The following state agency health care hearings have been scheduled between May 23 and June 12.
5/26/2015
Texas Health and Human Services Commission
May 26, 2015 – 09:00 AM
Brown-Heatly Building , Public Hearing Room , 4900 North Lamar Blvd., Austin
Medicaid Rules regarding Private Duty Nursing Services. Health and Human Services Commission (HHSC) will conduct a public hearing to receive comments on the proposed repeal of §§363.301, 363.303, 363.305, 363.307, 363.309, 363.311, 363.313, 363.315, and 363.317 and new §§363.301, 363.303, 363.305, 363.307, 363.309, 363.311, and 363.313 rules. The proposal was published in the May 1, 2015, issue of the Texas Register. See 40 TexReg 2347 (May 1, 2015). Written Comments. Written comments on the proposed amendments to the rule may be submitted to Brian Dees, Policy Advisor, Medicaid and Children's Health Insurance Program Division, HHSC, at 4900 N Lamar Blvd, Austin, Texas 78751; or by email to brian.dees@hhsc.state.tx.us within 30 days of publication of this proposal in the Texas Register.
Texas State Board of Pharmacy
May 26, 2015 – 09:00 AM
333 Guadalupe Street, Tower II, Room 400A, Austin
Agenda A. KA Consideration of Show Cause Order Pursuant to Section 568.0036 of the Texas Pharmacy Act of: Registration #218823 of Travis Ivy A.1 Executive Session Concerning Show Cause Order Pursuant to Section 568.0036 of the Texas Pharmacy Act of the above-listed registrant. Additional Information Contact: Ann Driscoll, 512/305-8048
Texas State Board of Pharmacy
May 26, 2015 – 09:30 AM
333 Guadalupe Street, Tower II, Room 400A, Austin
Agenda A. KA Consideration of Temporary Suspension with Notice of: Pharmacy License #27422 of Supreme Rx Pharmacy; Pharmacist License #19454 of Jesse Cornell Sanders II; and Pharmacist License #41192 of Ragan Yvette Webster A.1 Executive Session Concerning Temporary Suspension of the above-listed licensees. Additional Information Contact: Ann Driscoll, 512/305-8048
Texas Medical Board
May 26, 2015 – 12:00 PM
333 Guadalupe, Tower 3, Suite 780, Austin
Disciplinary Panel. Information has come to the attention of the board that needs 1. Call to order. 2. Roll call. 3. Consideration of the Application for Temporary Suspension With Notice pursuant to Texas Occupations Code, s164.059, of the license of Abdussamed Kose, M.D., License No. BP10048004. 4. Adjourn. Additional Information Contact: Laura Fleharty, 512/305-7174
Texas State Board of Pharmacy
May 26, 2015 – 01:00 PM
333 Guadalupe Street, Tower II, Room 400A, Austin
Agenda A. KA Consideration of Temporary Suspension or Restriction With Notice of: Pharmacy License #13332 of IVMedco Fort Worth A.1 Executive Session Concerning Temporary Suspension or Restriction of the above-listed licensee. Additional Information Contact: Ann Driscoll, 512/305-8048
5/29/2015
Texas Medical Board
May 29, 2015 – 09:00 AM
333 Guadalupe, Tower II, Suite 400A, Austin
Texas Physician Health Program. Agenda item numbers are assigned for ease of reference only and do not necessarily reflect the order of their consideration by the Board. Call to Order; Roll Call; Welcome Agenda Item 1 Discussion, recommendations, and possible action regarding March 27, 2015 Board meeting minutes. Agenda Item 2 Discussion, recommendations, and possible action regarding case advisory panels, case reviews, proposed agreement terminations and modifications. Agenda Item 3 Discussion, recommendations, and possible action regarding the scheduling and procedures of TXPHP Governing Board meetings. Agenda Item 4 Discussion, recommendations, and possible action regarding program operations. a) Status of program enrollment to date, tracking outcomes of past participants, and related information. b) Budget update c) Legal Update Agenda Item 5 Discussion, recommendations, and possible action regarding TXPHP Sunset Review, and TXPHP policies and procedures Agenda Item 6 Discussion, recommendations, and possible action regarding the TXPHP Advisory Committee process, activities, and membership. Agenda Item 7 Discussion, recommendations, and possible action regarding TXPHP guidelines for agreements with health and rehabilitation centers and sending out data questionnaires and making site visits. Agenda Item 8 