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DADS Provider News, Alerts & Bulletins — Texas Home Living (TxHmL)

Medicaid Eligibility Reference Guide

The Health and Human Services Commission (HHSC) created a Medicaid Eligibility Reference Guide to provide high-level information to providers regarding eligibility for Medicaid.

The guide is available at: http://www.dads.state.tx.us/providers/HHSCMEReferenceGuid.pdf

The eligibility determination process is complex and providers should not attempt to advise applicants, recipients, or their families on Medicaid eligibility policy. Providers should direct any questions about an applicant’s eligibility for Medicaid benefits to the Health and Human Services Commission.

(6/24/2014)

STAR+PLUS Enrollment Packet Error

HHSC is notifying stakeholders that STAR+PLUS enrollment packets were sent in error to about 2,800 individuals in an intellectual and developmental disability (IDD) waiver who have Medicare and live in a Medicaid rural service area. We are sending notices to those individuals letting them know that they got the letters by mistake and that they don’t need to take any action. These individuals will not be enrolled into STAR+PLUS. Please direct individuals, or those helping them, who may have been affected and have concerns to call the enrollment broker helpline at 1-877-782-6440.

A map with the Medicaid rural service areas can be found here. http://www.hhsc.state.tx.us/medicaid/managed-care/mmc/STARPLUS-MRSA-map.pdf

The individuals who got the letters by mistake receive services through one of these waivers:

  • Home and Community-based Services (HCS)
  • Community Living Assistance and Support Services (CLASS)
  • Deaf Blind with Multiple Disabilities (DBMD)
  • Texas Home Living (TxHmL)

Anyone receiving services through one of these waivers, who also receives Medicare Part B, is excluded from STAR+PLUS enrollment.

(6/24/2014)

IDD Acute Care Carve-In to STAR+PLUS Managed Care

Become Informed, Educated, and Ready to Provide Support and Information to the Individuals You Serve

In the near future, enrollment letters for STAR+PLUS managed care plans will go out to certain individuals for whom you provide services. Click here for information on how you can make the transition into managed care for them as smooth as possible.

(6/16/2014)

STAR+PLUS Provider Training Webinars

HHSC will host STAR+PLUS provider training webinars for the following Long-term Services and Support Providers:

  • Community Based Alternatives (CBA)
  • Primary Home Care (PHC)
  • Day Activity and Health Services (DAHS)
  • Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID)
  • Community Living Assistance and Support Services (CLASS)
  • Deaf Blind with Multiple Disabilities (DBMD)
  • Home and Community-based Services (HCS)
  • Texas Home Living (TxHmL)

On September 1, 2014, the STAR+PLUS Medicaid managed care program will expand statewide to the Medicaid rural service areas of Texas (Central, Northeast and West). People who are age 65 or older or who have disabilities and are covered by Medicaid will begin receiving services through a STAR+PLUS managed care health plan.

Also on September 1, 2014, individuals with intellectual and developmental disabilities (IDD) who are covered by Medicaid and reside in a community-based ICF/IID or receive services through a 1915© IDD waiver will begin receiving acute care services through a STAR+PLUS managed care health plan. Long-term services and supports will continue to be provided through the Department of Aging and Disability Services (DADS).

The Texas Health and Human Services Commission (HHSC) is holding provider trainings to educate providers on STAR+PLUS managed care and what changes to expect. The "STAR+PLUS Provider Training" will be a general STAR+PLUS managed care training targeted to providers in the rural service areas. The "STAR+PLUS Training for IDD Providers" will be targeted to providers who serve individuals with IDD statewide.

The webinars will be offered as follows:

Date Time Training
June 16, 2014 9 a.m. - 10 a.m. STAR+PLUS Provider Training
 

10 a.m. - Noon

STAR+PLUS Training for IDD Providers

July 8, 2014 1 p.m. - 2 p.m. STAR+PLUS Provider Training
  2 p.m. - 4 p.m. STAR+PLUS Training for IDD Providers
August 12, 2014 9 a.m. - 10 a.m. STAR+PLUS Provider Training
  10 a.m. - Noon STAR+PLUS Training for IDD Providers

Please click here to register for one of these webinars.

A series of provider trainings will be offered in person. For additional details and training dates, check the meeting notices on the HHSC website for listings entitled, “STAR+PLUS Trainings.”

(6/11/2014)

Heat Advisory Reminder

Excessive heat is forecast for the upcoming weeks across the state of Texas. It is imperative to ensure everyone’s safety when out in the heat and when transporting people in vehicles.

It is especially important for providers to understand the dangers of excessive heat, symptoms of heat related illness, and preventive measures. Providers should take extra precautions and train staff to ensure all individuals are safely transported and that all individuals safely exit the vehicle when reaching its destination. Staff should be trained and reminded of the following:

  • Have a list of all individuals that are being transported and verify at drop-off locations that everyone has exited the vehicle.
  • If possible, conduct a secondary check of the vehicle every time the vehicle is parked to assure that no one remains in the vehicle
  • Make sure that the seat belt and seat surface are not too hot before assisting individuals with buckling up.

