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DADS Provider Alerts — Texas Home Living (TxHmL)

HHSC to Host Feedback Sessions on STAR+PLUS Expansion for People with IDD

The Texas Health and Human Service Commission (HHSC) is hosting several feedback sessions to gather information about the STAR+PLUS expansion for people with intellectual and developmental disabilities (IDD).

During these sessions, people with IDD, their family members, advocates, and acute care and long-term care providers will be able to give their feedback about the STAR+PLUS transition. HHSC will not present information during these sessions, but instead will collect feedback and ideas that may affect future managed care initiatives.

A list of meeting locations is available on the HHSC website at http://www.hhsc.state.tx.us/news/meetings.asp. Questions can be directed to Heather Kuhlman at 512-462-6356 or through email at Heather.Kuhlman@hhsc.state.tx.us.

(9/22/2014)

National Medication Schedule Change

The Texas Board of Nursing, Texas Medical Board and Texas State Board of Pharmacy are encouraging all DADS providers to review the attached information, in PDF format, about the reclassification of hydrocodone combination products (HCPs) by the U.S. Drug Enforcement Agency.

Remember, all providers that order, dispense, or prescribe HCPs in Texas must comply with requirements for prescribing Schedule II medications as set forth in state and federal law beginning Oct. 6, 2014.

(9/19/2014)

Providers Who Want to Discontinue their Participation in the Licensed Vocational Nurse (LVN) On-Call Pilot Program

The Texas Department of Aging and Disability Services (DADS) is asking providers that want to discontinue their participation in the LVN On-Call Pilot Program to complete Form 5944, Discontinuation of Provider from the Licensed Vocational Nurse (LVN) On-Call Pilot Program, and fax it to Waiver Survey and Certification (WS&C) at 512-438-4171.

This request applies to the following providers:

  • Home and Community-based Services
  • Texas Home Living
  • Intermediate Care Facility for Individuals with an Intellectual Disability or Related Conditions (ICF/IID), with a capacity of 13 bed or fewer

Providers that chose not to participate in the statewide pilot program are reminded they must use a registered nurse to provide on-call telephone services in accordance with  Texas Administrative Code, Title 22, Part 11, Chapter 217, Standards of Nursing Practice, §217.11(2) and (3) and Texas Board of Nursing policy.

For more information on the LVN On-Call Pilot Program, please visit the Nursing Services Changes website.

If you have any questions regarding the information in this alert, please contact:

  • the WS&C at 512-438-4163; or
  • an ICF/IID policy specialist at 512-438-3161.
(9/15/2014)

HCBS Rules: Webinar Training

In January 2014, the Center for Medicare and Medicaid Services issued final guidance on new rules effective March 17, 2014 governing 1915(c) Medicaid waivers and programs under 1915(i) and 1915(k) of the Social Security Act. The rules ensure individuals receive Medicaid Home and Community Based Services (HCBS) in settings that are integrated in and support full access to the greater community and include opportunities for competitive employment, control of personal resources and the ability to live in the same way as individuals not receiving home and community-based services (HCBS).

These webinars are being offered to help familiarize providers, advocates and individuals receiving services about the new rules and how stakeholders can provide input as the state continues the process of assessing compliance with the new regulations and making plans for any rule or policy changes that may be necessary.

Registration
Please reserve your webinar date from one of the options offered below. Space is limited, so you are encouraged to register early.

Space is limited. Reserve your Webinar seat now at:
September 11, 2014: 3 p.m. to 5 p.m. https://www1.gotomeeting.com/register/416572432
September 30, 2014: 10 a.m. to noon https://www1.gotomeeting.com/register/856428640

The rule text can be viewed at: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Supports/Home-and-Community-Based-Services/Home-and-Community-Based-Services.html 

In addition, the Impact of Federal HCBS Rules on DADS 1915(c) Waiver Programs, which assesses compliance with the settings provisions, can be viewed at: http://www.dads.state.tx.us/providers/communications/alerts/HCBS_settingsassessment.pdf.