Discussion, recommendations, and possible action regarding TXPHP outreach activities. Agenda Item 9 Discussion, recommendations, and possible action regarding upcoming Board meetings, member rotation, and possible agenda topics. Agenda Item 10 Open forum for public comments. Executive Session The Board may close the meeting to the public and continue in executive session for the following reasons: a. Private consultation and advice of legal counsel concerning pending or contemplated litigation, settlement offers, and/or legal matters subject to the attorney-client privilege under the authority of the Open Meetings Act Section 551.071, Government Code. b. Deliberations concerning the appointment, evaluation, reassignment, duties, discipline or dismissal of a public officer or employee under the authority of the Open Meetings Act Section 551.074, Government Code. While in executive session, the Board will not take any action, make any decision, or vote with regard to any matter that may be considered or discussed. A certified agenda of any executive session will be made. Additional Information Contact: 512/305-7051
Texas Health and Human Services Commission
May 29, 2015 – 10:00 AM
4900 N Lamar Blvd. (HHSC, Brown-Heatly Bldg., Room 4501), Austin
Advisory Committee on Qualifications for Health Care Translators and Interpreters 1. Call to order. 2. Approval of minutes from the March 27, 2015 meeting. (vote required) 3. Discussion on culturally effective health care training with HHSC Center for Elimination of Disproportionality and Disparities. 4. Discussion on disseminating information on the committee recommendations to the Executive Commissioner about qualifications for health care translators and interpreters, pursuant to Texas Government Code s531.706. 5. Public comment. 6. Discuss goals and work plan for committee. 7. Adjourn. Additional Information Contact: 512/438-2944
Texas Health and Human Services Commission
May 29, 2015 – 10:00 AM
4900 North Lamar Blvd. (HHSC, Brown-Heatly Bldg., Public Hearing Rooms 1420-1430), Austin
Consumer Direction Workgroup This meeting will be webcast. To access the webcast, go to http://www.hhsc.state.tx.us/news/meetings.asp the day and time of the meeting. 1. Welcome, Introductions and Announcements – Nancy Crowther. 2. Approval of Minutes of March 13, 2015, meeting (Vote Required). 3. Chair report on Consumer Directed issues from state and national organizations and associations – Nancy Crowther. 4. Legislative update on bills impacting consumer direction – Nancy Crowther. 5. Discuss Consumer Directed Services (CDS) in the Consumer Managed Personal Attendant Services (CMPAS) program – Nancy Crowther and Ron Cranston 6. Public Comment. 7. Lunch (recess). 8. Reports from Consumer Direction Workgroup representatives on Senate Bill 7 Advisory Committees – Ricky Broussard, Linda Levine and Helen Baker. 9. Discussion of proposed guidelines for the Subcommittees – Nancy Crowther. 10. Standing Committee reports. a. Quality Improvement – Helen Baker b. Employer Support – Joshua Oyeniyi c. Service Expansion – Linda Levine and Leslie Curtis 11. Update on Community First Choice services in managed care – Chris Welch, Health and Human Services Commission (HHSC). 12. Update on Enhancement Rate for CDS Employers – Pam McDonald, HHSC. 13. State Agency Reports. a. Department of Aging and Disability Services b. Department of Assistive and Rehabilitation Services c. Department of State Health Services d. HHSC e. Texas Workforce Commission 14. Public Comment. 15. Closing Remarks and Adjournment. Additional Information Contact: Sallie Allen, 512/424-6969
6/1/2015
Texas Health and Human Services Commission
June 1, 2015 – 10:30 AM
6330 East Highway 290 (ITT Institute Building, Theory/Classrooms #3 and #4), Austin
The Perinatal Advisory Council 1. Welcome. 2. Approval of the Minutes (Meeting April 13, 2015). 3. Status of New Subcommittees: a. Rural and Family Medicine b. General Obstetrics/Gynecologic Practitioners 4. Status of Draft Rules proposed for Neonatal Levels of Care. 5. Legislative Update. 6. Discussion on Maternal Levels of Care.* 7. Lunch (Recess). 8. Public Comment. 9. Set agendas, dates, times and locations of upcoming meetings in 2015. 10. Adjourn. * It is anticipated that agenda item will continue to be considered after the Lunch Recess. Additional Information Contact: David Williams, 512/380-4374
