Quarterly Webinars

May 17, 2017

Feb. 13, 2017

Sept. 9, 2016

Feb. 12, 2016

Agenda

  • Employment Recruitment Coordinator
  • IPC Coversheet Use
  • Common Issues with Individual Plans of Care and Levels of Care
  • Discontinuing Use of Purpose Code E for Reinstatement of Lapsed Diagnostic Eligibility
  • Common Problems with Vehicle Modifications
  • Revisions to the CLASS Provider Manual Published November 20, 2015
  • Frequently Cited Issues on Contract Monitoring
  • Community First Choice Update
  • CLASS Waiver Renewal Status
  • Contracting for CLASS Services

DADS Employment Recruitment Coordinator (ERC)

Money Follows the Person (MFP) Employment Initiatives
  • Information Letter 15-72, November 16, 2015 introducing the role.
  • In concert with other DADS employment initiatives, DADS determined the need for Employment Recruitment Coordinator (ERC) activities to compliment other projects;
  • Field based work statewide to reach beyond a state office based approach with a direct face to face representative;
  • Ultimate goal is to increase employer awareness of the population we serve and increase integrated employment opportunities.
DADS Goals for the Employment Recruitment Coordinator
  • Establish ongoing relationships with businesses / employers and serve as a point of contact for those entities;
  • Network and establish community and civic organization relationships to promote employment for persons with disabilities.
  • Work with other agencies for common interest projects related to promoting employment for persons with disabilities;
  • Secure job descriptions and key skills needed for specific job descriptions from employers to share with providers in building those skills with persons served;
  • Increase number of persons with developmental disabilities in integrated employment;
  • Assist with other DADS MFP employment initiatives towards the overall goal of assisting persons with developmental disabilities pursuing employment.
  • DADS Goals for the Employment Recruitment Coordinator (cont'd)
  • The Big Goal: Market to employers why employing persons with disabilities is a good business decision!
Who Is the Target Employment Group
  • Individuals receiving services under programs administered by the Texas Department of Aging and Disability Services and served by providers in community settings such as group homes, State Supported Living Centers, or in home care.
  • Community Living Assistance and Support Services (CLASS)
  • Deaf Blind with Multiple Disabilities (DBMD)
  • Home and Community Based Services (HCS)
  • Texas Home Living (TxHML)
  • State of Texas Access Reform (STAR) + PLUS
  • Medically Dependent Children Program (MDCP)
  • State Supported Living Centers (SSLC)
A Focus on a Person's Ability as Opposed to Disability
  • Individuals served under a DADS program who desire to work in integrated employment and demonstrate what they can bring the workplace as a productive member of the organization.
  • Out of the box thinking with the ability to meet the employers need with difficult to fill or high turnover positions.
  • Individuals served have a genuine desire to be employed.
How is the message being delivered?
  • Direct interaction with employers in face to face settings
    • Presentations
    • Informal discussions
    • Cold calls
  • Presentations at Chamber and Rotary meetings;
  • Networking and expansion of employers already employing persons with disabilities;
  • How is the message being delivered?
  • Networking and relationship expansion with DARS;
  • Job Fairs (both larger and targeted audiences);
  • ERC will be working throughout the state as a front line representative for DADS to garner an understanding and commitment from employers.
Difference between the ERC and DARS field specialists
  • ERC focus is more broad based to center on the employer overall as opposed to individual employment cases;
  • Focus is more statewide as opposed to local;
  • Open doors with employers that have a statewide presence with intent of establishing large scale initiatives;
  • Work in concert with DARS staff on mutually beneficial projects such as job fairs and encourage provider attendance.
Tools to Communicate
  • Packet of Information to remain with employers;
  • One Page Brochure selling employer benefits for hiring;
  • Better Bottom Line document;
  • Power Point employer focused presentation;
  • Publicity Consent Form and Statement of Participation for employers;
  • Employer list (web and other mediums);
  • DARS "Guide for Hiring People with Disabilities";
  • DADS Employment Marketing video (to be released near end of January, 2016).
  • Enhancements to DADS Employment Services web presence to list employers and those ideal positions for employment
Why Employment is Important

Individuals with disabilities are only a small percentage of the population, right?

No. According to the U.S. Census Bureau, approximately 20% of Americans have one or more diagnosed psychological or physical disability. Thus, every 1 in 5 persons in the U.S. have some form of a disability.

