November 8, 2018 - 9:00am

Health and Human Services Commission, John H. Winters Human Services Complex, Public Hearing Room
701 West 51st St.
Austin, TX 78751

Webcasting Available

This meeting will be webcast. To access the webcast, go to https://hhs.texas.gov/about-hhs/communications-events/live-archived-meetings the day and time of the meeting.

  1. Initiate formal meeting: Gilbert Handal, M.D., Medical Care Advisory Committee Chair
  2. Medicaid and Children’s Health Insurance Program (CHIP) activities: Stephanie Stephens, Health and Human Services Commission (HHSC) Deputy State Medicaid Director
  3. Approval of August 16, 2018, meeting minutes (Vote required)

     

    ACTION ITEMS:

  4. Contracting for Community Services

    HHSC proposes amendments to Texas Administrative Code (TAC) Title 40, Part 1, Chapter 49 concerning Contracting for Community Services: §49.101, concerning Application; §49.102, concerning Definitions; §49.201, concerning Contractors Not Subject to Certain Portions of Subchapter B; §49.205, concerning License, Certification, Accreditation, and Other Requirements; §49.309, concerning Complaint Process; §49.701, concerning Contractors Not Subject to Subchapter G; new §49.301, concerning Contractors Not Subject to Certain Portions of Subchapter C; and the repeal of §49.301, concerning Purpose

    - Dana Williamson, Director, Medicaid and CHIP Services Department, HHSC

  5. Primary Home Care, Community Attendant Services, and Family Care Programs

    HHSC proposes amendments to TAC Title 40, Part 1, Chapter 47 concerning Contracting to Provide Primary Home Care: §47.1, concerning Purpose; §47.3, concerning Definitions; §47.21, concerning Supervisor Training Requirements; §47.23, concerning Attendant Qualifications; §47.25, concerning Attendant Orientation; §47.41, concerning Allowable Tasks; §47.45, concerning Pre-Initiation Activities; §47.47, concerning Medical Need Determination; §47.49, concerning Interdisciplinary Team; §47.57, concerning Service Delivery Options; §47.61, concerning Service Initiation; §47.63, concerning Service Delivery; §47.67, concerning Service Delivery Plan Changes; §47.69, concerning Transfers; §47.71, concerning Suspensions; §47.73, concerning Annual Reauthorization for Community Attendant Services (CAS); §47.81, concerning Monitoring Medicaid Eligibility; §47.83, concerning Monitoring Reviews; §47.85, concerning Retroactive Payment Procedures; §47.89, concerning Reimbursement; §47.91, concerning Utilization Review; new §47.43, concerning Referrals and Authorizations; §47.74, concerning Prohibition of Restraint and Seclusion; §47.101, concerning Requirements for Providers Related to the Abuse, Neglect, and Exploitation of an Individual; and §47.103, concerning Requirements for Providers Related to the Abuse, Neglect, and Exploitation of an Individual Receiving Services in the Primary Home Care Program and Community Attendant Services Program Through the Agency Option or the Service Responsibility Option; and the repeal of §47.43, concerning Referrals; §47.59, concerning Support Consultation; and §47.72, concerning Compliance with Program Requirements.

    - Dana Williamson, Director, Medicaid and CHIP Services Department, HHSC

  6. Requirements in the Deaf Blind with Multiple Disabilities (DBMD) Program

    HHSC proposes amendments to TAC Title 40, Part 1, Chapter 42 concerning Deaf Blind with Multiple Disabilities (DBMD) Program and Community First Choice (CFC) Services: §42.103, concerning Definitions; §42.201, concerning Eligibility Criteria for DBMD Program Services and CFC Services; §42.211 concerning Written Offer of DBMD Program Services; §42.212, concerning Process for Enrollment of an Individual; §42.216, concerning DADS Review of Request for Enrollment; §42.221, concerning Utilization Review of Individual Plan of Care (IPC) by DADS; §42.223, concerning Period Review and Update of IPC and IPP; §42.301, concerning Program Provider Compliance with Rules; §42.401, concerning Protection of Individual; §42.405, concerning Recordkeeping Requirements; §42.406, concerning Quality Assurance; §42.613, concerning Requesting Authorization to Purchase a Minor Home Modification that Costs Less than $1,000; §42.614, concerning Requesting Authorization to Purchase a Minor Home Modification that Costs $1,000 or More; §42.617, concerning Time Frames for Completion of Minor Home Modification; §42.623, concerning Case Management; §42.632, concerning Therapies; §42.641, concerning Non-Billable Time and Activities; new §42.220, concerning Tracking Annual Renewal of an Intellectual Disability/Related Condition (ID/RC) Assessment and an IPC; §42.403, concerning Training; §42.410, concerning Reporting Allegations of Abuse, Neglect, or Exploitation of an Individual; §42.411, concerning Requirements Related to the Abuse, Neglect, and Exploitation of an Individual; and the repeal of §42.222, concerning Annual Review and Reinstatement of Lapsed Diagnostic Eligibility; and §42.403, concerning Training