HCBS Rules: Public Meeting

The Health and Human Services Commission (HHSC), Department of State Health Services (DSHS) and the Department of Aging and Disability Services (DADS) are holding a public stakeholder meeting on October 13, 2014, from 9 a.m. to 5 p.m., to hear public testimony about recently-adopted Centers for Medicare and Medicaid Services (CMS) rules. The rules concern Home and Community Based Services (HCBS), and its impact on certain programs administered by HHSC, DSHS and DADS.

The public will be able to provide public testimony on the following 1915(c) Medicaid waivers:

  • Community Living Assistance and Support Services (CLASS)
  • Deaf Blind Multiple Disabilities (DBMD)
  • Medically Dependent Children Program (MDCP)
  • Home and Community-based Services (HCS)
  • Texas Home Living (TxHmL)
  • Youth Empowerment Services (YES)

Public Comment

HHSC, DADS and DSHS will accept comments through several channels. 

  • A person can attend the public meeting on October 13, 2014 in person and sign up onsite for a maximum of three (3) minutes of speaking time.
  • A person can submit written comments before, during, and after the public stakeholder meeting to:
(9/2/2014)

STAR+PLUS Enrollment Date Extended for Some Individuals

Some mandatory STAR+PLUS candidates who have intellectual and developmental disabilities (IDD) will have extra time to pick a STAR+PLUS managed care organization health plan because they did not receive enrollment information. Adults enrolled in one of the five IDD programs (listed below) prior to July 17, 2014 who do not have Medicare Part B and did not receive an enrollment packet in July or August 2014 will have until December 12, 2014 to pick a STAR+PLUS health plan to provide acute health-care services.

  • Intermediate Care Facility 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) or
  • Texas Home Living (TxHmL)

Long Term Services and Support (LTSS) providers are asked to call MAXIMUS at 1-877-782-6440 to report mandatory candidates who did not received an enrollment packet. These people may not have received a packet for the following reasons:

  • Invalid addresses in the State Medicaid Eligibility System. Medicaid authorized representatives are requested to provide current address information for:
  • Supplement Security Income (SSI) recipients by calling the SSA at 1-800-772-1213, or

contacting the individual's local SSA office.

  • Medical Assistance Only (MAO) recipients by calling 2-1-1.
  • A lapse in Medicaid eligibility. Once Medicaid has been reinstated, an enrollment packet will be sent to a person who meets requirements for mandatory STAR+PLUS enrollment.

Those in this group who do not pick a STAR+PLUS health plan by the December 12, 2014 deadline will be enrolled into a STAR+PLUS health plan through HHSC's auto-assignment process. Their enrollment for STAR+PLUS acute care services will be effective January 1, 2015. Effective September 1, 2014, people identified as new mandatory candidates for STAR+PLUS will follow the standard enrollment process.

What is the standard managed care enrollment process?

For Medicaid members identified as mandatory for STAR+PLUS after September 1, HHSC will follow the standard enrollment process. These people will receive an enrollment packet in the mail from HHSC and have at least 15 days to pick a STAR+PLUS health plan. If the person does not pick a health plan, HHSC will auto-assign the person to a STAR+PLUS health plan in the service area in which they live. Anyone in STAR+PLUS can call HHSC at any time to change their health plan or to ask questions. The number to call is 1-877-782-6440. It can take 15 to 45 days for a health plan change to take effect.

Where do I go to learn more about the September 1, 2014 changes?

Visit the Expansion of Medicaid Managed Care section of the HHSC website.

(8/29/2014)

Addition of the Approved Texas Home Living (TxHmL) Waiver Amendment to the Texas Department of Aging and Disability Services (DADS) Website

In August 2014, the Centers for Medicare & Medicaid Services (CMS) approved a waiver amendment with an effective date of August 8, 2014 for the TxHmL waiver.

A copy of the approved waiver amendment is available as a portable document format (PDF) file on the DADS website at the following link: www.dads.state.tx.us/providers/txhml/TxHmLAmend_8-8-14.pdf

(8/29/2014)

Community First Choice (CFC) Stakeholder Meeting - September 3, 2014

The Texas Health and Human Services Commission (HHSC) is hosting a stakeholder meeting on Wednesday, September 3, 2014, at 2 p.m. to receive public comment on a proposed Medicaid state plan amendment that would implement the Community First Choice (CFC) program.

