who are providing community attendant services in the following programs are required to participate in Electronic Visit Verification (EVV):
- Community Based Alternatives
- Community Living Assistance and Support Services
- Medically Dependent Children
- Primary Home Care
- Community Attendant Services
- Family Care
DADS is requesting comment from those providers on two topics related to the EVV system which are discussed in detail below. The topics are:
- Reduction in the number of reason codes associated with variations from schedule or authorized hours; and
- Reason code alternatives for use when a Fixed Visit Verification (FVV) device is broken.
Comments should be emailed to CPC@dads.state.tx.us by Thursday, August 22. In the subject line, please specify "Reason Code Comment."
- Reduction in the number of reason codes associated with variations from schedule or authorized hours:
Providers have asked DADS to review the required use of reason codes associated with variations from schedule or authorized hours to determine whether codes could be simplified based on our current experience with provider and contract monitoring practice.
The Santrax system requires providers enter a schedule for each client. The system attempts to match calls in and calls out to a particular individual and schedule using the phone number the call was made from, the attendant ID entered, and the time of the call in and call out. Providers have the option to set their system so that calls in or calls out within either two hours or four hours of the scheduled times are accepted without exception. Variations outside those parameters, including calls received that do not match a schedule, are recorded as exceptions and require entry of a reason code in the visit maintenance system.
Following are the reason codes associated with variations from scheduled or authorized hours:
Individual Requested that Personal Care Attendant (PCA) Not Work
Reason Code 07 is selected when a scheduled visit does not occur because the individual receiving services has chosen to cancel the visit. This is a preferred reason code. Less than 1% of June preferred reason code usage.
Additional Hours Per Program Policy
Reason Code 09 is selected when the attendant provides more hours of service to the individual than are authorized when allowed per program policy. This is a preferred reason code. Less than 3% of June preferred reason code usage.
Reason Code 12 is selected when scheduled visits in the system do not occur because the provider has suspended the individual's services per program policy (e.g., individual has been temporarily hospitalized or temporarily in a nursing facility). This is a preferred reason code. Less than 1% of June preferred reason code usage.
Schedule Variation within Authorized Hours
Reason Code 19 is used when the attendant provides more or fewer hours of service to the individual than scheduled or when there is a routine schedule variation, but only the authorized hours are billed to DADS and the individual is within the authorized hours. This is a preferred reason code. Approximately 26% of June preferred reason code usage was RC 19 and RC 23 (now replaced by RC 19).
Individual Agreed PCA Not Work Schedule
Reason Code 22 is selected when the provider contacts the individual receiving services to cancel the visit and the individual agrees to the change in schedule. This is a preferred reason code. Less than 2% of June preferred reason code usage.
Reason Code 25 is used when respite hours are provided. Providers have the option of using variable schedule or the respite reason code for respite hours since frequently these hours are unscheduled or may fluctuate based on the needs of the caregiver. This is a preferred reason code. Not in place in June.
DADS does not require providers to document schedule variations where total hours worked do not exceed authorized hours unless the individual is a priority client requiring a fixed schedule. DADS does require providers to document situations where the hours of service provided exceed the authorized hours. DADS also requires documentation of interruptions in service or breaks in service in certain circumstances.
DADS requests comment on the following options for use of reason codes for schedule variations:
- Replace all of the above reason codes with one reason code with the description: "Schedule variation -- RC xx is used when the attendant provides more or fewer hours of service to the individual than scheduled. All situations that require documentation must be documented in the case record."
- Combine Reason Codes 9, 12, 19 and 25 into one new code and retain Reason Codes 07 and 22 as is. The new reason code would have the description, "RC xx to be used when the attendant provides more or fewer hours of service to the individual than scheduled. RC 07 and 22 may be used in lieu of case record documentation when the individual receiving services has either requested (RC 07) or agreed to (RC 22) a service interruption."
- Leave all of the above codes exactly as they are. If this is done, providers must use the reason codes as described. A provider could not select RC 19 for a schedule variation if a more specific reason code was available. For example, if fewer hours were worked than scheduled because of a service suspension, the service suspension reason code (RC 12) would be used rather than RC 19. If more hours were worked than scheduled on a particular day because of client needs on that day, but the total weekly hours were within the authorized hours, RC 19 would be the appropriate reason code.
- Reason code alternatives for use when a Fixed Visit Verification (FVV) device is broken.
The existing reason codes associated with use of a fixed visit verification (FVV) device are:
Phone Unavailable --
Reason Code 03 is selected when an attendant cannot use the phone to call in/out of the system because the phone is in use when the service provision begins or ends (e.g., the individual is on the line with his/her doctor when the attendant begins their shift). If this becomes a routine issue, an FVV device should be ordered. This is a preferred reason code.
