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DADS Provider Alerts — Consumer Managed Personal Attendant Services (CMPAS)

DADS to Require New Forms as Part of Contracting Process

DADS stakeholders that apply for a contract with the agency or that respond to a request for proposal after April 6, 2015, will need to complete a Data Usage Agreement if the resulting contract would provide the contractor access to confidential information.

Beginning May 1, 2015, the agency also will require a completed Information Security and Privacy Initial Inquiry if the contract will require access to confidential information.

This process is being implemented in all Texas health and human services agencies to establish a clear and consistent process for safeguarding confidential information and for reporting and correcting any unauthorized use or disclosure of the confidential information.

Providers can review the documents at: http://www.hhsc.state.tx.us/about_hhsc/BusOpp/BO_home.shtml.

Email questions pertaining to DADS active contracts to Kathie.carleton-morales@dads.state.tx.us.

Email questions about this policy to Sylvia.kauffman@hhsc.state.tx.us.

(4/6/2015)

Department of Labor Appeals Home Care Ruling

The U.S. Department of Labor (DOL) has appealed the ruling in the lawsuit brought by associations of home care companies challenging the Home Care Final Rule (PDF). (See DADS alert titled “Recent Court Decision Regarding Amended United States Department of Labor Regulations.”)

The DOL stated its enforcement schedule, announced Oct. 9, 2014, would not change. The appeal is proceeding on an expedited schedule and a decision could be made as early as this summer.

The changes that are being appealed effect the companionship services exemption in the Fair Labor Standards Act that may pertain to these DADS programs:

  • Financial Management Services (also called CDS)
  • Medically Dependent Children Program
  • Primary Home Care, Community Attendant Services and Family Care
  • Consumer Managed Personal Attendant Services
  • Community Living Assistance and Support Services
  • Deaf Blind with Multiple Disabilities
  • Home and Community-based Services
  • Texas Home Living

If the Court of Appeals issues a decision favorable to the DOL on or after July 1, 2015, the DOL stated it immediately will implement the selective enforcement process as outlined in the enforcement schedule. Providers and CDS employers should continue to assess the budgetary, staffing and administrative impact of the Home Care Final Rule, if any, and be prepared to alter the budgets or hire additional staff to meet compliance should the DOL win its appeal.

For more information, visit the DOL homecare website, call the DOL at 1-866-487-9243 or consult your legal counsel.

(4/2/2015)

CMPAS Copayment Schedule Has Been Updated

The CMPAS Copayment Schedule has been updated to reflect an increase in the Social Security income limit, effective Jan.1, 2015. CMPAS providers must implement individuals’ new copay amounts, if applicable, as soon as possible.

The schedule can be found in the CMPAS Provider Manual, Section 2000.

Questions can be emailed to CMPAS@dads.state.tx.us.

(2/10/2015)

Recent Court Decisions Regarding Amended United States Department of Labor Regulations

The purpose of this notification is to inform providers and consumer directed services (CDS) employers in the programs or services listed below of two U.S. District Court decisions regarding the amended U.S. Department of Labor (DOL) regulations known as the "Home Care Final Rule." The amended regulations made changes regarding the companionship services exemption in the Fair Labor Standards Act and were to go into effect on January 1, 2015.

Financial Management Services (also called CDS);
Medically Dependent Children Program;
Primary Home Care, Community Attendant Services, and Family Care;
Consumer Managed Personal Attendant Services;
Community Living Assistance and Support Services;
Deaf Blind with Multiple Disabilities;
Home and Community-based Services; and
Texas Home Living.

On December 22, 2014, U.S. District Court Judge Richard Leon issued an opinion and order in Home Care Association of America v. Weil, Civil Action No. 14-967 (D.D.C.), vacating the third party regulation amended by the Home Care Final Rule. To view the decision, see: https://ecf.dcd.uscourts.gov/cgi-bin/show_public_doc?2014cv0967-21

On January 14, 2015, Judge Leon issued an opinion and order vacating the Final Rule’s revised definition of companionship services. To view the decision, see: https://ecf.dcd.uscourts.gov/cgi-bin/show_public_doc?2014cv0967-32. The district court's orders "vacating" the rule means the Home Care Rule is not in effect.

