Revision 22-2; Effective May 1, 2022
The following changes(s) were made:
Section | Title | Change |
---|---|---|
2000 | Service Coordination | Adds how to access the Texas Medicaid & Healthcare Partnership (TMHP) user guides. Throughout the section, deletes all references to specific CARE and replaces “CARE” with “HHSC data system,” Local Authority (LA)” with “Local Intellectual and Developmental Disability Authority (LIDDA),” “Department of Assistive and Rehabilitation Services (DARS)” with “Texas Workforce Commission (TWC),” “Consumer Rights and Services” with “IDD Ombudsman,” “Department of Aging and Disability (DADS)” with “Health and Human Services Commission (HHSC),” “Consumer Directed Services Agency (CDSA)” with “Financial Management Services Agency (FMSA),” and “Texas Youth Commission” with “Texas Juvenile Justice Department.” |
2120 | Person-Directed Plan Development | Deletes an external weblink and updates the name of the HCS Program Billing Requirements. Adds a link to Form 8665, Person-Directed Plan. |
2130 | Enrollment Activities | Makes minor wording changes. |
2151 | Individual Plan of Care Renewal | Deletes information about the 21-day notification and informing the individual/LAR about receiving attendant care. |
2152 | Individual Plan of Care Revision | Deletes the purpose information for documenting an Individual Plan of Care (IPC) revision in a contact note. |
2155 | Home and Community-based Services Program Suspension | Changes the section title and deletes “Previously Referred to as Temporary Discharge.” |
2156 | Termination of Home and Community-based Services | Changes the section title and deletes “Previously Referred to as Permanent Discharge.” |
2157 | Transfers | Deletes information about submitting a written request to transfer. |
2160 | Additional Service Coordinator Responsibilities | Deletes notice of the development of the “Rights of Individuals to be Protected and Promoted by the HCS Provider.” Specifies when the service coordinator (SC) should give a copy of the booklet, “Your Rights in a Home and Community-based Services (HCS) Program,” to an individual/legally authorized representative (LAR). Replaces the listed phone number with a weblink for listings of Early Childhood Intervention (ECI) programs by county. Adds how often the SC should determine if the guardianship for an individual is current. Adds that the SC must request the current letter of guardianship and keep a copy in the individual’s record and if the letter of guardianship is not current, to obtain signatures of both the individual and the person listed as guardian until appropriate steps can be taken to verify current guardianship. |
3000 | Enrollments | Adds how to access the TMHP user guides. Changes “Department of Aging and Disability Services (DADS)” to “Health and Human Services Commission (HHSC).” Deletes information about the CARE user guide and child care facility regulated by the Texas Department of Family and Protective Services. |
5000 | Level of Care and Level of Need | Deletes all references to specific CARE screens and CARE screen shots throughout the section. Adds information about accessing the TMHP user guides. Adds the descriptions of the Level of Care (LOC) and Level of Need (LON). Replaces “CARE” with “HHSC data system.” |
5100 | Intellectual Disability/Related Condition Assessment Process | Clarifies who must sign Form 8578, Intellectual Disability/Related Condition Assessment, and makes minor wording changes. Adds reports will also be noted in the form history in the HHSC data system. Moves information about the review of the ID/RC. Adds a program provider may request an increase in LON for an individual for medical and/or behavioral reasons. This is one level higher than the LON assessed by the ICAP tool. |
5200 | Service Coordinator Review of Intellectual Disability/Related Condition | Makes minor wording changes. Deletes the description of the LOC and LON, and information about the review of the ID/RC (now in Section 5100). Deletes individual profiles information and adds links to LON resources. |
6000 | Individual Plan of Care | Adds how to access the TMHP user guides. Throughout the section, deletes references to specific CARE screens and CARE screenshots and changes. Changes “Department of Aging and Disability Services (DADS)” to “Health and Human Services Commission (HHSC),” “CARE” to “HHSC data system,” ”Local Authority (LA)” to “Local Intellectual and Developmental Disability Authority (LIDDA),” “provider” to “program provider,” and “Program Enrollment (PE)” to “Utilization Review (UR)” |
6100 | Overview of the IPC | Adds Form 3608, Individual Plan of Care (IPC) – HCS/CFC, and replaces “changed” with “transfers.” Deletes the links to “HCS and MRA User Guides” and “during the IPC meeting.” |
