CLASS Quarterly WebinarMay 22, 2018

CLASS Webinar Agenda

• Employment First Training Across the State

• CLASS Policy Updates

• Abuse, Neglect, and Exploitation Training

• IPC/LOC Tracking Systems

• Coordination of Care Form

• Verification of Freedom of Choice

• CLASS Computer-Based Training

• Frequent Contract Monitoring Citations

• CLASS Catchment Areas Providers

• Respond to Webinar Questions

Employment First!

IT’S ABOUT WORK!

Nehtra Davis, M.Ed., SMQT, CI

Program Specialist, HHSC

Topics for Today

• Employment First Training Across the State

• Employment Resources

• Provider Training

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Employment First!It Works!

• HHSC will be providing a free one-day training on:

• Texas Employment First Policy

• Employment Services in Medicaid waivers, including billable services and billing information

• How Medicaid waiver employment services and Texas Workforce Solutions-Vocational Rehabilitation Services works

• Overview of Social Security Administration disability benefits

• HCBS settings rule changes

• HHS Employment Recruitment Coordinator Project and Employment Initiatives

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Who should attend:

• The training again is free and open to:

• Providers, LIDDAs, professional and direct care staff.

• Individuals we serve, their families and guardians are welcome to attend as well.

• Anyone who wants a better understanding of how Employment Services work is welcome to attend.

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Location of Employment First Training

• The trainings will be held Statewide

• Locations will be posted on the HHS Employment First webpage

• Registration links for the various locations near you will be available as well on the Employment First webpage

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Dates and times:

• Trainings are scheduled to start in July and run through October and possibly through November.

• The time of the one day trainings in the various locations throughout the state will be from 9 a.m. to 4 p.m.

• More information on exact dates and locations will be provided once the official roll-out of the Employment First Training begins.

• Please keep an eye out for those notifications on the HHS webpage and other HHS communications.

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Trainers

• All trainers are Subject Matter Utilization Resource Facilitators (SMURFS)

• One of the trainers is a part time staff at Texas Workforce Commission (TWC) and HHSC

• All of the trainers are familiar with the Employment First Initiatives across the state

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Resources

• Employment Services Web-based Training:

https://hhs.texas.gov/doing-business-hhs/training/training-initiatives

• HHSC Guide to Employment for People with Disabilities:

https://hhs.texas.gov/services/disability/employment/employment-first/employment-guide-people-disabilities

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Resources (cont.)

• Employment First:

https://hhs.texas.gov/services/disability/employment/employment-first

• Texas Transition and Employment Guide

http://www.transitionintexas.org/cms/lib/TX01001018/Centricity/Domain/3/Texas%20Transition%20and%20Employment%20Guide%202014.pdf

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Resources (cont.)

• Working and Benefits

www.ssa.gov/ssi/text-work-ussi.htm

• TWS-VRS

http://www.twc.state.tx.us/programs/vocational-rehabilitation-program-overview

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Provider Training

• University of North Texas’ Workplace Inclusion and Sustainable Employment http://wise.unt.edu/crptrainingoffers online courses:

• Job Coach / Job Skills Trainer (15 hours)

• Job Placement Specialist (20 hours)

• Supported Employment Specialist (30 hours)

• Supported Employment: Discovering Untapped Talent http://wise.unt.edu/node/394 (40 hours)

• Training Resource Network (https://trn-store.com/) offers a variety of online training courses.

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Provider Training (cont.)

• U.S. Department of Labor, Office of Disability Employment Policy http://www.dol.gov/odep/topics/youth/softskills/

• Virginia Commonwealth University Rehabilitation Research and Training Center http://www.worksupport.com/

• College of Employment Services http://directcourseonline.com/employmentservices/

• DADS Guide to Employment for People With Disabilities

https://hhs.texas.gov/services/disability/employment/employment-first/employment-guide-people-disabilities

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Contact Information

Nehtra Davis, Program Specialist

Texas Health and Human Services Commission

Medical and Social Services Division

IDD and Behavioral Health Services/Special Projects Unit

Nehtra.davis2@hhsc.state.tx.us

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Thank you

CLASS Policy Updates

May 22, 2018

CMS Requirements

CMS issued guidance in 2014 and we must be in full compliance for the waiver renewal which must be submitted and approved by 9/1/19.