Based on these decisions, DADS rescinds DADS Bulletin dated December 2, 2014 and Information Letter 14-66 , dated October 17, 2014, regarding Impact of Department of Labor Companionship Exemption on Financial Management Services Agencies and Consumer Directed Services Employers.

For information about these district court decisions, please see the following DOL website at http://www.dol.gov/whd/homecare/; call DOL’s toll-free information and helpline, 1-866-4USWAGE (1-866-487-9243), available 8am to 5pm in your time zone; or consult your legal counsel.

The DOL may appeal the district court’s decision. DADS will provide updates as information becomes available.

(1/20/2015)

Revised Contract and Fiscal Compliance Monitoring Protocol for DBMD, ERS, CMPAS and SSPD

Beginning Jan. 1, 2015, DADS contract staff monitoring the DBMD, ERS, CMPAS and SSPD contracts will use the same streamlined contract monitoring procedures that have been used since 2009 for other community services contracts. The major changes include:

  • Sample size
    • DBMD - up to 5 people.
    • ERS, CMPAS and SSPD - up to 30 people. This replaces the current sampling process which starts with an initial sample of up to 25 people and expands to a larger sample size if the initial monitored sample reveals deficiencies.
  • Monitoring period – The monitoring period will be 24 months instead of 3-6 months. Although the number of months in the monitoring period is increasing, it is important to note that the number of months in the review period and in the service delivery documentation that DADS contract staff review remain the same.
  • Missing documents - Documents requested by contract staff during the monitoring are due by the exit conference versus 3 workdays after the exit conference.

Please email questions to Kathie.Carleton-Morales@dads.state.tx.us.

(12/3/2014)

Amended United States Department of Labor Regulations Effective January 1, 2015

The purpose of this notification is to inform providers in the following programs or services that amended U.S. Department of Labor (DOL) regulations will go into effect on January 1, 2015.

Medically Dependent Children Program;
Primary Home Care, Community Attendant Services, and Family Care;
Consumer Managed Personal Attendant Services;
Community Living Assistance and Support Services;
Deaf Blind with Multiple Disabilities;
Home and Community-based Services; and
Texas Home Living.

The amended regulations prohibit third party employers (which includes private entities) of domestic service employees, from claiming the companionship services exemption or the live-in domestic service employee exemption to the Fair Labor Standards Act. The regulations may be found at 29 CFR Part 552. Consequently, effective January 1, 2015, the regulations require you to pay at least the federal minimum wage and overtime pay to your domestic service employees, regardless of the employees’ duties.

For information about the amended DOL regulations, including DOL Fact Sheets, please see the following DOL website: http://www.dol.gov/whd/homecare/; call DOL’s toll-free information and helpline, 1-866-4USWAGE (1-866-487-9243), available 8am to 5pm in your time zone; or consult your legal counsel.

DADS rescinds this bulletin per the DADS Bulletin dated January 20, 2015.

(12/2/2014)

Ebola Health Alert

For the latest and most reliable information about the Ebola virus in Texas, go here https://service.govdelivery.com/accounts/TXHHSC/subscriber/new and sign up for email updates from the Texas Department of State Health Services (DSHS).

DSHS has confirmed one case of Ebola in Dallas County, and has issued an alert that can be seen here www.dallascounty.org/department/hhs/documents/DSHS_EbolaTestHealthAlert.pdf. DSHS emphasizes that the virus is transmitted only through direct contact with the blood or body fluids of someone infected with the disease.

The Centers for Disease Control and Prevention has developed a checklist www.cdc.gov/vhf/ebola/pdf/hospital-checklist-ebola-preparedness.pdf to use in case your organization identifies anyone who has traveled to or from an area affected by Ebola.

The checklist will help detect and respond appropriately to possible Ebola cases, while protecting clients and facility staff.

(10/3/2014)

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)

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)

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