The stakeholder meeting will be held at:

The Texas Department of Aging and Disability Services
John H. Winters Building Public Hearing Room located at:
701 West 51st Street
Austin, Texas 78751

Entry is through Security at the front of the building facing 51st Street. Please be prepared to show your current identification for a visitor pass.

The proposed amendment and related documents will be made available by August 29, 2014 on the meeting agenda's webpage at http://www.hhsc.state.tx.us/news/meetings/2014/090314-PH-CFCP.shtml. Written comments regarding the amendment may be submitted in lieu of, or in addition to, oral testimony. Written comments may be sent by U.S. mail to:

HHSC, Policy Development Support Department, Mail Code H-600
P.O. Box 85200, Austin, Texas 78708-5200;
by fax to Policy Development at (512)730-7472; or
e-mail to beren.dutra@hhsc.state.tx.us.

Written comment may be sent by overnight mail or hand delivered to:

HHSC, Policy Development Support Department
Mail Code H-600
4900 North Lamar, Austin, Texas 78751

Persons with disabilities who plan to attend the stakeholder meeting and require auxiliary aids or services should contact Beren Dutra at (512) 728-1932 at least three (3) business days before the meeting so appropriate arrangements can be made.

(8/26/2014)

Adoption of Repealed Rules in 40 Texas Administrative Code, Chapter 69, Contract Administration

The Texas Health and Human Services Commission, on behalf of the Department of Aging and Disability Services, adopts the repeal of Chapter 69, consisting of §§69.1 - 69.4, 69.11 - 69.19, 69.31 - 69.40, 69.51 - 69.55, 69.71 - 69.73, 69.81, 69.91 - 69.93, 69.101 - 69.103, 69.111 - 69.118, 69.131 - 69.139, 69.151 - 69.160, and 69.171 - 69.186, concerning Contract Administration, without changes to the proposal as published in the April 18, 2014, issue of the Texas Register (39 TexReg 3210).

The adoption of the repealed rules was published in the August 22, 2014 issue of the Texas Register. The adopted rules are effective September 1, 2014.

You may access the rules in the Texas Register online at:
http://www.sos.state.tx.us/texreg/archive/August222014/Adopted%20Rules/40.SOCIAL%20SERVICES%20AND%20ASSISTANCE.html#298

(8/25/2014)

Adoption of Rules in 40 Texas Administrative Code, Chapter 49, Contracting for Community Care Services

The Texas Health and Human Services Commission, on behalf of the Department of Aging and Disability Services, adopts the repeal of Chapter 49, Contracting for Community Care Services, Subchapter A, consisting of §49.1, concerning definitions; Subchapter B, consisting of §§49.11 - 49.18 and §49.20, concerning contractor requirements; Subchapter C, consisting of §§49.31 - 49.33, concerning records; Subchapter D, consisting of §49.41 and §49.42, concerning billings and payments; Subchapter E, consisting of §§49.51 - 49.54, concerning audits, monitoring, and reviews; Subchapter F, consisting of §§49.61 - 49.63, concerning sanctions and terminations; and Subchapter G, consisting of §§49.71 - 49.73, concerning personal attendants wages; and adopts new Chapter 49, Contracting for Community Services, Subchapter A, consisting of §49.101 and §49.102, concerning application and definitions; Subchapter B, consisting of §§49.201 - 49.211, concerning contractor enrollment; Subchapter C, consisting of §§49.301 - 49.312, concerning requirements of a contractor; Subchapter D, Division 1, consisting of §49.401, concerning applicability of Subchapter D; Division 2, consisting of §§49.411 - 49.414, concerning monitoring and investigation; Subchapter E, Division 1, consisting of §49.501, concerning applicability of Subchapter E; Division 2, consisting of §49.511, concerning immediate protection; Division 3, consisting of §§49.521 - 49.523, concerning actions; Division 4, consisting of §§49.531 - 49.534, concerning sanctions; Division 5, consisting of §49.541, appeals; Division 6, consisting of §49.551, concerning termination by contractor; Subchapter F, consisting of §49.601, concerning review by DADS of expiring or terminated contract; and Subchapter G, consisting of §49.701 and §49.702, concerning application denial period, in Chapter 49, Contracting for Community Care Services. New §§49.101, 49.102, 49.204, 49.205, 49.208, 49.304, 49.305, 49.308, 49.309, 49.310, 49.413, 49.522, and 49.551 are adopted with changes to the proposed text published in the April 18, 2014, issue of the Texas Register (39 TexReg 3148). New §§49.201 - 49.203, 49.206, 49.207, 49.209 - 49.211, 49.301 - 49.303, 49.306, 49.307, 49.311, 49.312, 49.401, 49.411, 49.412, 49.414, 49.501, 49.511, 49.521, 49.523, 49.531 - 49.534, 49.541, 49.601, 49.701 and 49.702 are adopted without changes to the proposed text.