• 2014 CMS Guidance can be found here:

https://www.medicaid.gov/medicaid-chip-program-information/by-topics/waivers/downloads/3-cmcs-quality-memo-narrative.pdf

• Waiver Technical Guidance can be found here:

https://www.medicaid.gov/medicaid-chip-program-information/by-topics/waivers/downloads/technical-guidance.pdf

Critical Incident Tracking

Beginning September 1,2018 CLASS and DBMD providers are required to submit critical incident reports to HHSC by the last calendar day of the month following the incident.

• The categories for critical incidents are as follows:

• Elopement/Missing Individual

• Choking

• Emergency Room visit due to Illness or Injury

• Medication Error

• Theft or Property Damage under $25

85th Texas Legislature, Senate Bill 2027, An Act

Critical Incident Tracking

• The categories for critical incidents are as follows (cont.):

• Emergency Situations

• Criminal Conduct

• Physical Altercation

• Authorized Restraint (DBMD only)

• Death (CLASS only)

• Other incidents or events that involve harm or risk of harm to an individual

85th Texas Legislature, Senate Bill 2027, An Act

Critical Incident Tracking

• To avoid duplication Home and Community Support

Services Agencies (HCSSA) will continue to submit

abuse, neglect and exploitation using form 3613.

https://hhs.texas.gov/laws-regulations/forms/3000-

3999/form-3613-provider-investigation-report-fax-

cover-sheet-home-health-hospice-personal-assistance

CLASS/DBMD Notification of Critical Incidents Form

• Form is located at:

http://texashhs.force.com/NCIForm

• May report multiple incidents on one form

• May not report for multiple individuals on one form

• Timelines:

• Must report a critical incident to HHSC by the last calendar day of the following month.

• Must report to the CMA or DSA within 5 days of reporting to HHSC

**based on date of awareness

Critical Incident Form

85th Texas Legislature, Senate Bill 2027, An Act

DRAFT

Critical Incident Form

DRAFT

Critical Incident Form

DRAFT

Critical Incident Form

DRAFT

Abuse, Neglect, and Exploitation Training

New ANE Training Requirements

• Acts that constitute ANE

• Signs and symptoms of ANE

• Methods to prevent ANE

See TAC 45.704 and 45.804 in the proposed rules

ANE Competency Exam

• To demonstrate knowledge of the topics on the previous slide staff must pass the ANE Competency Exam with an 80% or higher.

• HHSC is developing a computer based training and exam that will meet all the training requirements as well as administering the test.

Timelines

• New staff must meet the new training requirements as of the effective date in the new rules (anticipated 9/1/18)

• Current staff that receive annual ANE training prior to the effective date in the rules (anticipated 9/1/18) will have until their next annual training due date to come into compliance.

Additional Changes

IPC/LOC Tracking Systems

• DSAs must have tracking systems in place to notify

staff to ensure timely submission of the Level of

Care (ID/RC) documents as well as policies and

procedures for the use of these tracking systems.

• CMAs must have tracking systems in place to notify

staff to ensure timely submission of the Individual

Plan of Care (IPC) document as well as policies and

procedures for the use of these tracking systems.

Coordination of Care Form

COMING SOON-Providers must begin using the new CLASS/DBMD Coordination of Care form to document the SPT’s follow up to the 6515 CLASS/DBMD Nursing Assessment Addendum E.

Verification of Freedom of Choice

• SPTs occurring on (anticipated) September 1, 2018 or later must provide choice between institutional care and the community based waiver program at enrollment and annually thereafter.

• Form 8601 can be found at the following link:

https://hhs.texas.gov/laws-regulations/forms/8000-8999/form-8601-verification-freedom-choice

Thank you

CLASS Computer-Based Training

Computer-Based Training

This training is designed to provide CLASS services providers with information on developing and completing a successful service planning packet.