6/2/2015
Texas Health and Human Services Commission
June 2, 2015 – 10:30 AM
4900 N Lamar Blvd. (HHSC, Brown-Heatly Bldg., Room 2301), Austin
The Intellectual and Developmental Disability System Redesign Advisory Committee Transition to Managed Care Sub-Committee Meeting 1. Welcome and Introductions. 2. Review and accept January 15, 2015, and March 16, 2015, Intellectual and Developmental Disability System Redesign Advisory Committee Transition to Managed Care Subcommittee Meeting Minutes. 3. State Agency Updates. a. Community First Choice updates b. Legislative update c. Employment First Initiative/Employment Assistance d. Transition to Managed Care 4. Health Services Coordination Discussion. 5. Senate Bill 7 Pilots Update. 6. Discussion of Future Meeting Date and Agenda Items. 7. Adjourn. Additional Information Contact: Kathi Montalbano, 512/730-7409
Texas Health and Human Services Commission
June 2, 2015 – 01:30 PM
701 West 51st St. (DADS, Winters Bldg., Public Hearing Rm), Austin
Hospital Payment Advisory Committee 1. Opening Comments: William Galinksy, Hospital Payment Advisory Committee Chair. 2. Approval of February 12, 2015, Meeting Minutes. (Vote required) informational items: 3. Inpatient Hospital Reimbursement.* The Health and Human Services Commission (HHSC) proposes amendments to Title 1, Part 15, Chapter 355, Subchapter J, Division 4, Rule s355.8052, Inpatient Hospital Reimbursement. The proposed amendments will allow HHSC to implement targeted inpatient hospital rate increases funded through House Bill 1, 84th Legislature, Regular Session, 2015, Article II. Proposed amendments may include increases in the percentages used in determining the trauma add-on amounts for hospitals eligible for an increase to their base standard dollar amount through a trauma add-on. Proposed amendments may also include the implementation of a targeted rate add-on for safety-net hospitals. Increases will be contingent upon the full federal allocation of disproportionate share hospital (DSH) funding (excluding that portion of the allocation associated with state-owned or operated hospitals) being matched by local intergovernmental transfers. – Laura Skaggs, Coordinator, Hospital Rates and Payments, HHSC 4. Outpatient Hospital Reimbursement.* HHSC proposes amendments to Title 1, Part 15, Chapter 355, Subchapter J, Division 4, Rule s355.8061, Outpatient Hospital Reimbursement. The proposed amendments will allow HHSC to implement increases in, or add-ons to general outpatient reimbursement rates, non-emergent emergency department rates, outpatient hospital imaging services fees and/or outpatient clinical laboratory services fees for hospitals located in a county with 60,000 or fewer persons according to the 2010 U.S. Census, and Medicare-designated Rural Referral Centers (RCC), Sole Community Hospitals (SCH), and Critical Access Hospitals (CAH). – Laura Skaggs, Coordinator, Hospital Rates and Payments, HHSC 5. Tuberculosis Institution, Chapter 354.* HHSC proposes to amend Title 1, Part 15, Chapter 354, Subchapter A, Division 10, s354.1121 (relating to Definitions) and Division 11, s354.1149 (relating to Exclusions and Limitations). HHSC also proposes to amend the title of the rule in Division 28, s354.1371 (relating to Benefits and Limitations). The Social Security Act historically precluded participation in Medicaid by a tuberculosis (TB) institution, but the exclusion was removed. The proposed amendments align Texas Medicaid rules with federal statute by removing the prohibition against paying a TB institution for inpatient services provided through Texas Medicaid. The state of Texas currently has one TB institution, the Texas Center for Infectious Disease (TCID), which is operated by the Department of State Health Services (DSHS). The proposed change would allow TCID to bill Medicaid for Medicaid-enrolled individuals receiving treatment for TB. – Laurie Vanhoose, Director, Policy Development and Alex Melis, Senior Policy Analyst, HHSC 6. Public Comment. 7. Proposed Next Meeting: Thursday, August 13, 2015, at 1:30 p.m. 8. Adjourn. *Public comment will be taken on this agenda item. Additional Information Contact: Sallie Allen, 512/424-6969