    - Dana Williamson, Director, Medicaid and CHIP Services Department, HHSC

  7. Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Programs

    HHSC proposes amendments to TAC Title 40, Part 1, Chapter 9, concerning Intellectual Disability Services--Medicaid State Operating Agency Responsibilities: §9.153, concerning Definitions; §9.177, concerning Certification Principles: Staff Member and Service Provider Requirements; §9.178, concerning Certification Principles: Quality Assurance; and §9.190, concerning Local Intellectual and Developmental Disability Authority (LIDDA) Requirements for Providing Service Coordination in the HCS Program; and new §9.175, concerning Certification Principles: Requirements Related to the Abuse, Neglect, and Exploitation of an Individual, in Subchapter D, Home and Community-based Services (HCS) Program and Community First Choice (CFC); and amendments to §9.553, concerning Definitions; §9.555, concerning Description of TxHmL Program Services; §9.579, concerning Qualified Personnel; §9.580, concerning Certification Principles: Quality Assurance; and §9.583, concerning TxHmL Program Principles for LIDDAs; and new §9.585, concerning Certification Principles: Requirements Related to the Abuse, Neglect, and Exploitation of an Individual, in Subchapter N, Texas Home Living (TxHmL) Program and Community First Choice (CFC

    - Dana Williamson, Director, Medicaid and CHIP Services Department, HHSC

  8. Community Living Assistance and Support Services (CLASS) Program

    HHSC proposes amendments to TAC Title 40, Part 1, Chapter 45, Community Living Assistance and Support Services (CLASS) and Community First Choice (CFC) Services: §45.103, concerning Definitions; §45.201, concerning Eligibility Criteria for CLASS Program Services and CFC Services; §45.212, concerning Process for Enrollment of an Individual; §45.213, concerning Determination of Diagnostic Eligibility by DADS; §45.214, concerning Development of Enrollment IPC; §45.216, concerning DADS Review of an Enrollment IPC; §45.221, concerning Annual Review and Reinstatement of Diagnostic Eligibility; §45.223, concerning Renewal and Revision of an IPC; §45.225, concerning Utilization Review of an IPC by DADS; §45.403, concerning Denial of a CLASS Program Service or CFC Service; §45.405, concerning Reduction of a CLASS Program Service or CFC Service; §45.406, concerning Termination of CLASS Program Services and CFC Services With Advance Notice Because of Ineligibility or Leave from the State or Because Direct Services Agency (DSAs) Cannot Ensure Health and Safety; §45.702, concerning Protection of Individual, Initial and Annual Explanations, and Offering Access to Other Services; §45.704, concerning Training of Case Management Agency (CMA) Staff Persons; §45.707, concerning CMA: Quality Management Process; §45.802, concerning DSA: Protection of Individuals; §45.804, concerning Training of DSA Staff Persons; and §45.807, concerning DSA: Systems and Recordkeeping; new §45.226, concerning Tracking Annual Renewal of an ID/RC Assessment by a DSA; §45.227, concerning Tracking Annual Renewal of an IPC by a CMA; §45.706, concerning CMA Documentation of Services Delivered and Recordkeeping; §45.708, concerning CMA: Reporting Allegations of Abuse, Neglect, or Exploitation of an Individual; §45.709, concerning CMA: Requirements Related to the Abuse, Neglect, and Exploitation of an Individual; §45.810, concerning DSA: Reporting Allegations of Abuse, Neglect, or Exploitation of an Individual; and §45.811, concerning DSA: Requirements Related to the Abuse, Neglect, and Exploitation of an Individual; and the repeal of §45.706, concerning CMA Recordkeeping
    - Dana Williamson, Director, Medicaid and CHIP Services Department, HHSC