6120 | IPC Begin, End and Effective Dates | Adds “the next day after the previous IPC ends.” |
6130 | IPC Meeting | Adds “that does not require a change to the PDP.” |
6140 | IPC Types | Makes a minor wording change. |
6150 | Consumer Directed Services (CDS) and IPCs | Replaces SC with service coordinator (SC), replaces “those” with “Adds program.” Modifies employer with “CDS” and deletes “(i.e., individual or LAR).” Makes minor wording changes. |
6160 | Health and Human Services Commission (HHSC) Role | Changes the section title. Adds that HHSC may review any type of IPC at any time to determine if the appropriate type and amount of services are being requested and utilized. HHSC may take action on an IPC, reducing or denying services or amounts of services if there is not documentation to support the need for the requested services. |
6210 | Initial (Enrollment) IPC Overview | Replaces “LA service coordinator” with “LIDDA representative.” |
6220 | LIDDA and Service Coordinator Responsibilities for Initial IPC | Changes the section title. |
6221 | IPC Meeting to Develop Initial IPC | Removes link to Acronyms. |
6223 | Units of Service | Changes the typical number of days of day habilitation attendance from “250” to “260” and changes “therapy” to “professional therapies.” Adds that a revision of IPC can be completed after an assessment is completed. Adds nursing, professional therapies and dental services are limited in availability for individuals enrolling who are 20 years and younger because they must be accessed through State Plan Services. Deletes information about additional planning to determine number of service hours. |
6224 | Non-HCS Services | Removes link to Acronyms. |
6225 | Initial IPC Signatures and Signature Dates | Removes link to Acronyms. |
6226 | Transmission of Initial IPC | Makes minor wording changes. |
6230 | Provider Responsibilities for Initial IPC | Makes minor wording changes. |
6310 | Renewal IPC Overview | Deletes Texas Administrative Code (TAC) reference and makes minor wording changes. |
6320 | Program Provider Responsibilities for Renewal IPC | Changes the section title. |
6321 | IPC Meeting to Develop Renewal IPC | Makes a minor wording change. |
6323 | Units of Service | Changes the typical number of days of day habilitation attendance from “250” to “260” and changes “health care professional” to “licensed professional.” Adds nursing, professional therapies and dental services are limited in availability for individuals enrolling who are 20 years and younger because they must be accessed through State Plan Services. Deletes information about additional planning to determine number of service hours. |
6324 | Renewal IPC Signatures and Signature Dates | Makes minor wording changes and adds “Then the hardcopy form is submitted to the SC for review.” |
6325 | Transmission of Renewal IPC | Adds ‘Once the required signatures have been obtained’ and makes minor wording changes. |
6330 | Service Coordinator Responsibilities for Renewal IPC | Deletes weblink and “in accordance with Section 2151, Individual Plan of Care Renewal.” Emphasizes the importance of the SC completing the Person-Directed Plan (PDP) in a timely manner and makes minor wording changes. |
6410 | IPC Revision Overview | Adds “requested units of services for an added service should be prorated as need based on the time remaining in the IPC year” and makes minor wording changes. |
6411 | Provider Responsibilities for IPC Revision | Deletes a weblink and makes minor wording changes. |
6412 | Service Coordinator Responsibilities for IPC Revision | Clarifies that when a program provider becomes aware of a need to revise an individual's IPC, the program provider submits a revised IPC to the SC that does not require a change to the PDP. |
6421 | Provider Responsibilities for IPC Revision That Reflects a PDP Change | Deletes information about IPC revision in response to emergency provision of services. |
6421.2 | Signatures and Signature Dates for IPC Revision That Reflects a PDP Change | Removes link to Acronyms. |
6421.3 | Transmission of IPC Revision That Reflects a PDP Change | Makes minor wording changes. |
6422 | Service Coordinator Responsibilities for IPC Revision that Reflects a PDP Change | Makes minor wording change and removes a weblink. |
6430 | Revision to Increase/Decrease an Existing HCS Service | Deletes information about nursing service component and “in accordance with Section 6600, Service Coordinator Review Process.” Adds a link to Form 3608 and makes minor wording changes. |
