Transition Assistance Services Orientation Handbook

Section 1000, TAS Overview

Revision 06-0; Effective May 22, 2006

 

TAS Purpose

Transition Assistance Services (TAS) assists Medicaid recipients who are nursing facility residents discharged from the facility to set up a household in the community. TAS is only available to nursing facility residents who are discharged from the facility into certain waiver programs. TAS is not available to residents moving from a nursing facility who are approved for any of the following waiver services:

All nursing facility residents who are being discharged into the community under some of the Medicaid waiver programs will be offered TAS by the case manager to establish a household. A nursing facility resident certified for waiver services may receive a one-time TAS authorization of up to $2,500, if the case manager determines that no other resources are available to pay for the basic services/items needed by the individual. Example: Expenses covered by TAS are security and utility deposits, moving expenses and essential furnishings necessary to establish a basic living arrangement.

TAS includes, but is not limited, to payment or purchase of:

Section 2000, Programs Offering TAS

 

 

Revision 06-0; Effective May 22, 2006

 

The Texas Department of Aging and Disability Services (DADS) has implemented TAS in the following 1915(c) Medicaid waiver programs:

Section 3000, Eligible Transition Assistance Services Providers

 

 

Revision 06-0; Effective May 22, 2006

 

All authorized Transition Assistance Services (TAS) will be delivered by a Department of Aging and Disability Services (DADS) contracted TAS provider agency. The provider agency must meet all provisions described in the Texas Administrative Code (TAC), Chapter 62, Contracting to Provide Transition Assistance Services, and Chapter 49, Contracting for Community Care Services.

The provider agency must:

A TAS provider agency must meet the requirements described in §62.11, Contracting Requirements. Relocation services are considered a community service; therefore, an entity that currently contracts with DADS to provide relocation services may contract to provide TAS. A TAS provider agency may subcontract this service with approval from DADS contract management staff. Once a TAS provider agency is awarded a contract, the TAS provider agency will be included on a regional TAS provider agency choice list. The waiver case manager will have the applicant choose the TAS provider agency during the waiver application process.

The provider agency must deliver DADS authorized Transition Assistance Services to Medicaid waiver individuals according to applicable TAS rules and the procedures as addressed in this orientation handbook. See authorization and assessment forms that are used for TAS, as well as Chapter 62, Contracting to Provide Transition Assistance Services.

The provider agency employees who deliver services must:

Section 4000, Authorization and Referral Process

 

 

Revision 06-0; Effective May 22, 2006

 

The provider agency must accept all individuals of any waiver program who are referred to the provider agency for services.

Step Action
1 The case manager will:
  • meet with the nursing facility resident and/or the resident's representative to discuss the waiver service array and living arrangement options, and obtain the resident's choice of provider agencies;
  • work with the resident and/or the resident's representative to identify the essential Transition Assistance Services (TAS) needed under the categories of Deposits, Household Needs and Site Preparation, as found on the assessment form;
  • determine if other resources are available to purchase the needed services; and
  • document the identified services/items on the TAS assessment form.
2 The case manager will:
  • finalize and authorize waiver services once the applicant meets all of the eligibility criteria;
  • contact the applicant to confirm the nursing facility discharge date and the individual's new address in the community; and
  • notify the individual that he/she is eligible for waiver services, including TAS, and send the individual a waiver eligibility notice.
3 The case manager will send the TAS authorization form and assessment forms to the selected TAS provider agency. The authorization form will include the individual's identifying information (name, address, etc.), the total dollar amount authorized for TAS and the TAS completion date. The assessment form will include the authorized services/items and the corresponding maximum dollar amount authorized.
 
4 The case manager will notify the TAS provider agency when an individual will not relocate into the community as planned. The case manager will also request that the provider agency not make any TAS purchases. The TAS provider agency can submit a claim for services that were already purchased and delivered.

Section 5000, Delivery of Transition Assistance Services (TAS)

 

 

Revision 06-0; Effective May 22, 2006

 

The TAS provider agency must deliver the authorized service at least two days before the individual's nursing facility discharge date. The TAS completion date will be included in the TAS authorization form. Below is a summary of the TAS provider agency procedures.

The TAS provider agency must:

The TAS provider agency may contact the individual or individual's representative, if necessary, to coordinate service delivery.

The case manager will contact the individual within three workdays of the nursing facility discharge date to ensure that the individual received all the TAS items and services authorized. If the individual did not receive all items and services within the required timeframe, the case manager will contact the TAS provider agency by telephone to determine the reason why the service delivery was not completed by the due date.