Individual Does Not Have Home Phone -- Verified Services Were Delivered
Reason Code 10 is selected when an individual qualifies for and requires the use of an FVV device, but one has not yet been requested by the provider. If a provider encounters a frequent use of this reason code, the provider must contact DADS to request direction regarding documentation of the situation in question.This is a preferred reason code.
Individual Does Not Have a Home Phone (FVV Ordered) -- Verified Services Were Delivered
Reason Code 16 is only selected when an FVV device has been requested for an individual that does not have a home phone available for EVV, but the provider has not yet received the device. This is a preferred reason code.
Individual Does Not Have a Home Phone (Does Not Qualify for FVV) -- Verified Services Were Delivered
Reason Code 17 is only used to document service delivery to individuals that do not have a home phone available for EVV and are authorized or scheduled to receive services less than once per week (e.g., MDCP respite and adjunct support services). These individuals would not qualify for an FVV device. This is a preferred reason code.
None of these codes addresses the situation when an FVV device is broken and in the process of being replaced. DADS requests comment on the following options for addressing this gap:
- Create a new code to address this specific situation with this description: "Reason Code xx is used to document service delivery when the FVV device is not working. The device may be in the individual's home, in transit to Sandata or returned to Sandata. A replacement device has not been received. This is a preferred reason code." The benefit of creating a new code is that it provides DADS with the ability to track the number of events and the period of time when FVV devices are broken. That information is not currently available from Sandata, and we do not anticipate it becoming available.
- Modify Reason Code #16 to cover any period of time when a device has been ordered and is not in place or is not working. The benefit of this alternative is having fewer reason codes than option 1.
DRAFT Proposed Rules for Title 40, Chapter 49, Contracting for Community Services
The Department of Aging and Disability Services (DADS) has initiated a comprehensive revision to DADS rules related to DADS community services contract requirements.
Significant changes include:
- Applicability to the HCS and TxHmL Waiver programs (refer to 49.101 for program applicability);
- Use of a provisional contract for all programs under Chapter 49; and
- Use of an application denial period.
Concurrent to the revisions to Chapter 49, DADS will propose revisions related to program rules. The companion program rules will be available for review and comment at a later date.
DADS is offering a 30 day informal comment period ending Aug. 14, 2013. Comments may be submitted to: PDO@dads.state.tx.us. Please note "Chapter 49" in the subject line of the email.
Contract Re-enrollment Update
IL 13-19 notified providers required to use EVV of the planned contract re-enrollment for all contracts subject to EVV requirements. On May 1, providers were sent documents necessary to re-enroll their contracts. Currently, the reports necessary to monitor EVV contract compliance are not available in the Santrax system. Some providers have expressed concerns about being subject to compliance requirements before those reports are available.
A provider may terminate their contracts with DADS by giving DADS 60 days notice in writing.
Providers who wish to continue to contract with DADS are required to sign the re-enrollment contract. Failure to submit the required documents by the due date will be interpreted by DADS as an indication of the provider's intent to voluntarily terminate the contract.
The effective date of the new contracts will be no earlier than October 1, 2013. There will be two hold-harmless periods, each lasting one quarter. The first hold-harmless period will not begin until the compliance plan reports are available, even if that is later than October 1, 2013, because DADS has committed that providers will have two quarterly hold-harmless periods to monitor their performance before a quarter begins for which there is a possibility of liquidated damages.
Providers who have not submitted their re-enrollment documents should do so immediately. Providers who have not received their re-enrollment documents should contact Terry Pierce via email at firstname.lastname@example.org.(6/11/2013)
New Appendix - DADS Contract Management
The Department of Aging and Disability Services (DADS) deployed a new appendix to several provider manuals on April 25, 2013. The appendix title is DADS Contract Management. For the applicable programs, this new appendix provides general information about contract management activities, including contract maintenance, contract and fiscal compliance monitoring and investigations.
This shared appendix appears in the following handbooks and manuals on the DADS website:
- Community Based Alternatives Provider Manual (CBA): Appendix XI
- Community Living and Assistance and Support Services Provider Manual (CLASSPM): Appendix VI
- Contracting to Provide Assisted Living and Residential Care Services (CPALRCS): Appendix IX
- Contracting to Provide Home-Delivered Meals (CPHDM): Appendix VI
- Contracting to Provide Primary Home Care Services (CPPHCS): Appendix II
- Contracting to Provide Special Services to Persons with Disabilities (CPSSPD): Appendix VII
- Day Activity and Health Services Provider Manual (DAHS): Appendix X
- Deaf Blind with Multiple Disabilities Provider Manual (DBMD): Appendix I
- Emergency Response Services Provider Manual (ERS): Appendix VII
For questions about this appendix, contact your contract manager.(4/26/2013)
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Updated: April 19, 2013