• Within this training you will find information regarding:

• Submission of enrollment, renewal and revised individual plan of care packets

• Specific information for completing IPC forms, transfers, Intellectual Disability/Related Condition Assessment forms and individual program plans

• The most common mistakes made with each of these packets

Computer-Based Training

• Access the training from the CLASS Website at

https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/community-living-assistance-support-services-class

• Training is divided into:

• CMA responsibilities

• DSA responsibilities.

Computer-BasedTraining Topics

• CLASS Submission Process

• Enrollment Packets (DSA and CMA Responsibilities)

• Renewal Packets (DSA and CMA Responsibilities)

• Revision Packets (DSA and CMA Responsibilities)

• Transfer Packets (DSA and CMA Responsibilities)

• Suspension Packets (CMA Responsibilities)

• Termination Packets (DSA and CMA Responsibilities)

Computer-BasedTraining Topics (cont.)

• CLASS/CFC - Individual Plan of Care Form

• Individual Program Plan (IPP) Form

• Intellectual Disability/Related Condition Assessment (ID/RC) Form

• TIPS/Frequently Asked Questions

• CLASS Contact Information

• Glossary

• Acronyms

• CLASS Resources

Computer-Based Training

• All forms DSA must complete and submit to HHS

for an approved level of care, including renewal.

• All forms DSA must complete and provide to CMA

required for an enrollment or a renewal IPC.

• All forms DSA must complete only if that service is

requested as part of an enrollment, a renewal, or

a revision.

• All forms CMA must submit for an enrollment,

renewal, or revision IPC.

Computer-Based Training

• Forms required for transferring DSAs or CMAs.

• Forms required for a change from agency directed services to consumer directed services.

• Actions CMA must take to insure a successful enrollment.

• Common errors on IPCs noted by UR staff.

• Common errors on ID/RC documents.

• Common errors on RCESI form.

• List of all ABL assessments for CLASS

Computer-Based Training

Helpful Tips Section

• CMA and DSA Timeline for Enrollments is included.

• Submission timelines for IPCs and ID/RCs.

• Quality assurance check suggestions

Frequently Asked Questions

• Service Limits

• Specialized Therapy Requisition Fees

• Third Party Resources

• Bids for Adaptive Aids and Minor Home Modifications

Thank you

Contract Administration & Provider Monitoring

Updates on Contract Compliance and

Frequent Citations

Contract Compliance

Points to Remember:

TAC §49.302:

(c)- ensure that an employee, subcontractor, or volunteer can effectively communicate with an individual/LAR concerning service planning and the provision of services, which may require the contractor to provide an interpreter for the individual

(d)- must not allow an individual to perform services under the contract or perform other work that benefits the contractor

(e)- comply with the terms of the contract, which requires compliance with federal and state laws, rules, and regulations, including TAC Chapter 49,

rules governing services provided under the contract,

and applicable reimbursement rules in TAC Chapter 355

Contract Compliance

Points to Remember:

TAC §49.302 (cont):

(g)(1)- subscribe to receive HHSC e-mail updates, using the link provided at the HHSC website

https://service.govdelivery.com/accounts/TXHHSC/subscriber/new

(h)- notify HHSC of a change of ownership or change in legal entity in accordance with § 49.210(a)(1)

(i)(1-2)- notify HHSC of a change to contract’s contact information (mailing, physical, e-mail address, phone, fax numbers, etc)

At least 30 days before the change

Within 3 days after the change if a natural disaster or unforeseen disaster prevents compliance with above

CLASS Contract Monitoring

• Frequent Citations- Case Management Agency

• Please see CLASS CMA Monitoring Workbook for reference information

https://hhs.texas.gov/Doing-Business-HHS/Provider-Portals/Resources/Contract-Fiscal-Compliance-Monitoring-Tools

Standard III.5 & 6: Renewal SPT

1.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.

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

3.Within 10 business days of HHSC notification of approval, the case manager must provide copies of the HHSC 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.