6431 | Provider Responsibilities for IPC Revision to Increase/Decrease an Existing HCS Service | Deletes “If the IPC revision increases or decreases an existing HCS service and is supported by a current outcome in the PDP, an IPC meeting is not necessary.” Adds “if an IPC meeting is not held” and makes minor wording changes. |
6431.1 | IPC Effective Date for IPC Revision that Does Not Require an IPC Meeting | Changes the section title and adds link to Form 3608. |
6431.2 | Signatures and Signature Dates for IPC Revision that Do Not Require an IPC Meeting | Changes the section title and makes a minor wording change. |
6431.3 | Transmission of IPC Revision that Does Not Require an IPC Meeting | Changes the section title and clarifies that the program provider may enter the revised IPC in the HHSC data system after the individual’s or LAR’s signature is obtained on the revised IPC. |
6431.4 | Activity Following Transmission of IPC Revision that Does Not Require an IPC Meeting | Changes the section title and makes a minor wording change. |
6432 | Service Coordinator Responsibilities for IPC Revision that Do Not Require an IPC Meeting | Changes the section title and adds link to Form 3608. |
6432.1 | Service Coordinator Response Section of Form 3608 | Changes the section title and adds a link to Form 3608. |
6432.2 | If Service Coordinator Agrees the IPC Revision Does Not Require an IPC Meeting | Changes the section title. |
6432.3 | If Service Coordinator Has Concerns with the IPC Revision | Changes the section title and adds “If the SC and the program provider cannot come to agreement about the amount of the services or supports being requested, the SC completes Form 8579, Notification of Service Coordinator (SC) Disagreement, and submits it to HHSC UR.” |
6441.3 | Transmission of IPC Revision to Add/Change a Requisition Fee Only | Makes minor wording changes. |
6510 | Transfer IPC Overview | Makes minor wording changes. |
6520 | LIDDA and Service Coordinator Responsibilities for Transfer IPC | Changes the section title. |
6523 | Transfer IPC Signatures and Signature Dates | Removes link to Acronyms. |
6524 | Transmission of Transfer IPC | Adds “If two LIDDAs are assisting with a transfer IPC, the transferring LIDDA sends the IPC to the receiving LIDDA for data entry” and to refer to Section 8000, Transfers and Local Authority Reassignments for additional information on the transfer process. |
6525 | Emergency Transfer | Makes a wording changes. |
6531 | Transferring Provider | Makes minor wording changes. |
6610 | Service Coordinator Review Process Overview | Makes minor wording changes. |
6611 | Reasons the IPC is Returned to the Provider | Makes minor wording changes. |
6612 | Service Coordinator’s Agreement/Disagreement with IPC | Makes minor wording changes. |
6621 | If the IPC is Returned to Provider | Makes minor wording changes. |
6622 | Service Coordinator's Agreement/Disagreement with IPC | Changes “attest” to “agree” and makes minor wording changes. |
6622.1 | Agreement with IPC | Clarifies that the SC must agree with the IPC in the HHSC data system to move it forward for review. |
6622.2 | Disagreement with IPC | Makes minor wording changes. |
6623 | If Service Coordinator CARE Screens for Service Coordinator Review | Deletes section. |
6623.1 | CARE Screen L83 | Deletes section. |
6623.2 | CARE Screen L31 | Deletes section. |
6630 | Provider Responsibilities | Makes a minor wording change. |
6631 | Service Coordinator Returns IPC in the HHSC Data System | Changes the section title and deletes information about CARE screen. |
6632 | Activity to Address a Returned IPC | Makes minor wording changes. |
6633 | Error Correction | Deletes section. |
6634 | Delete and Re-enter IPC | Deletes section. |
6635 | CARE Screen Examples | Deletes section. |
8000 | Transfers and Local Intellectual and Developmental Disability Authority (LIDDA) Reassignments | Changes the section title. |
8100 | Overview | Deletes obsolete TAC information. |
8210 | Transfers Must be Planned | Modifies several sentences for clarity. Adds a transfer effective date must be agreed to by all parties involved in the transfer. |
8220 | No Prior SC Notification | Modifies several sentences for clarity. |
8230 | Emergency Transfer | Adds TAC definitions of “emergency” and “emergency situation.” Modifies several sentences for clarity. Clarifies in an emergency, the receiving provider notifies the SC if they are unaware of the emergency situation. Clarifies that the SC submits supporting documentation to HHSC. Deletes “contract.” |
8231 | Data Entry of Emergency Transfer in the HHSC Data System | Changes the section title and removes information about entry of non-emergency transfer. |
8310 | Simultaneous Transfer of Program Provider and FMSA | Changes the section title and makes minor wording changes. |
