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DADS Provider Alerts — Adult Day Care/Day Activity and Health Services (ADC/DAHS)

Region 6 Assisted Living Facility (ALF) /Adult Day Care (ADC) Provider Meeting to Be Held in Houston on September 30, 2014

You are invited to attend an Assisted Living Facility/Adult Day Care provider meeting presented by the Texas Department of Aging & Disability Services, Regulatory Services Division, Region 6 staff. The following topics will be presented:

  • ALF/ADC Legislative Updates
    Dotty Acosta, ALF/ADC Program Specialist, DADS Regulatory Services Division, Austin, TX
  • Role of the Long-Term Care Ombudsman – Advocates for Long-Term Care Residents
    Carmen Castro, MS, CHES, Managing Local Ombudsman, Harris County Long Term Care Ombudsman Program
  • Life Safety Code Updates
    Fred Worley, Life Safety Code Manager, DADS Regulatory Services Division, Administrator of Local Survey Operations, Austin, TX

This meeting will be held on September 30, 2014 from 1 p.m. to 4 p.m. at the United Way of Greater Houston, 50 Waugh, Houston, TX 77007. Registration begins at 12:30 p.m. Please submit your questions for the presenters by the registration deadline for on-line registration by September 1, 2014. Registration is limited to four (4) providers per facility.

Register at: https://www.surveymonkey.com/s/Region6ALFADC2014

(9/5/2014)

Adult Day Care Facility Provider Meeting

You are invited to attend the annual Adult Day Care Facility Provider Meeting presented by the Texas Department of Aging & Disability Services (DADS), Regulatory Services Division, Region 8 on October 9th in San Antonio. Registration sign-in starts at 1 p.m. and the program starts promptly at 1:30 p.m. Please complete your registration on the link below if you wish to attend this meeting.

The following topics will be presented:

  • Emergency Preparedness and Life Safety Code Updates
    Deneen J. Carnathan
    Life Safety Code Program Specialist
    DADS Region 8, Life Safety Code Unit
    Rebecca K. Graham
    Architect
    DADS Region 8, Life Safety Code Unit

  • The Investigation Process
    Eric D. Greene
    Program Manager
    DADS Region 8, Regulatory Services Division

The meeting will be:

October 9, 2014
1 p.m. to 4:30 p.m.
AL J. Notzon III Board Room Alamo Area Council of Governments (AACOG)
8700 Tesoro Drive, Ste 100
San Antonio, Texas 78217

Due to space limitations, registration is limited to Region 8 Adult Day Care Facility Providers and only two per facility.

For questions, please contact Vangie Rosales, Region 8 Facility/Surveyor Liaison at 210-438-6394.

The cutoff date for registration is Monday, October 6, 2014 or earlier if registration reaches maximum capacity at the meeting location.

Registration: https://www.surveymonkey.com/s/Region8ADC2014

(9/3/2014)

Statewide Infection Control Training

Infection Control is an on-going healthcare issue in Texas. Due to the continuing rise in infections in all care settings, the Texas Department of State Health Services (DSHS) has partnered with the Texas Society of Infection Control & Prevention (TSICP) to provide free conferences to enhance knowledge and understanding of infection prevention strategies.

DSHS and TSICP have joined together in presenting these one day conferences that will address a number of infection control and prevention topics, including:

  • Introduction to Multidrug Resistant Organisms (MDROs) and Clostridium difficile,
  • Infection trends,
  • Antibiotic stewardship,
  • Surveillance and reporting requirements,
  • Prevention,
  • Quality improvement, and
  • Local case studies.

Conferences in Austin and Fort Worth have been completed, but an additional 16 sessions will be scheduled in other areas of the state. Registration for these conferences is free of charge and contact hours are provided. Each session is limited to 100 people, so if you are interested in attending, please register for a session in your area as soon as possible! Conference locations, dates and registration can be found at http://www.tsicp.org/.

(8/29/2014)

Adoption of Rules in 40 Texas Administrative Code, Chapter 98, Adult Day Care and Day Activity and Health Services Requirements

The Texas Health and Human Services Commission, on behalf of the Department of Aging and Disability Services, adopts amendments to §§98.202, 98.210, and 98.212, concerning program overview; administrative errors and corrections; and sanctions, in Chapter 98, Adult Day Care and Day Activity and Health Services Requirements. The amendment to §98.210 is adopted with changes to the proposed text as published in the April 18, 2014, issue of the Texas Register (39 TexReg 3218). The amendments to §98.202 and §98.212 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#312

(8/27/2014)

REVISED Automatic Medicaid Managed Care (STAR+PLUS) Enrollment for Some CBA, PHC and DAHS Individuals

Automatic Medicaid Managed Care Enrollment for Some Individuals

Why am I receiving this alert?