Business Tax Credits for Employing Persons with Disabilities

  • Work Opportunity Tax Credit up to $2,400 a year
  • Small Business Tax Credit up to $5,000 a year
  • The Architectural/Transportation Tax Credit up to $15,000 a year
The Bottom Line for Employers
  • Return on Investment
  • Marketing
  • Innovation
What's the benefit of hiring persons with disabilities?
  • Have equal or higher job performance rates
  • Have higher retention rates
  • Are experienced problem-solvers with a proven ability to adapt
What is Desired from the Business / Employer
  • Commit to providing two or more job descriptions and the skill sets needed that would be ideal for the target audience.
  • Consider focusing on high turnover and entry level positions. Generally part-time
  • Not asking for any commitment or promise to meet a quota or percentage.
  • Not asking for a commitment to promise to hire anyone.
  • Simply asking for a an awareness and consideration of the target audience for appropriate job opportunities and share information about those positions with the key skill sets needed, which will be shared with providers to enhance skills of individuals served.
Interaction with the Provider Community

ERC will work with providers to:

  • Identify employers that have embraced hiring individuals served;
  • Determine mechanisms to support providers assisting individuals pursuing integrated employment;
  • Make presentations requested by providers or may request to make the presentation;
  • Establish potential mini-job fairs for local provider attendance;
    • Upcoming mini-job fair in December at an employer in Austin
  • Share information with providers about employers , potential jobs and skill sets needed;
  • Work with providers on Employment First principled efforts that may enhance opportunities with employers (mutually determined efforts;
  • Communicate in person, phone, email and Information Letters on important information;
Employment Recruitment Coordinator Contact Information

Monty Chamberlain
701 W. 51st Street
Austin, Texas 78751
Mail Code: W-580
512-971-8839
monty.chamberlain@dads.state.tx.us
erc@dads.state.tx.us

IPC Coversheet Use

CLASS IPC/IDRC Cover Sheet Form 3591

PURPOSE

  • CMA and DSA staff use this form as a cover sheet to submit an IPC form or an ID/RC assessment form to DADS.
  • DADS staff use this form to record receipt of the IPC or ID/RC submission, and the review decision.
When to Prepare
  • A CLASS CMA makes an IPC submission to DADS,
  • A CLASS DSA makes an ID/RC submission to DADS, or
  • A CLASS CMA or DSA responds to a request from DADS for additional information relating to an IPC or ID/RC submission.

Common Issues with Individual Plans of Care and Levels of Care

IPC Submission Common Issues
  • Legibility – include clear copy
  • IPPs not matching IPC or vs.
  • Missing or incorrect "C" or "N" notations
  • Error corrections (not as per Chapter 49 TAC)
  • Habilitation Plan not justifying requested service amount
  • Parental barriers not documented
  • Treatment Plans must include baselines, goals and measurable objectives
  • Missing or incorrect vendor numbers
  • Missing or incorrect IPC effective period
  • Renewal IPCs proposing SVC 10/10v instead of 10CFC/10CFV
ID/RC Submission Common Issues
  • Legibility – include clear copy
  • Required fields not populated or not coded as per instructions
  • Submission outside the submission window (120 – 60 days before the end of an IPC period)
  • Primary Diagnosis not a Related Condition
  • Diagnosis not coded in ICD-10 format
  • Nonsensical onset date of primary diagnosis
  • Missing or misplaced MD/OD attestation
  • Recommended LOC not in alignment with assessments and findings
  • Error corrections
  • ABL assessment tool expired

Purpose Code E – Discontinued

  • Intellectual Disability/Related Condition (ID/RC) assessment is performed at enrollment and annually to document that diagnostic / functional eligibility criteria have been established.
  • The ID/RC must be submitted to (DADS) at least 60 calendar days before the expiration of an individual plan of care (IPC) .
  • DADS considers an individual's diagnostic / functional eligibility to be lapsed if the program provider does not submit a completed ID/RC before the end of the IPC period.
  • Reinstatement of lapsed of lapsed diagnostic / functional eligibility is limited to a period of no more than 180 calendar days before the date DADS receives such a request.
Before Information Letter No. 15-74

To reinstate lapsed diagnostic / functional eligibility for CLASS services, a DSA program provider must submit in addition to the ID/RC Purpose Code 3 an ID/RC using Purpose Code E.

