Texas – Home and Community-based Services (HCS) 0110 R07.04

Waiver Title

Home and Community-based Services (HCS) 0110 R07.04

Description of Emergency

COVID-19 pandemic. This amendment will apply waiver-wide for each waiver included in this Appendix, to all individuals impacted by the virus or the response to the virus (e.g. closure of day programs, etc.). HHSC requests approval to implement the following flexibilities up through the end of the disaster

period. Based on the evolving situation, HHSC continues to determine the most appropriate

timeframe for each waiver or modification, which is not to exceed the disaster period.

The COVID-19 pandemic has imposed challenges for providers statewide requiring HCS waiver

participants residing in group homes to receive in-home Day habilitation services in order to

comply with state and local public health and social distancing guidelines. The current facility

day habilitation rates do not support the staffing ratios required to provide in-home day

habilitation services in a group home setting. The change in this Appendix K is additive to the Appendix K submission approved on 06/08/2020.

Waiver Description

HCBS Program (0110.R07.00): Provides day habilitation, respite, supported employment, adaptive aids, audiology, occupational therapy, physical therapy, prescribed drugs, speech and language pathology, financial management services, support consultation, behavioral support, cognitive rehabilitation therapy, dental treatment, dietary services, employment assistance, minor home modifications, nursing, residential assistance (host home/companion care, supervised living, residential support services), social work, supported home living, transition assistance services for individuals with ID/DD ages 0 – no max age

Start Date

4/1/2020

End Date

1/26/2021

Description of Transition Plan

All activities will take place in response to the impact of COVID-19 as efficiently and effectively as possible based upon the complexity of the change.

Area(s) Affected

Area Affected

These actions will apply across the waiver to all individuals impacted by the COVID-19 virus or the response to the virus. Statewide.

Access and Eligibility

Increase Cost Limits

N/A

Modify Targeting Criteria

N/A

Services

Modify Scope or Coverage

N/A

Exceed Service Limitations

N/A

Add Services

N/A

Expand Settings

N/A

Provide Service Out of State

N/A

Allow Payment for Services by Families

N/A

Modify Provider Qualifications

Modification of Provider Qualifications

N/A

Modify Provider Types

N/A

Modify Licensure/Requirements for Waiver Settings

N/A

Modification LOC Eval and Re-Eval Processes

N/A

Increase Payment Rates

In response to COVID-19, HHSC is proposing a temporary add-on for Home and Communitybased Services (HCS) Supervised Living and Residential Support Services (SL/RSS) providers who are providing in-home day habilitation to individuals living in group homes. The add-on will be paid in addition to the current Day Habilitation rates. SL/RSS providers must maintain higher staffing ratios than day habilitation providers. As a result, HHSC calculated an add-on to compensate group home providers for providing in-home day habilitation services. The temporary add-on will increase day habilitation rates sufficient to maintain hourly direct care staff wages that have been affected by reduced client to staff ratios. HHSC is requesting an effective date of April 1, 2020 through the end of the federal emergency declaration. Service Current Rate COVID Add-on

Day Habilitation LON 1 $28.13 $9.46

Day Habilitation LON 5 $30.95 $10.60

Day Habilitation LON 8 $36.57 $12.44

Day Habilitation LON 6 $45.68 $14.53

Day Habilitation LON 9 $149.50 $18.99

Modifications of ISP

N/A

Modify Incident Reporting/Med Management Safeguards

N/A

Allow Payment for Services During Acute Care Hospital/Short Term Institutional Stay

N/A

Inclusion of Retainer Payments

N/A

Institute/Expand Opportunities for Self-Direction

N/A

Increase Factor C

N/A

Other Changes Necessary

N/A

Addendum

HCBS Regulations

Not comply with the HCBS settings requirement at 42 CFR 441.301(c)(4)(vi)(D) that individuals are able to have visitors of their choosing at any time, for settings added after March 17, 2014, to minimize the spread of infection during the COVID-19 pandemic.

Services

Add Electronic Method of Service Delivery

N/A

Add Home Delivered Meals

N/A

Add Medical Supplies, Equipment and Appliances

N/A

Add Assistive Technology

N/A

Conflict of Interest

Other Changes Necessary

N/A

Other Changes Necessary

N/A

Provider Qualifications

Allow Spouses and Parents of Minor Children to Provide Personal Care Servcies

N/A

Allow a Family Member to be Paid to Render Services to an Individual

N/A

Allow Other Practitioners in Lieu of Approved Providers Within the Waiver

N/A

Modify Service Providers for Home-Delivered Meals to Allow for Additional Providers, Including Non-Traditional Providers

N/A

Processes

Allow an Extension for Reassessments and Reevaluations for up to One Year Past the Due Date

N/A

Allow the Option to Conduct Evaluations, Assessments, and Person-Centered Service Planning Meetings Virtually/Remotely in lieu of Face-to-Face Meetings

N/A

Adjust Prior Approval/Authorization Elements Approved in Waiver

N/A

Adjust Assessment Requirements

N/A

Add an Electronic Method of Signing Off on Required Documents Duch As The Person-Centered Service Plan

N/A

Link To Application

N/A

Link to Approval Letter

N/A