You are a provider for one or more of the following:

  • Community Based Alternatives (CBA)
  • Primary Home Care (PHC)
  • Day Activity Health Services (DAHS)

The Health and Human Services Commission (HHSC) wants to make sure you have the latest information regarding the September 1, 2014 expansion of STAR+PLUS to the Medicaid Rural Service Areas (MRSAs).

Some mandatory STAR+PLUS candidates currently receiving CBA, PHC or DAHS program services in the MRSAs did not receive a STAR+PLUS enrollment packet in the mail. HHSC will automatically assign these individuals to a managed care organization (MCO) in the service area in which they live and these individuals will be automatically enrolled in the STAR+PLUS program effective September 1. HHSC will take into consideration the person's current primary care provider, previous medical history, and the STAR MCO they may currently be enrolled with when making this MCO assignment. HHSC is taking this action to ensure the individuals you serve are able to continue receiving their long term services and supports.

The mandatory STAR+PLUS candidates we’re referring to in this letter did not receive an enrollment packet for the following reasons:

  • Invalid addresses in the State Medicaid Eligibility System.
  • A lapse in Medicaid eligibility. Some mandatory candidates lost Medicaid eligibility during July and August and have recently had their Medicaid eligibility reinstated.  This resulted in making them a mandatory candidate for STAR+PLUS effective September 1, 2014.

Who will be automatically enrolled into a MCO?

Mandatory candidates who must enroll in STAR+PLUS are adults age 21 and older residing in the MRSA Central, MRSA West, or MRSA Northeast who:

  • receive Social Security Income (SSI), or SSI-related benefits (including individuals enrolled in PHC or DAHS), and/or
  • are currently enrolled in CBA.

Who is excluded from automatic enrollment into a MCO?

Individuals who are mandatory for STAR+PLUS and reside in an intermediate care facility for individuals with intellectual disabilities and related conditions (ICF-IID) or receive services through Texas Home Living, Home and Community-based Services, Deaf Blind Multiple Disabilities, Community Living Assistance and Support Services waivers will not be automatically enrolled at this time.

How can you help?

Please encourage the individuals you serve to update their address with the appropriate entity to ensure HHSC and the managed care enrollment broker, MAXIMUS, have the correct address. This will help with future mailings and appropriate assignment to a MCO.

Individuals, Medicaid authorized representatives, or representative payees, as appropriate, can provide current address information as follows:

  • Addresses for individuals receiving SSI can be updated through the Social Security Administration (SSA) by calling the SSA at 1-800-772-1213 or contacting the individual’s local SSA office.
  • Addresses for individuals currently not receiving SSI can be updated by calling 2-1-1.

What is the standard managed care enrollment process?

For candidates identified as mandatory for STAR+PLUS after September 1, HHSC will follow the standard enrollment process. These Individuals will receive an enrollment packet from MAXIMUS and have at least 15 days to choose a MCO. If a candidate does not choose an MCO, HHSC will auto-assign the individual to a MCO in the service area in which they live. Individuals can call MAXIMUS at any time to change their MCO or to ask questions by calling 1-877-782-6440. It can take 15 to 45 days for a MCO change to take effect.

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

Please visit the HHSC website, "Expansion of Medicaid Managed Care" at http://www.hhsc.state.tx.us/medicaid/managed-care/mmc.shtml.

The Department of Aging and Disability Services (DADS) publishes information regarding the transition of LTSS from DADS to the STAR+PLUS program on the DADS website at: www.dads.state.tx.us/providers.

Refer to information letters and alerts regarding managed care and STAR+PLUS topics

(8/25/2014)

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)

Discontinuation of Facility Initiated Referral Request by Day Activity Health Service Providers in the Medicaid Rural Service Area Due to September 1, 2014 STAR+PLUS Expansion

The Health and Human Services Commission (HHSC) is expanding the STAR+PLUS Medicaid managed care delivery system into the West, Central and Northeast service areas. The anticipated start date is September 1, 2014. The counties affected by the change are listed in the table below.