  9. Consumer Directed Services Option

    HHSC proposes amendments to TAC Title 40, Part 1, Chapter 41, Consumer Directed Services Option (CDS): §41.103, concerning Definitions; §41.108, concerning Services Available Through the CDS Option; §41.238, concerning Service Delivery Requirements; §41.301, concerning Contracting as a Financial Management Services Agency; §41.307, concerning Initial Orientation of an Employer; §41.309, concerning Financial Management Services, CFC Support Management, and Vendor Fiscal/Employer Agent Responsibilities; §41.313, concerning Individual Service Planning Process; §41.339, concerning Records; new §41.233, concerning Training and Management of Service Providers; §41.701, concerning Reporting Allegations of Abuse, Neglect, or Exploitation of an Individual; §41.702, concerning Requirements Related to HHSC Investigations When an Alleged Perpetrator is a Service Provider; and §41.703, concerning Requirements Related to HHSC Investigations When an Alleged Perpetrator is a Staff Person or a Controlling Person of an FMSA; and the repeal of §41.233, concerning Training and Management of Service Providers; and §41.701, concerning Reporting Allegations

    - Michelle Erwin, Director, Medicaid and CHIP Services Department, HHSC

  10. Case Management Services for Blind and Visually Impaired Children

    HHSC proposes to appeal TAC Title 1, Part 15, Chapter 354, Subchapter C, concerning Case Management for Children Who Are Blind and Visually Impaired, in its entirety.

    - Michelle Erwin, Director, Medicaid and CHIP Services Department, HHSC

  11. Pharmacy Dispensing Fee and Medication Synchronization

    HHSC proposes amendments to TAC Title 1, Part 15, Chapter 354, Subchapter F, Division 2, concerning Administration: §354.1831, concerning Covered Drugs; §354.1867, concerning Refills; §354.1921, concerning Addition of Drugs to the Texas Drug Code Index; and Chapter 355, Subchapter J, Division 28, concerning Pharmacy Services: Reimbursement: §355.8541, concerning Legend and Nonlegend Medications; §355.8548, concerning 340B Covered Entities; and §355.8551, concerning Professional Dispensing Fee

    - Priscilla Parrilla, Director, Pharmacy Operations, HHSC

    INFORMATIONAL ITEMS:

  12. Early Childhood Intervention Program Efficiencies

    HHSC proposes amendments to TAC Title 40, Part 2, Chapter 108, Subchapters A to H and J to N, concerning Early Childhood Intervention Services

    - Lindsey Rodgers, Associate Commissioner, Health Developmental and Independence Services, HHSC

  13. Demonstration Year (DY) 7 and DY8 Rural Uncompensated Care (UC) Amendment

    HHSC proposes an amendment to TAC Title 1, Part 15, Chapter 355, Subchapter J, Division 11, concerning Texas Healthcare Transformation and Quality Improvement Program Reimbursement: §355.8201, concerning Waiver Payments to Hospitals for Uncompensated Care

    - Charles Greenberg, Director of Hospital Finance and Waiver Programs, HHSC

  14. Quality Incentive Payment Program (QIPP) for Nursing Facilities

    HHSC proposes amendments to TAC Title 1, Part 15, Chapter 353, Subchapter O concerning Delivery System and Provider Payment Initiatives: §353.1303, concerning Quality Incentive Payment Program for Nursing Facilities before September 1, 2019; proposed new §353.1302, concerning Quality Incentive Payment Program for Nursing Facilities on or after September 1, 2019; and new §353.1304, concerning Quality Metrics for the Quality Incentive Payment Program for Nursing Facilities on or after September 1, 2019

    - Victoria Grady, Deputy Director of Rate Analysis, HHSC

  15. Cost Report Training and Cost Allocation Methods for State Supported Living Centers

    HHSC proposes amendments to TAC Title 1, Part 15, Subchapter A concerning Cost Determination Process: §355.102, concerning General Principles of Allowable and Unallowable Costs; §355.105, concerning General Reporting and Documentation Requirements, Methods, and Procedures; §355.112, concerning Attendant Compensation Rate Enhancement; and Subchapter C concerning Reimbursement Methodology for Nursing Facilities: §355.306, concerning Cost Finding Methodology

    - Victoria Grady, Deputy Director of Rate Analysis, HHSC

  16. Public comment

  17. Nominations for new Chair and Vice Chair

  18. Proposed next meeting: February 14, 2019, at 9:00 a.m.

  19. Adjourn

Public comment may be taken on any agenda item.

Contact: Questions regarding agenda items, content, or meeting arrangements should be directed to Natoshia Petsch, Medicaid and CHIP Services Department, 512-487-3307, natoshia.petsch@hhsc.state.tx.us.

This meeting is open to the public. No reservations are required, and there is no cost to attend this meeting.

People with disabilities who wish to attend the meeting and require auxiliary aids or services should contact Petsch at 512-487-3307 at least 72 hours before the meeting so appropriate arrangements can be made.