22-1, Updates to IDD PASRR Handbook
Body
Revision 22-1; Effective Nov. 28, 2022
The following changes were made in the Intellectual and Developmental Disability Preadmission Screening and Resident Review (IDD-PASRR) Handbook.
| Section | Title | Change |
|---|---|---|
| 1000 | Introduction to PASRR | Updates Texas Administrative Code (TAC) references. |
| 1100 | Definitions | Updates definitions. |
| 2000 | PL1 and PE | Edits throughout section to update acronyms and section numbers and make clarifications such as adding “calendar” to days. |
| 2100 | Purpose of PASRR | Updates language. |
| 2200 | Referring Entity | Updates and adds new text. |
| 2300 | PASRR Level 1 Screening (PL1) | Updates title by removing (PL1). |
| 2310 | Spousal Co-Payment | Incorporates policy from MEPD and TW Bulletin 22-09, 2. Spousal Impoverishment Dependent Allowance, released on June 1, 2022. |
| 2320 | PL1 Screening Form | Incorporates policy from MEPD and TW Bulletin 22-09, 2. Spousal Impoverishment Dependent Allowance, released on June 1, 2022. |
| 2320.1 | PL1 Submission | Updates and adds new text. |
| 2320.2 | Positive PL1 | Adds new information after enhancement in LTC online portal and additional instructions how to complete section E of PL1 if positive for PASRR. |
| 2320.3 | Negative PL1 | Updates language. |
| 2320.4 | Additional PL1 Responsibilities | Adds new section. |
| 2330 | Admission Types | |
| 2330.1 | Exempted Hospital Discharge | Updates language. |
| 2330.2 | Expedited Admission | Updates admission information relating to the LTC online portal. |
| 2330.3 | Preadmission | Updates language. |
| 2340 | Admission Type on PL1 | Updates language. |
| 2350 | PL1 Submission | Adds section. |
| 2400 | PASRR Level II Evaluation (PE) | Updates language and removes (PE) from title. |
| 2410 | Purpose, PASRR Status, and Staff Qualifications | Updates language about performing PE for people with positive P1. |
| 2410.1 | PASRR Positive | Updates determination status language. |
| 2410.2 | PASRR Negative | Updates determination status language. |
| 2410.3 | Staff Qualifications | Updates language. |
| 2420 | LTC Online Portal Notification | Updates P1 automatic alert process. |
| 2420.1 | Timing of Alert is Based on Admission Type | Updates language and link. |
| 2420.2 | Change of Ownership (CHOW) Extensions | Changes title to Change of Ownership Extensions. Updates language. |
| 2420.3 | Information Gathered by a LIDDA Following an Alert to Conduct a PE | Adds note about PE Evaluator login information in LTC online portal. |
| 2420.4 | Using Information Gathered by a LIDDA Following an Alert to Conduct a PE | Adds reference to Section 4910, Medicaid Eligibility Guidelines. |
| 2430 | Completing and Submitting the PE | Updates language and list of LIDDA requirements. |
| 2430.1 | Interpreter Services | Edits language. |
| 2430.2 | Person/LAR Refuses to Participate in PE | Changes title to Person or LAR Refuses to Participate in PE. Edits language. |
| 2430.3 | Documentation Review for PE Completion | Removes some acronyms and updates language. |
| 2430.4 | Information about Certain Community Programs in Section F0700 of the PE | Edits language. |
| 2430.5 | Presenting Information about Community Services as Part of the PE | Moves title and information about Person’s PE is Negative for ID or DD. |
| 2430.6 | PE for Resident Review | Changes title to Completing Section F, Return to Community Living. Adds new section related to Section F of the PE. Moves original section 2430.6 information to 2430.7. |
| 2430.7 | When a DID is Required to Adequately Complete the PE | Changes title to PE for Resident Review. Includes original and updated text formerly under section 2430.6. Clarifies information about expectations and process when completing PE for resident review. |
| 2430.8 | PE Submission | Changes title to When a DID is Required to Adequately Complete the PE. Moves information that was previously under section 2430.7. |
| 2430.9 | Specialized Services Recommendation Mapping. | Changes title to PE Submission. Moves information that was previously under section 2430.8 and updates language. |
| 2430.10 | Fair Hearing Related to Negative PE | Changes title to Specialized Services Recommendation Mapping. Moves information that was previously under section 2430.9 and updates language. |
| 2430.11 | PE Retention Period | Removes outdated information related to the replacement Medicaid card and aligns the MBI and MBIC sections. Adds related policy. (MBI/MBIC) |
| 2430.12 | PE Retention Period | Removes link to MIPPA application processing instructions. (MSP) |
| 2430.13 | Preadmissions involving Two LIDDAs | Incorporates policy from MEPD and TW Bulletin 21-22, 1. Eligibility for Federal Benefits for Afghan Evacuees, released on Nov. 1, 2021. (All Programs). Clarifies existing glossary definitions. |
| 2500 | PASRR Initial IDT/SPT Meeting | Incorporates policy from MEPD and TW Bulletin 22-09, 2. Spousal Impoverishment Dependent Allowance, released on June 1, 2022. |
| 2510 | NF Enters Initial IDT/SPT Meeting Information | Changes title to NF Enters Initial IDT and SPT Meeting Information. |
| 2520 | Confirmation of IDT/SPT Meeting Information | Changes title to Confirmation of IDT and SPT Meeting Information. Edits text. |
| 2600 | Initiating NF Specialized Services | Edits text. |
| 3000 | Diversion from NF Admission | Updates and makes minor edits throughout section. |
| 3100 | Diversion from Nursing Facility Admission | Edits language. |
| 3200 | Diverting from NF Admission | Edits language. |
| 3210 | Criteria for Diverting from NF Admission | Edits language. |
| 3220 | Requesting a Targeted NF HCS Diversion Slot | Edits language. |
| 3230 | Enrolling in HCS as a Diversion to NF Admission | Edits language and clarifies where essential supports are identified. |
| 3230.1 | Enhanced Community Coordination Funds | Edits language. |
| 3240 | Post Enrollment in HCS as a Diversion to NF Admission | Edits language. |
| 4000 | