Appendices
Appendix I, DADS Contract Management
Appendix II, HIV/AIDS in the Workplace
Appendix III, Medicaid for the Elderly and People with Disabilities
Appendix IV, List of Excluded Individuals and Entities (LEIE)
Appendix V, Mutually Exclusive Services
Appendix VI, Advance Directives
Appendix VII, Retired Information Letters
Revision 15-1; Effective December 17, 2015
The Department of Aging and Disability Services (DADS) will from time to time retire Information Letters (ILs) when policy has expired, retired or been replaced with new information.
Content in this manual and the Texas Administrative Code (TAC) supersedes any previous ILs or similar guidance published by DADS. The ILs retired as a result are listed below. DADS recommends that providers remove these ILs from their records to ensure they reference the most current information. Any letters or program guidance issued prior to Internet accessibility is null and void, including policy previously sent by U.S. mail.
| Number | Title | Date Posted | Date Removed |
|---|---|---|---|
| 11-31 | Complaints Regarding Solicitation | 04/15/2011 | 04/30/2019 |
| 09-162 | Personal Care Services and DBMD Residential Habilitation | 12/11/2009 | 11/03/2015 |
| 09-153 | Personal Care Services (PCS) and Waiver Services Replaced by IL 2015-71 | 10/30/2009 | 11/03/2015 |
Appendix VIII, Case Manager's Review Schedule
| Individual Plan of Care (IPC)Renewal Date | First Case Manager Review Due Date | Second Case Manager Review Due Date | Third Case Manager Review Due Date | Earliest Renewal Meeting Date | Latest Date to Submit IPC to DADS |
|---|---|---|---|---|---|
| Jan 1 | Mar 31 | June 30 | Sept 30 | Oct 3 | Dec 2 |
| Feb 1 | April 30 | July 31 | Oct 31 | Nov 3 | Jan 2 |
| Mar 1 | May 31 | Aug 31 | Nov 30 | Dec 1 | Jan 30 |
| April 1 | June 30 | Sept 30 | Dec 31 | Jan 1 | Mar 2 |
| May 1 | July 31 | Oct 31 | Jan 31 | Jan 31 | April 1 |
| June 1 | Aug 31 | Nov 30 | Feb 28 | Mar 3 | May 2 |
| July 1 | Sept 30 | Dec 31 | Mar 31 | April 2 | June 1 |
| Aug 1 | Oct 31 | Jan 31 | April 30 | May 3 | July 2 |
| Sept 1 | Nov 30 | Feb 28 | May 31 | June 3 | Aug 2 |
| Oct 1 | Dec 31 | Mar 31 | June 30 | July 3 | Sept 1 |
| Nov 1 | Jan 31 | April 30 | July 31 | Aug 3 | Oct 2 |
| Dec 1 | Feb 28 | May 31 | Aug 31 | Sept 2 | Nov 1 |
Note: The fourth case manager’s review of the IPC year is combined with the meeting of the Service Planning Team to develop a renewal IPC.
Appendix IX, Critical Incident Reporting
Appendix X, Solicitation Prohibition
Appendix XI, Abuse, Neglect, and Exploitation Training and Competency Test
Revision 19-3; Effective June 7, 2019
1. Requirement to Train DBMD Program Directors, Service Providers, Staff Persons and Volunteers
A DBMD program provider must ensure their program directors, service providers, staff persons and volunteers are:
- trained on:
- acts that constitute abuse, neglect and exploitation;
- signs and symptoms of abuse, neglect and exploitation; and
- methods to prevent abuse, neglect and exploitation; and
- knowledgeable of:
- acts that constitute abuse, neglect and exploitation;
- signs and symptoms of abuse, neglect and exploitation; and
- methods to prevent abuse, neglect and exploitation; and
- instructed to report to Department of Family and Protective Services (DFPS) immediately, but not later than 24 hours, after having knowledge or suspicion that an individual has been, or is being, abused, neglected or exploited by:
- calling the DFPS Abuse Hotline toll-free telephone number, 1-800-252-5400; or
- using the DFPS Abuse Hotline website; and
- provided with these instructions described in paragraph c of this section, in writing.
2. Optional Computer-Based Training
A DBMD program provider has the option of requiring their DBMD program directors, staff persons, service providers and volunteers to complete HHSC’s ANE Competency Training.
The completion of the computer-based training by DBMD program directors, service providers, staff persons and volunteers meets the requirements in Section 1a of this appendix.