6/8/2015
Texas Health and Human Services Commission
June 8, 2015 – 01:00 PM
4900 North Lamar Blvd. (HHSC, Brown-Heatly Bldg., Public Hearing Room), Austin
STAR+PLUS Nursing Facility Advisory Committee 1. Call to Order. 2. Roll Call. 3. Approval of the Minutes (Meeting March 9, 2015). 4. Update on Nursing Facility Carve-In. 5. STAR+PLUS Quality Measures. 6. Public Comment. 7. Set agendas, dates, times and locations of upcoming meetings in 2015. 8. Adjournment. Additional Information Contact: David Williams, 877/541-7905
6/9/2015
Texas Health and Human Services Commission
June 9, 2015 – 09:00 AM
701 W 51st St. (DADS, Winters Bldg., Public Hearing Room), Austin
Medical Care Advisory Committee 1. Opening Comments: Gilbert Handal, M.D., Medical Care Advisory Committee Chair. 2. Comments from the Associate Commissioner for Medicaid and Children's Health Insurance Program (CHIP): Kay Ghahremani, Health and Human Services Commission (HHSC). 3. Approval of February 2015 Meeting Minutes. (Vote Required) 4. Presentation on the Transformation Waiver Renewal, Extension Request for Submission to Centers for Medicare and Medicaid Services (CMS): Ardas Khalsa, Deputy Medicaid/CHIP Director, Healthcare Transformation Waiver. HHSC staff will present an overview of current extension, renewal activities under the Texas Healthcare Transformation & Quality Improvement Program, otherwise known as the 1115 waiver. The overview will include an update on Delivery System Reform Incentive Payment (DSRIP) and Uncompensated Care (UC) and managed care. Informational items: 5. Payments to Long-Term Services and Supports (LTSS) Providers for Certain Costs Associated with the Affordable Care Act Employer Mandate. HHSC proposes amendments to Title 1, Part 15, Chapter 355, Subchapter A, Rule s355.112, Attendant Compensation Rate Enhancement, and Subchapter C, Rule s355.308, Direct Care Staff Rate Component. The proposed amendments will establish separate rate enhancement pools for certain LTSS providers. These enhancement pools will allow for additional payments to providers for new costs accrued in complying with the Affordable Care Act (ACA) Employer Responsibility provisions, which require certain employers to provide health insurance to their full-time employees and their dependents. These additional payments will be subject to spending accountability requirements to ensure that the additional funds are expended as intended. – Victor Perez, Director, Long Term Services and Supports, HHSC 6. Spending Accountability for the Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) Program. HHSC proposes amendments to Title 1, Part 15, Chapter 355, Subchapter D, Rule s355.456, Reimbursement Methodology. The proposed amendments will establish a system of spending accountability that requires each non-state-owned ICF/IID provider to expend at least 90 percent of funds received through the ICF/IID program's Medicaid payment rates on Medicaid allowable costs under this program. Providers who fail to meet the 90 percent spending requirement would be subject to a recoupment of the difference between the 90 percent spending requirement and their actual expenditures. – Victor Perez, Director, Long Term Services and Supports, HHSC 7. Spending Accountability for the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) Waiver Programs. HHSC proposes amendments to Title 1, Part 15, Chapter 355, Subchapter F, Rule s355.723, Reimbursement Methodology for Home and Community-Based Services and Texas Home Living Programs. The proposed amendments will establish a system of spending accountability that requires each HCS and TxHmL provider to expend at least 90 percent of funds received through the HCS and TxHmL waiver programs' Medicaid payment rates on Medicaid allowable costs under these programs. Providers who fail to meet the 90 percent spending requirement would be subject to a recoupment of the difference between the 90 percent spending requirement and their actual expenditures. – Victor Perez, Director, Long Term Services and Supports, HHSC 8. Reimbursement Methodologies for Physicians and Other