The adopted rules were published in the August 22, 2014 issue of the Texas Register.  The adopted rules are effective September 1, 2014.

You may access the rules in the Texas Register online at:
http://www.sos.state.tx.us/texreg/archive/August222014/Adopted%20Rules/40.SOCIAL%20SERVICES%20AND%20ASSISTANCE.html#224

(8/25/2014)

Adoption of Rules in 40 Texas Administrative Code, Chapter 9, Intellectual Disability Services - Medicaid State Operating Agency Responsibilities, Subchapter N, Texas Home Living (TxHmL) Program

The Texas Health and Human Services Commission, on behalf of the Department of Aging and Disability Services, adopts amendments to §9.551, concerning purpose; §9.552, concerning application; §9.553, concerning definitions; §9.554, concerning description of the Texas Home Living (TxHmL) Program; §9.555, concerning definitions of TxHmL Program service components; §9.556, concerning eligibility criteria; §9.558, concerning individual plan of care (IPC); §9.560, concerning level of care (LOC) determination; §9.561, concerning lapsed LOC; §9.562, concerning level of need (LON) assignment; §9.563, concerning DADS review of LON; §9.566, concerning notification of applicants; §9.567, concerning process for enrollment; §9.568, concerning revisions and renewals of IPCs, LOCs, and LONs for enrolled individuals; §9.570, concerning permanent discharge from TxHmL Program and suspension of TxHmL Program services; §9.571, concerning fair hearings; §9.572, concerning other program provider requirements; §9.573, concerning reimbursement; §9.574, concerning record retention; §9.575, concerning program provider's right to administrative hearing; §9.576, concerning program provider certification and review; §9.578, concerning program provider certification principles: service delivery; §9.579, concerning certification principles: qualified personnel; §9.580, concerning certification principles: quality assurance; §9.582, concerning compliance with TxHmL program principles for local authorities; and §9.583, concerning TxHmL program principles for local authorities; new §9.577, concerning program provider compliance and corrective action and §9.584, concerning certification principles: prohibitions; and the repeal of §9.557, concerning calculation of co-payment; §9.559, concerning request to increase service category limits; §9.569, concerning coordination of transfers; and §9.577, concerning program provider compliance and corrective action, in Subchapter N, Texas Home Living (TxHmL) Program, in Chapter 9, Intellectual Disability Services--Medicaid State Operating Agency Responsibilities. The amendments to §§9.553 - 9.555, 9.558, 9.567, 9.573, 9.578 - 9.580, and 9.583 are adopted with changes to the proposed text published in the April 18, 2014, issue of the Texas Register (39 TexReg 3078). The amendments to §§9.551, 9.552, 9.556, 9.560 - 9.563, 9.566, 9.568, 9.570 - 9.572, 9.574 - 9.576, and 9.582; new §9.577 and §9.584; and the repeal of §§9.557, 9.559, 9.569, and 9.577 are adopted without changes to the proposed text.

The adopted rules were published in the August 22, 2014 issue of the Texas Register. The adopted rules are effective September 1, 2014.

You may access the rules in the Texas Register online at:
http://www.sos.state.tx.us/texreg/archive/August222014/Adopted%20Rules/40.SOCIAL%20SERVICES%20AND%20ASSISTANCE.html#133

(8/25/2014)

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