Section 6000, Reimbursement and Billing

Revision 06-0; Effective May 22, 2006

The Department of Aging and Disability Services (DADS) will pay for authorized services provided and billed in compliance with Chapter 62.

DADS will reimburse the Transition Assistance Services (TAS) provider agency a one-time fee and the invoice amount for delivered TAS. The TAS provider agency must submit a claim for reimbursement to DADS after it has contacted the individual to confirm that the authorized TAS services were delivered. A separate claim may be submitted for each authorized and delivered item or service; however, the TAS provider agency is only entitled to one TAS fee per individual.

The following service codes and procedures (bill) codes have been established for TAS:

Description Service Code Procedure Code Qualifier Procedure Code Rate
CBA TAS 53 HC T2038 $1.00
CLASS TAS 53 HC T2038 $1.00
CWP TAS 53 HC T2038 $1.00
DBMD TAS 53 HC T2038 $1.00
MDCP TAS 53 HC T2038 $1.00

The TAS agency must enter the total dollar amount of the TAS purchases in the "number of units" and $1.00 in the "unit rate" field.

Description Service Code Procedure Code Qualifier Procedure Code Unit Rate
CBA TAS Fee 53A ZZ G0239 $156.00
CLASS TAS Fee 53A ZZ G0239 $156.00
CWP TAS Fee 53A ZZ G0239 $156.00
DBMD TAS Fee 53A ZZ G0239 $156.00
MDCP TAS Fee 53A ZZ G0239 $156.00

 

The TAS agency must enter a "1" in the "number of units" field and the effective TAS fee in the "unit rate" field.

Section 7000, Example of a Community Based Alternatives (CBA) Case

 

 

Revision 06-0; Effective May 22, 2006

 

 

January 6, 2006

 

Mr. Smith, a current Medicaid nursing facility resident, contacts the Department of Aging and Disability Services (DADS) intake staff to request services in the community.

 

January 15, 2006

 

The CBA case manager meets with Mr. Smith and his sister to discuss the CBA service array and living arrangement options, and to obtain his choice of provider agencies. During the interview, Mr. Smith indicates that he plans to live in a house owned by his sister, Mary. Mary informs the case manager that she married and moved from her house last month and the home has all utility services in place. She also indicates the house already has living room/bedroom furniture, a clothes dryer, a fully equipped kitchen (with the exception of pots and pans), window blinds, a closet full of linens, etc. Mr. Smith indicates that he needs a dinette set, microwave oven, pots and pans, and washing machine. The case manager documents the identified items on the TAS assessment form.

 

January 16, 2006

 

The case manager authorizes a CBA Home and Community Support Services (HCSS) agency to perform a pre-enrollment assessment to identify Mr. Smith's total needs for CBA services and to develop an individual service plan (ISP).

 

February 12, 2006

 

The case manager determines that Mr. Smith meets all eligibility criteria for the CBA program and that no other resources are available to pay for his basic furnishings. The case manager finalizes the ISP, establishes an ISP effective date, and confirms the nursing facility discharge date and Mr. Smith's new home address. The case manager will send the TAS authorization and assessment forms to the TAS provider agency selected by Mr. Smith. The items authorized, with corresponding maximum costs per item, will be a small oak dinette ($200), a small microwave oven ($100), pots and pans ($50) and a washing machine ($400). The authorization will also include Mr. Smith's nursing facility discharge date of February 20, 1006, his address, and delivery date of February 20.

 

February 14, 2006

 

A TAS provider agency employee contacts the case manager to find out if Mr. Smith requested specific types of pots and pans.

 

February 14, 2006

 

The case manager contacts Mr. Smith to find out what specific pots and pans are needed. Mr. Smith informs the case manager that he needs stainless steel and prefers two medium pans and a small, medium and large pot. The case manager documents Mr. Smith's preferences on the assessment form and sends the revised form to the TAS provider agency.

 

February 16, 2006

 

The TAS provider agency employee goes to the local retail store to purchase the authorized items and arranges for delivery and installation on February 20, 2006. The TAS provider agency must ensure the sales receipt includes the purchase date, the item purchased and the total cost (including sales tax and delivery/installation charge, if any).

 

February 20, 2006

 

The TAS agency contacts Mr. Smith or his sister to confirm that the authorized items were delivered. The TAS agency documents the delivery and submits a claim for reimbursement.