After Information Letter No. 15-74

Effective November 15, 2015, a DSA program provider submits ONE ID/RC using Purpose Code 3 to renew diagnostic/functional eligibility for the IPC year and to request reinstatement of lapsed diagnostic / functional eligibility.

Vehicle Modification

Common Problems associated with procurement:

  • Individual / family member does not own the vehicle that is expected to be modified.
  • No / insufficient specifications.
  • No / insufficient bids.
  • Specifications not based on professional assessment.
  • Bids not developed based on specifications.
  • Procurement of funding for a vehicle modification performed in the past.
  • Submission of identical specifications and bids instead of discrete specs and bids.
  • No breakdown of bid components (labor, material, shipping).
  • Timeline of procurement of funds / service delivery not met as defined in TAC.

The CLASS program currently requires that vehicles older than 5 years and mileage exceeding 50,000 miles must be inspected by a certified automotive technician to be considered the basis for a CLASS funded vehicle modification.

~ POLL ~

Would it be helpful if DADS developed an inspection report (DADS form) including all required components of such an inspection?

Overview of CLASS Provider Manual Revisions Effective 11/20/15

Chapter 2000 – Case Management

CMA Responsibilities:

  • Updates the functions the CMS must complete within 14 days of receipt of the Selection Determination.
  • Updates functions CMA must complete between 30 and 90 days before the end of IPC year.
  • CMA must use the date which DSA RN documents individual was in immediate jeopardy.

Defines IPP Service Reviews will occur in accordance with the schedule in Appendix X.

  • Was service backup plan implemented?
  • Meet the individual's needs?
  • Convene Service Planning Team (SPT) for revision of plan?

Adds requirement for CMA to provide a copy of the reduction of services notification to the DSA, FMSA, and SFS provider if an individual's services are reduced.

Chapter 3000 – Direct Services
  • Defines SPT as individual/legally authorized representative (LAR), case manager and a DSA representative.
  • Licensed professionals may bill for attending the SPT meeting.
  • DSA IPP Service Summary schedule in Appendix X
  • Defines IPP Service Summary
  • DSA reviews individual's progress on IPP goals and objectives.
  • IPP goals must be observable and measureable.
  • Was service backup plan implemented?
  • Meet the individual's needs?
Chapter 7000 – Billing
  • Defines Cognitive Rehabilitative Therapy
  • Defines Employment Assistance.
  • Defines Dietary Services (Nutritional Services)
  • Defines Auditory Integration/Auditory Enhancement Training
  • Changes "Speech Therapy" to "Speech and Language Pathology."
  • Defines Supported Employment.
  • Defines Employment Assistance
  • Adds the respite provider cannot provide respite services while living in the same residence as the individual.
Appendix I - Adaptive Aids (AA)
  • Resource for nutritional supplements.
  • SPT is not required to complete 3660, for repair and maintenance that does not exceed $300.
  • Updated Medicare resource related to AA.
  • Limitations regarding CLASS purchases of AA.
Appendix II - MHM
  • Completing Specifications form (3849-A).
  • Explanation of minor home modification (MHM) limits.
  • Requirements regarding upgrades to items beyond the basic item/construction.
  • No 3660 required to submit specifications.
Appendix V - ID/RC Processing

New Nursing assessment published to Provider Manual.

Use for any nursing assessments conducted after January 29, 2016.

CLASS Program Contract Monitoring Frequent Citations

Case Management Agency - Most Common Citations

Please see CMA Workbook for reference information

Standard III.5. Renewal SPT

The CMA must explain to the individual/LAR or person actively involved with the individual, orally and in writing the mandatory participation requirements of an individual as described in §45.302.

The SPT meeting must be convened at least annually, between 30 and 90 calendar days before the end of the IPC period.

Standard III.6. Renewal SPT

Within 10 business days of DADS notification of approval, the case manager must provide copies of the DADS authorized IPC, IPPs, habilitation plan/habilitation training plan, SPT notes and ID/RC to all members of the SPT and to any additional CLASS service providers (FMSA, Continued Family Services [CFS], and Support Family Services [SFS]), as necessary.

Within 10 business days of DADS notification of approval, the case manager must provide copies of the DADS authorized IPC, IPPs, habilitation plan/habilitation training plan, SPT notes and ID/RC to all members of the SPT and to any additional CLASS service providers (FMSA, Continued Family Services [CFS], and Support Family Services [SFS]), as necessary.