8330 | Reserved for Future Use | Deletes section formerly “Data Entry in the HHSC Data System.” |
8340 | Verification of Guardianship | Deletes references to CARE screens. Makes minor wording changes. |
8360 | Contacting HHSC | Changes the section title and makes minor wording changes. |
8400 | Program Provider Transfer Involving One Local Intellectual and Developmental Disability Authority (LIDDA) | Changes the section title. |
8430 | Ensuring Agreement on Transfer Effective Date | Makes a minor word change. |
8450 | Developing the Transfer IPC | Replaces “Section I” with “Column 3.” |
8460 | Sharing Documents | Makes a minor wording change. |
8470 | Completing Data Entry in the HHSC Data System and Submitting Documents to HHSC | Changes the section title and “group home” to “three-person or four-person residence.” Corrects forms should be submitted through the IDD Operations Portal and the receiving program provider should contact HHSC Program Eligibility and Support (PES) for assistance if they don’t have access to the HHSC data system. Adds to use the existing local case number if the individual already has one with the program provider's component code. |
8500 | Program Provider Transfer Involving Two Local Intellectual and Developmental Disability Authorities (LIDDAs) | Changes the section title. |
8510 | Confirming the Desire to Transfer | Deletes transferring SC contacting HHSC PES for SC information. Adds the transferring SC submits an Individual Movement (IMT) form/LA reassignment form in the HHSC data system and the receiving LIDDA must acknowledge the IMT/LA reassignment form in the HHSC data system. |
8520 | Selecting a Receiving Program Provider | Makes a minor wording change. |
8530 | Ensuring Agreement on Transfer Effective Date | Makes a minor wording change. |
8540 | Completing Form 3617 | Makes a minor wording change. |
8550 | Developing the Transfer IPC | Makes a minor wording change. |
8560 | Sharing Documents | Adds that the transferring SC must submit current copies of documents to the receiving SC before the submission of the IMT form in the HHSC data system. |
8570 | Completing Data Entry in the HHSC Data System and Faxing Documents to HHSC | Changes that the receiving LIDDA/SC, not transferring LIDDA/SC, submits the transfer documents to HHSC PES and contacts HHSC PES for assistance if the receiving program provider does not have access to the HHSC data system. |
8600 | FMSA Transfer and Changing Service Delivery Option | Changes the section title. |
8610 | Confirming the Desire to Transfer or Change Service Delivery Option | Makes minor wording changes. |
8620 | Selecting a Receiving FMSA or Receiving Program Provider | Changes the section title. |
8630 | Ensuring Agreement on Transfer Effective Date | Makes minor wording changes. |
8640 | Completing Form 3617 | Makes minor wording changes. |
8650 | Developing the Transfer IPC | Makes minor wording changes and replaces “Section I and Section III” with “Column 3.” |
8660 | Completing Data Entry in the HHSC Data System and Submitting Documents to HHSC | Changes the section title and changes “fax” to “submit.” Deletes information about sending documents to assigned HHSC staff. Adds to use the existing local case number if the individual already has one with the program provider's component code. |
8700 | Notification by HHSC Program Eligibility and Support (PES) | Deletes information about transfer authorization letters. |
8800 | Local Intellectual and Developmental Disability Authority (LIDDA) Reassignment | Changes the section title. Adds the transferring LIDDA submits an Individual Movement (IMT) form/LA reassignment form in the HHSC data system for a reassignment, and the receiving LIDDA acknowledges the IMT/LA reassignment in the HHSC data system. Deletes references to CARE user guide and updates the email and phone number for HHSC PES. |
9000 | Suspensions | Deletes all references to specific CARE screens. Adds information about accessing TMHP user guides. Throughout the section, changes “Department of Aging and Disability Services (DADS)” to “Health and Human Services Commission (HHSC),” “Intellectual and Developmental Disability (IDD) Waivers Program Enrollment/Utilization Review (PE/UR)” to “Program Eligibility and Support (PES).” |
9100 | Reasons for Suspension of Waiver Program Services | Deletes the listed reasons for suspension. Adds Home and Community-based Services (HCS)/Texas Home Living (TxHmL) services must be suspended when an individual is temporarily admitted to these settings: hospital; ICF/IID; nursing facility; ALF; residential child care facility licensed by HHSC unless it is an agency foster home; inpatient chemical dependency treatment facility; mental health facility; residential facility operated by the Texas Workforce Commission; or a residential facility operated by the Texas Juvenile Justice Department, a jail or a prison. |