Practitioners. HHSC proposes amendments to Title 1, Part 15, Chapter 355, Subchapter J, Division 5, Rule s355.8085, Reimbursement Methodology for Physicians and Other Practitioners. The proposed amendments will allow HHSC to maintain enhanced reimbursement rates for primary care services for certain providers as directed by House Bill 1, 84th Legislature, Regular Session, 2015, Article II and to add Peer Support Specialists, dental hygienists, and dental hygiene practitioners as eligible Medicaid providers. – Ross Keenon, Rate Analyst for Acute Care, HHSC 9. Reimbursement Methodologies for Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Services. HHSC proposes amendments to Title 1, Part 15, Chapter 355, Subchapter J, Division 23, Rule s355.8441, Reimbursement Methodologies for EPSDT Services. The proposed amendments will add dental hygienists and dental hygiene practitioners as eligible Medicaid providers. – Rozsalind Brown, Rate Analyst for Acute Care, HHSC 10. Reimbursement Methodology for Telemedicine, Telehealth, and Home Telemonitoring Services. HHSC proposes amendments to Title 1, Part 15, Chapter 355, Subchapter G, Rule s355.7001, Reimbursement Methodology for Telemedicine, Telehealth, and Home Telemonitoring Services. The proposed amendments will update the Medicaid reimbursement methodology to state that telemedicine, telehealth, and telemonitoring services will be reimbursed under pilot programs and established Medicaid programs for children and/or adults in accordance with program rules and reimbursement methodologies for Telemedicine, Telehealth, and Home Telemonitoring Services including School Health and Related Services. – Rozsalind Brown, Rate Analyst for Acute Care, HHSC 11. Minimum Payment Amounts to Qualified Nursing Facilities, Chapter 353. The Health and Human Services Commission (HHSC) amends Title 1, Part 15, Chapter 353, Subchapter G, s353.608, concerning Minimum Payment Amounts to Qualified Nursing Facilities. Participation in the nursing facility (NF) minimum payment amounts program (MPAP) is limited to NFs where a non-state governmental entity holds the license and is party to the NF's Medicaid provider enrollment agreement with the State. Due to the lead time required to calculate, adopt, and implement managed care capitation rates, NFs must be identified as qualified MPAP participants significantly prior to the effective date of the capitation rates. For the final MPAP eligibility period (Eligibility Period Two), the list of qualified NFs was required to be finalized by March 15, 2015. To comply with this deadline, s353.608 indicated that, for Eligibility Period Two (September 1, 2015 through August 31, 2016), a NF may be eligible only if its contract was assigned by the Department of Aging and Disability Services (DADS) to a non-state governmental entity by February 28, 2015. Due to the unprecedented number of change of ownership (CHOW) applications submitted for Eligibility Period Two and the fact that the majority of those applications were incomplete when submitted, there was a large backlog of CHOW applications at DADS. Only a portion of those applications were able to be processed by the February 28, 2015, cut-off date for Eligibility Period Two. Without further action on HHSC's part, NFs whose CHOWs were not processed by February 28, 2015, would not be eligible for the NF MPAP for any part of Eligibility Period Two. In order to allow these remaining NFs an opportunity to participate in the MPAP for some portion of state fiscal year 2016 while still ensuring that capitation rate calculations are based on a finalized list of participating NFs, HHSC plans to conduct a mid-year capitation rate review for capitation rates to be effective December 1, 2015, and adopts an amendment to s353.608 to add a third eligibility period, Eligibility Period Two-A, to cover-December 1, 2015, through August 31, 2016. Eligibility for Eligibility Period Two-A will be limited to NFs that submitted CHOW applications to DADS by February 1, 2015, that were not processed by the February 28, 2015, cut-off date for Eligibility Period Two because they were incomplete when submitted. – Pam McDonald, Director, HHSC Rate Analysis 12. Inpatient Hospital Reimbursement. HHSC proposes amendments to Title 1, Part 15, Chapter 355, Subchapter J, Division 4, Rule s355.8052, Inpatient Hospital Reimbursement. The proposed amendments will allow HHSC to implement targeted inpatient hospital rate increases funded through House Bill 1, 84th Legislature, Regular Session, 2015, Article II. Proposed amendments may include increases in the percentages us