Medicaid Rural Service Areas Counties
West Andrews, Archer, Armstrong, Bailey, Baylor, Borden, Brewster, Briscoe, Brown, Callahan, Castro, Childress, Clay, Cochran, Coke, Coleman Collingsworth, Concho, Cottle, Crane, Crockett, Culberson, Dallam, Dawson, Dickens, Dimmit, Donley, Eastland, Ector, Edwards, Fisher, Foard, Frio, Gaines, Glasscock, Gray, Hall, Hansford, Hardeman, Hartley, Haskell, Hemphill, Howard, Irion, Jack, Jeff Davis, Jones, Kent, Kerr, Kimble, King, Kinney, Knox, La Salle, Lipscomb, Loving, Martin, Mason, McCulloch, Menard, Midland, Mitchell, Moore, Motley, Nolan, Ochiltree, Oldham, Palo Pinto, Parmer, Pecos, Presidio, Reagan, Real, Reeves, Roberts, Runnels, Schleicher, Scurry, Shackelford, Sherman, Stephens, Sterling, Stonewall, Sutton, Taylor, Terrell, Throckmorton, Tom Green, Upton, Uvalde, Val Verde, Ward, Wheeler, Wichita, Wilbarger, Winkler, Yoakum, Young, and Zavala,
Central Bell, Blanco, Bosque, Brazos, Burleson, Colorado, Comanche, Coryell, DeWitt, Erath, Falls, Freestone, Gillespie, Gonzales, Grimes, Hamilton, Hill, Jackson, Lampasas, Lavaca, Leon, Limestone, Llano, Madison, McLennan, Milam, Mills, Robertson, San Saba, Somervell, and Washington
Northeast Anderson, Angelina, Bowie, Camp, Cass, Cherokee, Cooke, Delta, Fannin, Franklin, Grayson, Gregg, Harrison, Henderson, Hopkins, Houston, Lamar, Marion, Montague, Morris, Nacogdoches, Panola, Rains, Red River, Rusk, Sabine, San Augustine, Shelby, Smith, Titus, Trinity, Upshur, Van Zandt, and Wood

Effective with this Alert, Provider Initiated Referrals for Day Activity Health Services (DAHS) Title XIX will no longer be accepted in anticipation of the September 1, 2014, STAR+PLUS operational start day. In accordance with Information Letter 14-31 - Applying for Primary Home Care and Day Activity Health Services Pending STAR+PLUS Enrollment, from this date forth, any services provided in response to a provider initiated referral for an individual pending STAR+PLUS enrollment will not be reimbursed retroactively. The DAHS provider should consult with their contracted Managed Care Organization regarding its established process for the authorization and delivery of DAHS.

DADS will continue to provide Title XIX DAHS services to individuals receiving Medicaid who are not eligible to be enrolled in the STAR+PLUS program.

For questions regarding the content of this letter, contact DADS at: ccad@dads.state.tx.us

For more information regarding this expansion, and other managed care initiatives, please refer to the HHSC Medicaid Managed Care Initiatives webpage at: Medicaid Managed Care Initiatives

Email Contact Information for STAR+PLUS Questions or Complaints:

ManagedCareExpansion2014@hhsc.state.tx.us

HPM_Complaints@state.tx.us

(8/21/2014)

TxCCC/DADS 2014 Culture Change Conference

The Keys to Orchestrating a Person Centered Culture by Rethinking Care to Reconnect and Restore Quality in Life

Introducing Keynote Speaker: Erin Bonitto

This conference seeks to promote the preferences of individuals living or working in long term care settings to achieve healthy and happy outcomes for both those who live and serve there.

Registration

Online registrations can be paid by credit card through PayPal or by check. If paying by check, please enter all information online and choose check as your payment choice. Print your emailed confirmation and send to TxCCC with your payment. Please note if you are paying by check, registration is not considered complete until payment has been received. A link to conference materials will be sent to registrants prior to the conference.

Early bird rate ends August 31st!

Register Now

(8/12/2014)

Chapter 49, Contracting for Community Services Webinar

The Department of Aging and Disability Services (DADS) is hosting three webinars on the proposed Chapter 49, Contracting for Community Services, rule revisions:

August 18, 2014 from 1:30 p.m. until 4 p.m.
Space is limited.
Reserve your Webinar Seat Now at:
https://www1.gotomeeting.com/register/415951600

August 21, 2014 from 1:30 p.m. until 4 p.m.
Space is limited.
Reserve your Webinar Seat Now at:
https://www1.gotomeeting.com/register/322963073

August 26, 2014 from 1:30 p.m. until 4 p.m.
Space is limited.
Reserve your Webinar Seat Now at:
https://www1.gotomeeting.com/register/361402737

With webinars, you may choose to listen to the audio portion of the presentations by using your computer speakers. A phone line will also be available for those who may have a need to call in. Please be aware that attendees who choose the phone option may be subject to long distance phone charges.

After registering, you will receive a confirmation email containing information about joining the webinar.

System Requirements
PC-based attendees:
Required: Windows® 8, 7, Vista, XP or 2003 Server
Mac®-based attendees:
Required: Mac OS® X 10.6 or newer
Mobile attendees
Required: iPhone®, iPad®, Android™ phone or Android tablet

Please contact Kathie Carleton-Morales at Kathie.Carleton-Morales@dads.state.tx.us if you have any questions about the upcoming webinar.

(8/11/2014)

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