Additional Documents

Therapy Justifications (8606As) and Request for Adaptive Aids, Medical Supplies, or Minor Home Modifications (3660) must also be provided with the DADS authorized IPC, IPPs, habilitation plan/habilitation training plan, SPT notes and ID/RC, if applicable.

Standard III.8. Revision SPT

The CMA must submit revision documentation to DADS at least 30 calendar days before the proposed effective date.

Additional Documents

Within five business days of DADS transmission of the authorized IPC, as evidenced by the fax transmittal date on the documents, the case manager must provide copies of the DADS authorized IPC, IPPs, habilitation plan/habilitation training plan, the Service Planning Team (SPT) notes and intellectual disability/related condition (ID/RC) to all members of the SPT. The case manager must provide copies of this documentation to any additional CLASS service providers (FMSA, CFS, and SFS), as necessary.

Standard III.9. IPP Service Reviews

The CMA must in accordance with the CLASS Provider Manual meet with the individual/LAR to complete Form 3595, IPP Service Review, reviewing the individual's progress toward achieving the goals and objectives as described on the IPP. That includes the following documentation for all services on the IPC:

  • Documentation of progress or lack of progress toward goals/objectives as identified on the IPPs /IPC;
  • Assess the individual's satisfaction with the provision of CLASS program services;
  • Identify any changes to the individual's needs, if applicable; and
  • If applicable, FMS option.

Refer to Appendix X: Quarterly Due Dates Chart

The CMA must provide a copy of the IPP Quarterly/90-Day Service Review to the individual/LAR, DSA, and FMSA (if applicable) within 5 business days of the review date.

Standard III.10. Medicaid Eligibility

The CMA must verify the individual's Medicaid eligibility monthly.

Direct Service Agency (DSA) - Most Common Citations
Please see DSA Workbook for reference information.

Standard II.2. Staff Qualifications/Training

Habilitation staff must receive orientation before the first date of service delivery.

Standard II.4. Staff Qualifications/Training

Required staff must complete CPR certification which includes an in-person evaluation by a qualified instructor of the provider and maintain the required certification for the entire monitoring period.

Standard VI.2. Renewal

At the renewal SPT did the DSA explain orally and in writing to the individual and LAR or person actively involved with the individual:

  • rights and responsibilities including complaint procedures;
  • how to report an allegation of abuse, neglect, or exploitation; and
  • how to make a complaint.
IPP Service Summaries Section 3350

IPP Service Summaries required for the following:

  • auditory enhancement training
  • behavioral support
  • dietary services (nutritional services)
  • habilitation training
  • occupational therapy
  • physical therapy
  • prevocational services
  • specialized therapies
  • speech therapy
  • supported employment services

Copies of the completed IPP Service Summaries must be provided to the CMA within five business days of completing the IPP Service Summary.

The DSA quarterly review/90-Day Service Summary must include the following elements:

  • current observable/measurable goals and objectives;
  • frequency and duration of sessions attended;
  • rationale for missed sessions;
  • progress or lack of progress;
  • actions taken, as applicable (e.g., in-servicing, counseling, etc.); and
  • revisions of goals and objectives, as applicable

Refer to Appendix X: Quarterly Due Dates Chart

Transfers
  • Copies of the identified records must be delivered to the receiving DSA within five calendar days of notification by the case manager of the individual's decision to transfer to a different DSA.
  • The transferring DSA is required to maintain documentation of the specific records that were delivered to the receiving DSA, as well as the date of the delivery.
New CLASS Program Monitoring Tool was implemented on November 2014

Tools can be found online.

Contacts
Contacts Contract Enrollment and Administration
Name Phone Number/Email Address
Paul Straka, Manager (512) 438-3460
Nicole Simpson, Lead Contract Specialist (512) 438-3618
Fax Number (512) 438-5528
Email communityservicescontracts@dads.state.tx.us
Unit Voicemail Box (512) 438-3550
Contract Management and Monitoring
Name Phone Number
Sarah Schmidt, Manager (512) 438-5370
Letitia Parson, Program Consultant (512) 438-4607
Tinia Collins, Program Consultant (512) 438-2232
Desiree Martinez, Program Consultant (512) 438-2544
LaShunta Pringle-Osborne, Program Consultant (512) 438-4300
Fax Number (512) 438-3639 *New Number*

Community First Choice Update

CFC Amendments to Chapter 45
  • Expected to become effective March 20, 2016.
  • Watch for alert on DADS website
  • Allows DSAs and CMAs to be monitored for delivery of CFC services.
Chapter 45: Key Changes

Significant changes include:

  • provides a description of CFC services;
  • adds requirement for transportation plan;
  • adds eligibility requirements for the waiver;
  • requires monthly face-to-face or telephone contact by case manager;

Significant changes include:

  • adds respite service provider qualifications; and
  • adds person centered training requirement.
Chapter 45: Changes at Adoption

In response to comments or for clarification, DADS made these additional changes:

  • removed ERS licensure requirement;
  • clarified definition of health-related task; and
  • clarified an individual receiving Support Family services is not eligible for CFC.