ed in determining the trauma add-on amounts for hospitals eligible for an increase to their base standard dollar amount through a trauma add-on. Proposed amendments may also include the implementation of a targeted rate add-on for safety-net hospitals. Increases will be contingent upon the full federal allocation of disproportionate share hospital (DSH) funding (excluding that portion of the allocation associated with state-owned or operated hospitals) being matched by local intergovernmental transfers. – Laura Skaggs, Coordinator, Hospital Rates and Payments, HHSC 13. Outpatient Hospital Reimbursement. HHSC proposes amendments to Title 1, Part 15, Chapter 355, Subchapter J, Division 4, Rule s355.8061, Outpatient Hospital Reimbursement. The proposed amendments will allow HHSC to implement increases in, or add-ons to general outpatient reimbursement rates, non-emergent emergency department rates, outpatient hospital imaging services fees, and/or outpatient clinical laboratory services fees for hospitals located in a county with 60,000 or fewer persons according to the 2010 U.S. Census, and Medicare-designated Rural Referral Centers (RCC), Sole Community Hospitals (SCH), and Critical Access Hospitals (CAH). – Laura Skaggs, Coordinator, Hospital Rates and Payments, HHSC 14. Attendant Minimum Wage Requirements. HHSC, on behalf of DADS, proposes amendments to Title 40, Part 1, Chapter 41, Consumer Directed Services Option, and Chapter 49, Contracting for Community Services. The proposed amendments will increase the required base wage for personal attendants from $7.86 per hour to $8.00 per hour. – Bill Campbell, Director, Community Services Contracts, Access and Intake, dads notice of proposed rules/action items: 15. Vision Care Services, Chapter 355. HHSC proposes to amend Title 1, Part 15, Chapter 355, Subchapter J, Division 1, s355.8001 (relating to Reimbursement for Vision Care Services). The proposed amendments correct a cross reference and make other non-substantive language changes. The amendments to this rule are being proposed to coincide with other changes to rules in Chapters 354 and 363 also related to vision care. – Amy Chandler, Program Specialist, Medicaid/CHIP Policy Development Support, HHSC 16. Vision Care Services, Chapter 354. HHSC proposes to repeal Title 1, Part 15, Chapter 354, Subchapter A, Division 2, 354.1015 (relating to Benefits and Limitations), 354.1017 (relating to Specifications for Eyewear), 354.1021 (relating to Additional Claims Information Requirements), 354.1023 (relating to Optometric Services Provider), and 354.1025 (relating to Competitive Procurement of Vision Care Services). The proposed amendments simplify rule requirements related to vision care. Simplifying these rules allows HHSC more flexibility in developing timely and evidence-based medical policy. The existing rules provide detailed information on the provision of vision benefits. The current level of detail requires HHSC to amend the rules to implement simple updates and changes to the Texas Medicaid medical policy. The proposed rule amendments will align with legal requirements for the benefits and associated limitations while allowing for flexibility and enhanced timeliness in adopting future changes to medical benefits. – Laurie VanHoose, Director, Policy Development Support, HHSC 17. Vision Care Services, Chapter 363. HHSC proposes to amend Title 1, Part 15, Chapter 363, Subchapter E, 363.501 (relating to Definitions), 363.502 (relating to Benefits and Limitations), 363.503 (relating to Specifications for Eyewear), and 363.504 (relating to Claims Information Requirements). The proposed amendments simplify rule requirements related to vision care. Simplifying these rules allows HHSC more flexibility in developing timely and evidence-based medical policy. The existing rules provide detailed information