Staff members, service providers, and volunteers must first sign up on the Learning Portal to have access to HHSC approved trainings, including this ANE training, entitled ANE Competency Training and Exam (online). The ANE training is found in Medicaid Long Term Services and Supports Training under the Health and Human Services Commission Courses tab.
Link to the Learning Portal homepage: https://learningportal.hhs.texas.gov/
3. Mandatory Computer-Based Competency Test
A DBMD program provider must ensure that a person trained on abuse, neglect and exploitation, as required by Section 1a of this appendix, completes HHSC’s ANE Competency Final Test and receives a score of at least 80 percent.
Compliance with this section by DBMD program directors, service providers, staff persons and volunteers meets the requirement in Section 1b of this appendix.
Section 2 provides information on how to access the Competency Test on the Learning Portal.
4. When Compliance Must Begin and Frequency of Training
A DBMD program provider must ensure that the requirements in Section 1 of this appendix are met:
- for a program director, service provider, staff person or volunteer who is hired on or after July 1, 2019, before the DBMD program director, service provider, staff person or volunteer assumes job duties, and annually thereafter; and
- for a program director, service provider, staff person or volunteer who is hired before July 1, 2019, within one year after the person’s most recent training on abuse, neglect and exploitation, and annually thereafter.
5. Documentation Requirements
A DBMD program provider must:
- document:
- the name of the person who received the training required by Section 1a of this appendix;
- the date the training was conducted; and
- one of the following:
- the name of the person who conducted the training; or
- if the training is not in-person training, a description of the type of training provided; and
- maintain a copy of the certification generated from the HHSC ANE Competency Final Test for each DBMD program director, service provider, staff person and volunteer.
Appendix XII, Value-added Services
Revision 19-5; Effective November 25, 2019
Value-added services (VAS) are extra benefits offered by managed care organizations (MCOs) beyond the Medicaid-covered services. VAS may include routine dental, vision, podiatry, and health and wellness services. VAS may be actual health care services, benefits or positive incentives that Texas Health and Human Services Commission determines will promote healthy lifestyles and improve health outcomes among members. Each MCO offers a different set of VAS and the MCO can change the VAS it offers once per fiscal year beginning September 1.
MCOs must cover all benefits in Medicaid managed care programs, such as STAR+PLUS, STAR Kids and STAR Health. The MCOs utilize VAS as an incentive to assist the member in making the best plan choice. In addition, members may use VAS to help choose which MCO has the added benefits best suited for their needs.
VAS are not considered non-waiver resources and therefore, waiver program providers do not consider VAS offered by the MCO when considering third-party resources. VAS is an added benefit available to individuals from the MCO providing their acute care services.
Appendix XIII, Definition of the Term “Relative”
Revision 21-1; Effective June 23, 2021
A person is considered to be a relative if the person is related within the fourth degree of consanguinity or within the second degree of affinity.
Relationships of Consanguinity
Two people are related to each other by consanguinity if one is a descendant of the other or if they share a common ancestor. An adopted child is considered to be a child of the adoptive parent for this purpose.
Degrees of Consanguinity
| Individual | 1st Degree | 2nd Degree | 3rd Degree | 4th Degree |
|---|---|---|---|---|
| Person | child parent | grandchild, sister, brother, grandparent | great grandchild, niece, nephew, *aunt, *uncle, great grandparent | great-great grandchild, grandniece, grandnephew, first cousin, *great aunt, *great uncle, great-great grandparent |
*An aunt, uncle, great aunt or great uncle is related to a person by consanguinity only if he or she is the sibling of the person's parent or grandparent.
Example: Person A is related by the third degree of consanguinity to person B if person B is person A's uncle (brother of person A's father) because they share a common ancestor. However, person A is not related by consanguinity to person C if person C is the uncle's spouse because person A and person C share no common ancestor.
Relationships of Affinity
Two people are related by affinity if they are married to each other, or if one person’s spouse is related by consanguinity to the other person.
The ending of a marriage between two people by divorce or the death of a spouse ends relationships by affinity created by that marriage, unless a child of that marriage is living, in which case the marriage is considered to continue as long as a child of that marriage lives.
Degrees of Affinity
| Individual | 1st Degree | 2nd Degree |
|---|---|---|
| Person | spouse spouse’s child (stepchild) spouse’s parent child’s spouse parent’s spouse (stepparent) | spouse's grandchild (step grandchild) spouse's brother, spouse’s sister spouse's grandparent grandchild's spouse brother’s spouse, sister’s spouse grandparent’s spouse (step grandparent) |
Example: Person A is related by the second degree of affinity to the brother of person A's spouse because the brother and Person A’s spouse are related by the second degree of consanguinity.