TSA, Section 8000, Frequently Asked Questions

Revision 06-0; Effective May 22, 2006

 

Q: Can the individual receiving Transition Assistance Services (TAS) services request a specific brand or type of appliance, furniture or other TAS item, even if a similar item can be purchased at a lesser amount?
A: Yes, as long as the individual's needs are met within the cost limit.
Q: Can the TAS item be placed in someone else's home? For example, the individual is moving in with a daughter and they are requesting bedroom furniture.
A: TAS can be used in this situation only when furnishings are not available and are necessary for the individual to be able to transition from the nursing facility.
Q: Can TAS replace existing furniture that the individual/individual's representative deems no longer usable?
A: TAS can be used only to provide the necessary basic items for the individual to live in the community. If an existing item is truly not usable and the lack of a usable basic/essential item creates a barrier that keeps the individual from returning to the community, then the individual has a need for the item. However, TAS cannot be used for upgrading to a better quality item just because the individual would like new items.
Q: What happens to the TAS items if the individual chooses to return to the nursing facility?
A: If the individual has left the nursing facility and has possession of the TAS items, the items belong to the individual. The individual is responsible for making any decision regarding the disposition of the TAS items upon returning to the nursing facility
Q: Can security deposits or utility deposits be in someone's name other than the individual?
A: No. The deposits must be in the individual's name.
Q: Will TAS pay for the deposit on a cell phone if that is the individual's only telephone service?
A: Most cell phones do not require a deposit. Since a telephone is considered a basic need, TAS can purchase a telephone, but may not pay for any minutes or services.
Q: Can TAS be used to pay for arrears on previous utilities that must be paid before the new service is turned on?
A: Yes, only if it is in the individual's name and the individual will not be able to get utilities unless the previous balance is paid.
Q: Will TAS pay for pet deposits?
A: No, TAS will not pay pet deposits, unless the individual has a service animal. If the individual has a service animal, pet deposits can be considered essential to the individual.
Q: Can TAS be used to pay for repairs (not home modifications) on the individual's dwelling?
A: No. TAS cannot be used to pay for repairs.
Q: Can TAS be used to set up a septic system in rural areas?
A: No.
Q: It appears that the first day of authorization for TAS is the initial eligibility date from the Individual Service Plan/Individual Plan of Care form. The individual should still be in the nursing facility awaiting the completion of TAS and the start of service. Will the provider agency be able to bill for TAS items purchased during this period if nursing facility coverage is still open?
A: Yes. The system has been designed for this overlap.
Q: Does the case manager amend the TAS authorization form only if there is a new item requested, or must the case manager amend the TAS authorization form if there is a change in the price of a specific item?
A: The case manager amends the TAS authorization form, Individual Service Plan (ISP), for any valid change requests. If more funds are needed to purchase an item on the estimated cost list, the case manager also makes that change on the TAS authorization form.
Q: Is there a window of time in which the individual can request additional items on TAS? Implementation material states TAS is "one-time," but then allows for individuals to request additional items. How long after the initial authorization can the individual request additional items under TAS?
A: To assist the individual in making a successful transition to the community, the individual may request additional items or seek resolution of a problem until the completion date specified on the TAS authorization form. This date is two days prior to the planned discharge date. The case manager must make every effort to ensure that all basic/essential items are authorized while the individual is still in the nursing facility.
Q: If the individual requests items under TAS, can the case manager authorize a flat $2,500?
A: No.
Q: Should the TAS authorization form include the individual's date of birth and Social Security number, since utility companies for deposits usually require this information?
A: The case manager must provide any necessary information to the TAS agency. The TAS authorization form requires the individual's date of birth and Social Security number.
Q: Should a copy of the intake be sent with the TAS authorization?
A: To protect the privacy of the individual, a copy of the intake should not be provided to the TAS agency. If any additional information is needed, it should be attached on Form 2067, Case Information.
Q: Can the TAS agency exceed the amount for a particular item, as long as the amount for the total category is not exceeded? For example, a water deposit is noted for $100 and an electricity deposit is noted for $200. It turns out the electric company will only require a $100 deposit, but the water company raised its deposit to $150. The total for deposits is still under the $300 authorized.
A: Yes. The TAS agency can exceed the amount for a particular item as long as there are adequate funds authorized. The amounts listed in the guide are estimated, since utility deposits vary widely across the state. The case manager does not need to make a change on the authorization as long as there is adequate money authorized to cover the need.
Q: If the TAS agency finds it needs additional funds in a specific category, but fewer in others, should the case manager change the TAS authorization form?
A: No. The case manager does not change the TAS authorization form as long as the total authorized amount is adequate to cover the costs. However, if the TAS agency identifies a new item required by the individual, then a TAS authorization form is completed, processed as a change and sent to the agency with the additional items and amounts authorized.
Q: Does the agency request a change in the authorization if the amount of one of the items is not enough or if the amount of the categories is not enough?
A: The TAS agency may request a TAS authorization form change if the actual cost exceeds the authorized amount or if a new item/service not previously requested needs to be included.
Q: Long Term Care (LTC) Information Letter No. 04-33 states, "The TAS provider is authorized to purchase only the specific items or services found on the form, within the dollar amount authorized for each item or service." The memo also states the TAS provider may submit separate claims for each item or service. What does each item or service mean?
A: The memo quoted is LTC Information Letter No. 04-33, which was sent to providers from the Provider section. While the TAS agency is usually going to submit only one claim for all services, it can submit a second billing (or third, etc.) for additional items or changes added on a revised TAS authorization form. Examples of items and services include utility/security deposits, moving expenses and essential furnishings necessary to establish a household.
Q: If a TAS individual is moving into an apartment and the apartment requires the first and/or last month's rent as part of the security deposit, can TAS pay this amount?
A: According to the Centers for Medicare and Medicaid Services (CMS), security deposits may be paid as long as:
  • this payment is specifically called a security deposit and not rent;
  • the payment is for a one-time expense; and
  • the amount of the payment is no more than the equivalent of two months rent.
Q: The TAS agency purchases an item or service that has prior approval by the case manager, but the nursing facility resident changes his mind and doesn't leave the facility or dies before being discharged. What does the TAS agency do with the purchased item?
A:
  • The TAS agency must attempt to return the item. If the TAS agency receives a full refund, the TAS agency cannot bill for this item.
  • If the TAS agency cannot return the item, it must submit a written notice to the case manager. The case manager will contact a local charity and make arrangements for pick-up.
  • If the TAS agency can return the item for a partial refund, the TAS agency can bill for the amount it did not get back.
In each of the above cases, the agency can bill for the TAS fee. The case manager indicates the change and provides an explanation on Form 2067, Case Information, submitted with the TAS authorization form.
Q: If a TAS individual has no resources for purchasing food at the time of move-in, can TAS pay for food?
A: No, TAS funds cannot be used for food. The case manager may refer the individual to emergency Supplemental Nutrition Assistance Program (SNAP) or local food pantry resources. Some funding is available through the Transition to Living in the Community (TLC) program. TLC funds are primarily designated for non-waiver individuals, but if a waiver individual has no other resources, TLC may be able to pay for food.
Q: If an individual is moving from the nursing facility into an apartment, but plans to have a roommate, can TAS pay for (a) the security deposit and (b) furniture and other items the individual will need?
A:
  1. TAS can pay for the deposit only if the apartment is in the TAS individual's name and no other arrangement has been made with the roommate. This also depends on the timing of the move-in and agreement with the roommate and the apartment. The individual's transition from the nursing facility should not be unduly delayed waiting on the roommate.
  2. Yes, TAS can pay for furniture and other items that the individual needs. The individual and roommate must decide who will provide the furniture in the shared areas of the apartment. TAS can be used to purchase the items the individual agrees to provide. TAS funds cannot be used to buy furniture that would only be used by the roommate.Example: TAS could not purchase two bedroom suites for the individual. The individual may utilize TAS only to meet basic needs required to transition to the community.