Further information on heat related precautions may be found at the following websites:

DSHS Offers Hot Weather Precautions
DFPS Vehicle Safety

(6/3/2014)

HHSC to Host STAR+PLUS Provider Trainings for Those Serving People with IDD

Beginning September 1, 2014, eligible individuals with intellectual and developmental disabilities (IDD) who are covered by Medicaid will begin receiving their acute care medical services (such as physician visits and prescriptions) through a STAR+PLUS managed care health plan. The Texas Health and Human Services Commission (HHSC) is holding provider trainings across the state beginning in June to educate providers who serve individuals with IDD (excluding state supported living centers) on STAR+PLUS managed care and what changes to expect.

The managed care organizations covering that service area will be present to answer questions at the presentations.

For additional details regarding locations and times, check the meeting notices on the HHSC website.

You can learn more about the expansion of managed care here: http://www.hhsc.state.tx.us/medicaid/managed-care/mmc.shtml.

(5/29/2014)

Information Letter Feedback

DADS is seeking stakeholder feedback to draft information letters by COB Thursday, May 29th, 2014.

When an individual receiving Home and Community-based (HCS) or Texas Home Living (TxHmL) services is involved in an abuse, neglect or exploitation investigation of a service provider, the Department of Family and Protective Services (DFPS) may require that a forensic interview of the individual be conducted by a children’s advocacy center (CAC). CACs partner with local communities and agencies investigating and prosecuting abuse of a child or a person with a disability. The purpose of the letters are to inform HCS providers, TxHmL providers and Financial Management Service Agencies (FMSAs) of this and of the transportation assistance that will be requested by DFPS to the CAC during such investigations.

Draft of Transportation Requirements for Abuse, Neglect and Exploitation Investigations - Financial Management Services Agencies

Draft of Transportation Requirements for Abuse, Neglect and Exploitation Investigations - Home and Community-based Services and Texas Home Living Providers

Feedback on the draft information letters may be submitted to Jennifer.Chancellor@dads.state.tx.us.

(5/22/2014)

Information Letters from MAXIMUS Regarding STAR+PLUS Expansion

Beginning the week of May 5, 2014, MAXIMUS began sending a mail-out to individuals who will be covered under the STAR+PLUS Medicaid Managed Care expansion effective September 1, 2014. The expansion will affect individuals who reside in a Medicaid Rural Service Area (MRSA); AND individuals who are not in a MRSA but reside in an ICF/IID or are enrolled in the HCS, TxHmL, CLASS or DBMD waiver program as of September 1, 2014 or later.

MAXIMUS is sending the mail-out to individuals on behalf of the Health and Human Services Commission, in their capacity as the state's enrollment broker for managed care. The mail-out includes the letter, frequently asked questions and a comparison chart for the managed care organizations in each area. The materials (except for the comparison charts) in English and Spanish are posted at http://www.hhsc.state.tx.us/medicaid/managed-care/Letters-from-HHSC.shtml

(5/19/2014)

Mindful Planning to Promote Strong Integrated Employment Outcomes

During this online event, we will discuss what it means to be mindful in employment planning efforts and how to meet families and individuals where they are during various life stages. This approach should result in a plan that is action-oriented, realistic, and doable, and reflects tangible employment goals.

Designed for:
State and local agency representatives, service providers, and case managers, but all are welcome!

When
Date: May 20, 2014
Time: 3 p.m. ET
Length: 90 minutes

More details
For event details and to register click on this link: http://connectpro97884399.adobeconnect.com/selnfammindful/event/event_info.html.

(5/14/2014)

New Webpage for HCS and TxHmL Stakeholder Involvement

DADS has added a new webpage for IDD stakeholders to the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) webpages. The purpose of the webpage will be to solicit greater input from DADS external stakeholders. The link to this webpage: http://www.dads.state.tx.us/providers/iddstakeholders/. DADS policy staff will use this section of the HCS and TxHmL webpages to post draft policy and rules for stakeholder input.

Two documents have been added to this site for review and comment:

Home and Community-based (HCS) Rules, Chapter 9, Subchapter D
Feedback is requested to draft amendments to the Home and Community-based (HCS) rules, Chapter 9, Subchapter D (PDF format). The proposal will amend the HCS Program rules to add transition assistance services (TAS) as a new service for an individual enrolling into the HCS Program who is being discharged from a nursing facility, an intermediate care facility for individuals with an intellectual disability or related conditions (ICF/IID), or a general residential operation (GRO). The proposal will also implement an HCS waiver amendment by providing pre-enrollment assessments and minor home modifications to assist these individuals to move into the community. These services may be provided in addition to $1,000 or $2,500 for TAS services available under 40 TAC Chapter 62, Contracting to Provide Transition Assistance Services. The proposal will also describe a local authority’s responsibility related to CRT. Feedback is due by Monday, May 12, 2014, and may be submitted to hcs@dads.state.tx.us.

Chapter 62 - Transition Assistance Services
Feedback is request for draft rules to amend Chapter 62 - Transition Assistance Services (PDF format). The proposed amendments would allow individuals leaving DFPS General Residential Operations (GRO) facilities or Intermediate Care Facilities for Individuals with an Intellectual Disability (ICF/IDD) to receive transition assistance services; update definitions; and update rules to reflect person first respectful language. Feedback is due by Friday, May 16, 20014, and may be submitted to pdo@dads.state.tx.us.

(5/9/2014)

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