9200 | Program Provider Responsibilities | Replaces “temporary discharge” with “suspension” and deletes information about suspension due to loss of financial eligibility and informing the SC that an individual can resume participation in the waiver program. |
9300 | HHSC Activities | Changes the section title, makes minor wording changes and deletes information about secure email communication. |
9400 | Service Coordinator Responsibilities | Deletes information about suspension due to loss of financial eligibility and discussing if the individual should be terminated. Specifies that a request to continue the suspension is submitted to HHSC if continuation of the suspension is recommended beyond 270 days. |
9410 | Request to Continue Suspension of Waiver Program Services | Makes minor wording changes and deletes links to handbooks and CARE user guides. |
10000 | Terminations | Adds information on how to access TMHP user guides. Throughout the section, replaces “CARE” with “HHSC data system,” Local Authority (LA)” with “Local Intellectual and Developmental Disability Authority (LIDDA),” “Consumer Directed Services Agency (CDSA)” with “Financial Management Services Agency (FMSA),” “Department of Aging and Disability Program Enrollment (DADS PE)” with “Health and Human Services Commission Program Eligibility and Support (HHSC PES).” |
10100 | Process for Requesting Termination of Waiver Services – Texas Home Living and Home and Community-based Services | Adds HHSC prefers to receive required documentation for the termination of waiver program services through the IDD Operations Portal. Updates HHSC PES general email box address. Deletes all links and references to the CARE user guides. |
11100 | Financial Eligibility Guidelines for Texas Home Living and Home and Community-based Services | Replaces “Texas Department of Aging and Disability Services (DADS)” with “Health and Human Services Commission (HHSC).” |
12000 | Permanency Planning | Adds information about accessing the TMHP user guides. |
12100 | Resources | Replaces “Local Authority (LA)” with “Local Intellectual and Developmental Disability Authority (LIDDA).” Updates link to Permanency Planning forms and tools. Deletes CARE user guide information. |
13000 | Consumer Directed Services | Replaces “Consumer Directed Services Agency (CDSA)” with “Financial Management Services Agency (FMSA),” “provider managed option” to “agency option,” “CARE” with “HHSC data system,” and “Department of Aging and Disability Services (DADS)” to “Health and Human Services Commission (HHSC)” throughout the section. |
13110 | Home and Community-based Services Available Through the Consumer Directed Services Option | Changes “foster/companion care” to “host home/companion care” and “self-direction” to “CDS option.” Updates the list of HCS services available through the CDS option. |
13120 | Informing the Individual/LAR of the Consumer Directed Services (CDS) Option | Deletes “the self-assessment may not be used to determine that an individual/LAR cannot use the CDS option” and “probably.” Deletes information about conducting orientation in the individual’s home prior to service initiation and clarifies that FMSA conducts majority of its business electronically. |
13130 | Service Planning | Deletes “SHL or Respite.” |
13140 | Enrolling the Individual in the Consumer Directed Services Option | Makes minor wording changes. |
13160 | Monitoring Consumer Directed Services | Adds “This includes terminating the CDS option, if using CDS puts the individual’s health and safety at risk.” Updates the link to the IDD ombudsman webpage. |
13200 | Consumer Directed Services Resources | Makes a minor wording change. |
15000 | Review of Authority | Replaces “Local Authority (LA)” with “Local Intellectual and Developmental Disability Authority (LIDDA)” and “CARE” with “HHSC data system” throughout the section. |
15100 | Quality Oversight of Home and Community-based Services Program Local Intellectual and Developmental Disability Authority Responsibilities | Changes the section title and deletes “on-site” and information about random selection of HCS sample of participants. Removes a broken link to the LIDDA Performance Contract. Clarifies only new SCs assigned to the sample participants are reviewed. Replaces “documentation checklist” with “electronic tool” and “Report of Findings” with “HCS Authority Review Report of Findings.” Deletes “cited finding may be determined to be corrected on site.” Clarifies the corrective action plan (CAP) is due within 30 days after receipt of the HCS Authority Review Report of Findings. |