Appendices, TAS

Appendix I Title 40, Texas Administrative Code, Chapter 62

Revision 06-0; Effective May 22, 2006

 

§62.1 Purpose
§62.3 Definitions
§62.5 Service Description
§62.11 Contracting Requirements
§62.21 Staff Requirements
§62.31 Referrals
§62.33 Service Delivery
§62.41 Record Keeping
§62.43 Reimbursement

Appendix II, List of Excluded Individuals and Entities (LEIE)

Appendix III, Degree of Consanguinity or Affinity

Forms

 

Form Title
2067 Case Information

Informacion in espanol = form also available in Spanish.

Revisions, TAS

Revision 14-1, Appendix Added

Revision Notice 14-1; Effective September 30, 2014

 

Adds Appendix III, Degree of Consanguinity or Affinity, to the Appendices Table of Contents.

Revision 13-1, Appendix Added

Revision Notice 13-1; Effective November 1, 2013

 

Adds Appendix II, List of Excluded Individuals and Entities (LEIE), to the Appendices Table of Contents.

Revision 06-0, New TAS Orientation Handbook

 
 
Revision Notice 06-0; Effective May 22, 2006

 

The Transition Assistance Services Orientation Handbook is now available online. The handbook is a guide for providers for the delivery of TAS. Revisions will be made, as needed.

Contact Us

For questions about the Transition Assistance Services Orientation Handbook, email taspolicy@hhsc.state.tx.us

For technical or accessibility issues with this handbook, please email: Editorial_Services@hhsc.state.tx.us