CLASS Rules Revisions Effective November 15, 2015

Rules Effective November 2015
  • Rules revisions to CLASS rules in Title 40 of the Texas Administrative Code Chapter 45 were adopted effective November 15, 2015.
  • Primary revisions were to rules specific to the CLASS Interest List
  • Revisions to §45.103, Definitions
    • Defined habilitation plan as being developed by SPT
    • Defined IPC as being based on person-centered planning
    • Defined military member & military family member
    • Defined nursing facility
  • Revisions to §45.103, Definitions
    • Defined Person-Centered Planning to clarify the individual will lead discussion of goals & outcomes.
    • HCBS rules effective March 2014 require use when developing a service plan for an individual in waiver program.
    • Texas will develop more information in future.
  • Specifies financial eligibility criteria for CLASS program.
  • Specifies mutually exclusive services for waiver individuals.
  • Created new §45.202, CLASS Interest List and repealed previous version.

CLASS Waiver Renewal Update

Centers for Medicare and Medicaid Services (CMS) approved renewal of CLASS waiver application on February 2, 2016 with an effective date of September 1, 2014.

Contracting for Community Living Assistance and Support Services (CLASS)

CLASS Contracting Requirements

Applicants who wish to contract for the CLASS program must reference 40 Texas Administrative Code (TAC) §49.205 (a) (1) (2), which state the following:

To be a contractor, an applicant must have a license, certification, accreditation, or other document as follows:

CLASS-SFS requires a permit to operate a child-placing agency issued by DFPS in accordance with Chapter 745; or

a HCSSA license issued by DADS in accordance with Chapter 97 with: the licensed home health services (LHHS) category; or the licensed and certified home health services (L&CHHS) category;

CLASS-DSA requires a HCSSA license issued by DADS in accordance with 40 TAC Chapter 97 with: the LHHS category; or the L&CHHS category;

CLASS Accepting New Providers

Current Community Living Assistance and Support Services (CLASS) providers may apply to become a CLASS provider in one of these service areas (also called catchment areas):

  • Abilene
  • Eagle Pass/Uvalde
  • El Paso
  • Lufkin
  • Midland/Odessa
  • Waco/Temple
  • Wichita Falls

A list of the counties in each catchment area can be found on the HHS website under the instructions of the Form 3691, Service Area Designation.

Here is some important information to know when applying for a CLASS contract.

When applying for a CLASS contract, please note the following:

  • An entity may apply for either a CLASS/Case Management Agency (CMA) contract or a CLASS/Direct Services Agency (DSA) contract, but not both, in any particular catchment area.
  • CLASS/CMA contracts do not require the entity to have a license.
  • CLASS/DSA providers must have a current Home and Community Support Service Agency (HCSSA) license with at least the Licensed Home Health Services (LHHS) category of service on the license to be eligible to provide direct services in the CLASS program.

A CLASS provider must have a business location in the catchment area for which they wish to provide services. In order to provide direct services in a specific catchment area, a CLASS/DSA provider must have a licensed office location in that catchment area.

A CLASS provider must be able and willing to provide the entire array of services to the CLASS individuals they're serving.

For Questions about Contracting for CLASS

Send an email to: communityservicescontracts@dads.state.tx.us

Contact our Unit Support at 512-438-2080 and ask to speak with a contract specialist.

Wrap Up

Next CLASS Stakeholder webinar — May 2016

Next Webinar Announcement to go out by GovDelivery

Please keep up-to-date with DADS email alerts to learn when the next recorded webinar is posted to the CLASS webpage.

Your feedback will assist DADS in refining this communication format to suit the needs of CLASS providers and other interested parties. If you have comments regarding this webinar, please send them to the CLASS mailbox at class@dads.state.tx.us

Thank you for joining us!