on the provision of vision benefits. The current level of detail requires HHSC to amend the rules to implement simple updates and changes to the Texas Medicaid medical policy. The proposed rule amendments will align with legal requirements for the benefits and associated limitations while allowing for flexibility and enhanced timeliness in adopting future changes to medical benefits. – Laurie VanHoose, Director, Policy Development, HHSC 18. Exceptional Circumstances, Chapter 354. HHSC proposes to amend Title 1, Part 15, Chapter 354, Subchapter A, Division 3, s354.1039 (relating to Home Health Services Benefits and Limitations). The current rule does not provide clear guidance regarding documentation required to substantiate medical need for durable medical equipment that is not listed in the rule as reimbursable by Medicaid as part of home health services. The amended rule will clarify for a provider the required documentation to substantiate the medical need for durable medical equipment in an "exceptional circumstance." The rule will further clarify that HHSC makes the final decision on whether a client's condition meets the clinical criteria to qualify for the "exceptional circumstance" provision of this rule. – Laurie Van Hoose, Director, Policy Development, HHSC 19. Tuberculosis Institution, Chapter 354. HHSC proposes to amend Title 1, Part 15, Chapter 354, Subchapter A, Division 10, s354.1121 (relating to Definitions) and Division 11, s354.1149 (relating to Exclusions and Limitations). HHSC also proposes to amend the title of the rule in Division 28, s354.1371 (relating to Benefits and Limitations). The Social Security Act historically precluded participation in Medicaid by a tuberculosis (TB) institution, but the exclusion was removed. The proposed amendments align Texas Medicaid rules with federal statute by removing the prohibition against paying a TB institution for inpatient services provided through Texas Medicaid. The state of Texas currently has one TB institution, the Texas Center for Infectious Disease (TCID), which is operated by the Department of State Health Services (DSHS). The proposed change would allow TCID to bill Medicaid for Medicaid-enrolled individuals receiving treatment for TB. – Alex Melis, Policy Analyst, HHSC 20. Nurse Aide Registry and Renewal. HHSC, on behalf of DADS, proposes an amendment to Title 40, Part 1, s94.9, concerning Nurse Aide Registry and Renewal. The proposal allows a nurse aide to receive required in-service education from DADS or a healthcare entity (other than a nursing facility or skilled nursing facility) licensed by DADS or the Department of State Health Services or certified by the Board of Nursing. – Anne Trejo, Manager, NFA Licensing, Licensing & Credentialing Section, Regulatory Services, DADS 21. Deaf Blind with Multiple Disabilities, Community Living Assistance and Support Services, and Medically Dependent Children Program. HHSC, on behalf of DADS, proposes repeals, amendments, and new rules in Title 40, Part 1, Chapters 42, concerning Deaf Blind with Multiple Disabilities (DBMD); Chapter 45, concerning Community Living Assistance Support Services (CLASS); and Chapter 51, concerning Medically Dependent Children Program. The proposal aligns rules concerning waiver program interest lists and enrollment with current practice, clarifies how DADS maintains interest lists and makes and withdraws offers of waiver program services, and clarifies DADS' expectation for an individual plan of care (IPC) to be developed using person-centered planning. The proposal addresses the requirement for program provider membership on an individual's service planning team; clarifies the requirements and DADS' processes regarding an IPC, DADS' review of an enrollment request, utilization review of an IPC, lapsed diagnostic eligibility, denial of program eligibility or a service, and a service reduction; and requires an intervener and a service provider of employment assistance and supported employment to comply with the DBMD waiver application in Chapter 42, concerning DBMD. The proposal clarifies certain eligibility criteria, the requirements for the CLASS Program services identified in the IPC, and DADS review of an IPC in Chapter 45, concerning CLASS. The pro