Standard III.5 & 6:Renewal SPT

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

Standard III.8:Revision SPT

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

2.Within five business days of HHSC transmission of the authorized IPC, the case manager must provide copies to the individual/LAR and any additional CLASS service providers (DSA, 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.

Refer to Appendix X: Quarterly Due Dates Chart

Standard III.9:IPP Service Reviews (cont.)

That includes the following documentation for all services on the IPC:

1.Documentation of progress or lack of progress toward goals/objectives as identified on the IPPs /IPC

2.Assess the individual’s satisfaction with the provision of CLASS program services

3.Identify any changes to the individual’s needs, if applicable

4.If applicable, FMS option

5.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.

Refer to Appendix X: Quarterly Due Dates Chart

Standard III.10:Medicaid Eligibility

1.The CMA must verify the individual’s Medicaid eligibility monthly.*

Please ensure documentation clearly indicates what date Medicaid Eligibility was verified within the month.

Standard IV.7:Billing

1.The CMA must complete Form 3625 supported by written documentation or case note.

2.Timekeeper must sign Form 3625.

CLASS Contract Monitoring

• Frequent Citations- Direct Service Agency

• Please see CLASS DSA Monitoring Workbook for reference information

https://hhs.texas.gov/Doing-Business-HHS/Provider-Portals/Resources/Contract-Fiscal-Compliance-Monitoring-Tools

Standard II.2 & 3:StaffQualifications/Training

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

2.All DSA staff must receive annual training every 12 months on A/N/E, Rights and Responsibilities, and review of the CLASS rules in TAC Chapter 45.

Standard VI.2:Renewal

1.Annually, the DSA must explain orally and in writing to the individual and LAR or person actively involved with the individual:

a.Rights and responsibilities including complaint procedures

b.How to report an allegation of abuse, neglect, or exploitation

c. How to make a complaint

IPP Services 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

Refer to Appendix X: Quarterly Due Dates Chart

IPP Services Summary (cont.)

• IPP Service Summaries are required for the following:

• Auditory Enhancement Training

• Behavioral Support

• Dietary Services

• Habilitation Training

• Occupational Therapy

• Physical Therapy

• Prevocational Services

• Specialized Therapies

• Speech Therapy

• Supported Employment Services

Refer to Appendix X: Quarterly Due Dates Chart

IPP Services Summary (cont.)

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

Refer to Appendix X: Quarterly Due Dates Chart

Standard IX:Transfers

1.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.

2.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.

Corrective Action Plan (CAP)

• A Corrective Action Plan (CAP) will be required for any compliance standard that falls below 90%.

• There is no HHSC form for a Corrective Action Plans (CAP).

• Each contract must decide what format works best for their business practices.

• CMAs and DSAs must continue to adhere to any CAP approved by HHSC .

Who to Contact?

• Contract Enrollment and Administration

• Fax Number (512) 438-5528

• Emailcommunityservicescontracts@dads.state.tx.us

• Unit Voicemail Box (512) 438-3550

Who to Contact?

• Contract Administration and Provider Monitoring

• Alicia Alaniz, Interim Manager (512) 438-3136

• Tinia Collins, Contract Specialist (512) 438-2232

• Angie Campos, Contract Specialist (512) 438-2544

• Vacant, Contract Specialist (512) 438-4300

• Vacant, Contract Specialist (512) 438-4784

• Fax Number (512) 438-3639

• Unit Email

CAPM_CLASS_DBMD_Monitoring@hhsc.state.tx.us

Thank you

Alicia Alaniz, Interim Manager IVContract Administration & Provider Monitoring (CAPM)

Medicaid and CHIP Services

Alicia.Alaniz@hhsc.state.tx.us | 512-438-3136

Contracting for Community Living Assistance and Support Services (CLASS)

Paul Straka, Contract Specialist IV

Contracted Community Services (CCS)

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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 states the following:

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

• CLASS/Support Family Services (SFS) requires a permit to operate a child-placing agency issued by the Department of Family and Protective Services (DFPS) in accordance with Chapter 745; or a Home and Community Support Services Agency (HCSSA) license issued by the Department of Aging and Disability Services (DADS) in accordance with Chapter 97 with:

• Licensed Home Health Services (LHHS) category; or

• Licensed and Certified Home Health Services (L&CHHS) category 68

CLASS Contracting Requirements (cont.)