posal deletes the requirement that a primary caregiver's designee, if designated on a backup plan for respite or flexible family support services, must meet the qualifications for an attendant and corrects the requirements for a service provider of employment assistance and supported employment to comply with the MDCP waiver application in Chapter 51, concerning MDCP. The proposal repeals s48.1301, concerning interest lists for certain waiver programs, in Chapter 48, Community Care for Aged and Disabled. – Corliss Powell, Senior Policy Analyst/Rules Coordinator, Center for Policy and Innovation, DADS 22. Home and Community-based Services and Texas Home Living. HHSC, on behalf of DADS, proposes amendments, repeals, and new rules in Title 40, Part 1, Chapter 9, Subchapter D, concerning Home and Community-based Services (HCS) and Subchapter N, concerning Texas Home Living (TxHmL). The proposal aligns rules concerning waiver program interest lists with current practice and clarifies how DADS maintains interest lists and makes and withdraws offers of waiver program services; adds new requirements for a service coordinator and a program provider to participate in service planning team (SPT) meetings and other activities for waiver program applicants 21 years of age or older who reside in, or who are diverted from, a nursing facility; deletes the definition of "non-routine circumstances" and the requirement that respite be provided on a non-routine basis; revises the description of the process to request a reinstatement of a lapsed level of care (LOC) by no longer requiring an HCS provider or for TxHmL, the local authority, to document the begin date of the lapsed period on a DADS form; and requires a service provider of behavioral support to complete training required by DADS. The proposal implements transition assistance services as a new service; allows certain applicants to receive pre-enrollment minor home modifications (MHMs) and a pre-enrollment MHMs assessment; allows DADS to pay the program provider for providing pre-enrollment MHMs and pre-enrollment MHMs assessments if an applicant does not enroll with the program provider; requires a program provider to ensure a certain water temperature in residential settings; requires the service coordinator, between 60 to 90 calendar days before the expiration of an individual's plan of care, to notify the SPT that the individual's person-directed plan (PDP) must be reviewed and updated and to convene an SPT meeting to review and update the individual's PDP, and within ten calendar days after the PDP is updated, to send a copy to the program provider; clarifies that if DADS grants reinstatement of an LOC determination, the period of reinstatement will be for a period of not more than 180 calendar days after the end date of the previously authorized LOC; and allows DADS after a residential visit to require a program provider to submit evidence of corrective action within a time period determined by DADS, in Subchapter D, concerning HCS. – Amanda Woodall, Lead HCS and TxHmL Policy Specialist, Center for Policy and Innovation, DADS 23. Public Comment. 24. Proposed Next Meeting: Thursday, August 20, 2015, at 9:00 a.m. 25. Adjourn. Additional Information Contact: Sallie Allen, 512/424-6969
6/10/2015
Texas Health and Human Services Commission
June 10, 2015 – 10:00 AM
4900 N Lamar Blvd. (HHSC, Brown-Heatly, Public Hearing Room), Austin
Behavioral Health Integration Advisory Committee This meeting will be webcast. To access the webcast, go to http://www.hhsc.state.tx.us/news/meetings.asp the day and time of the meeting. 1. Welcome and Introductions. 2. Review and Approval of the March 11, 2015, minutes. 3. General updates on upcoming Medicaid mental health medical policy process by Health and Human Services Commission (HHSC) Staff. 4. Discussion/Vote on Report. 5. Lunch Break. (45 minutes) 6. *Discussion/Vote on Report continued. 7. Break. 8. Public Comment. 9. Discussion of Agenda Items at September 2015 Behavioral Health Integration Advisory Committee meeting. 10. Adjourn. *Public comment will be taken on this agenda item. Additional Information Contact: Monica Thyssen, 512/462-6217
-End of Report-