• CLASS/Direct Services Agency (DSA) requires a HCSSA license issued by HHS in accordance with 40 TAC Chapter 97 with:

• LHHS category; or

• L&CHHS category

• CLASS/Case Management Agency (CMA) contracts do not require a license

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CLASS Contracting Requirements (cont.)

• An entity may apply for either a CLASS/CMA contract or a CLASS/DSA contract, but not both, in any particular catchment area.

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

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CLASS Contracting Requirements (cont.)

• A CLASS provider must have a business location in the catchment area (service 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.

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CLASS Contracting Requirements (cont.)

• If you already have an existing contract with Health and Human Services (i.e. DBMD contract), you can simply request to add a contract for CLASS.

• The request must be signed by an authorized representative for your agency.

• The request can be faxed to CCS at: (512) 438-5522.

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CLASS Contracting Information

More information about the CLASS program can be found at:

https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/community-living-assistance-support-services-class.

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CLASS Contracting Information (cont.)

More information on how to become a CLASS provider and the address for submitting an application can be found at:

https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/community-living-assistance-support-services-class/how-become-a-class-provider.

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CLASS Contracting Information (cont.)

The Form 5830, Application Packet Checklist, includes all required forms and documents.

• This form can be found at:

https://hhs.texas.gov/laws-regulations/forms/5000-5999/form-5830-application-packet-checklist-state-office-enrolled.

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Requesting Contract Changes

Providers must notify HHSC of changes affecting their contracts such as:

• An ownership update (or stock transfer) at least 60 days in advance of the date of the change

• A change in the name of the individual(s) authorized to negotiate contracts on behalf of the provider within 30 days of the date of the change.

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Requesting Contract Changes (cont.)

• A change in the provider’s telephone number, fax number, physical address, mailing address or email address within 30 days of the date of the change or within 3 days after the change if reason is due to natural or unforeseen disaster.

Note that all requests must come from an individual having signature authority.

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Requesting a Change of Ownership or Change of Legal Entity

• A change of legal entity will be processed when there’s a change in the EIN, which generally indicates a change in the legal entity responsible for the contract.

• A change of ownership will be processed when, as the result of a stock transfer, one or more persons who collectively had less than 5 percent ownership before the stock transfer will now have at least 50 percent ownership after the stock transfer.

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Requesting a Change of Ownership or Change of Legal Entity (cont.)

• Must provide HHSC with at least sixty (60) days advance notice prior to the anticipated effective date of the contract assignment.

• Please refer to 40 Texas Administrative Code (TAC) §49.210 to review the applicable rule.

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More CLASS Providers Needed

Past CLASS Provider Alerts have indicated the need for more CLASS providers in the following service areas (catchment areas):

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• Amarillo• Abilene• Eagle Pass-Uvalde• El Paso• Lubbock

• Lufkin• Midland/Odessa• Waco/Temple• Wichita Falls

More CLASS Providers Needed (cont.)

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

• This list can be found at:

https://hhs.texas.gov/sites/hhs/files//documents/laws-regulations/forms/3691/CountiesbyCatchmentArea.pdf

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Contact Information for CCS

Email: ContractedCommunityServices@dads.state.tx.us

Phone, Unit Voice Mail: (512) 438-3550

Fax: (512) 438-5522

Mail: Health and Human Services Commission

Contracted Community Services

Mail Code W-357

P.O. Box 149030

Austin, Texas 78714-9030

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Thank you

Thank You For Your Attention!

Questions?

classpolicy@hhsc.state.tx.us

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Wrap Up

• Next Webinar is scheduled for August 2018

• Announcement to go out by GovDelivery

• Please keep up-to-date with HHSC email alerts to learn when this webinar is posted to the CLASS webpage.

Wrap Up

• Your feedback will assist HHSC 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 classpolicy@hhsc.state.tx.us

Thank You For Joining Us!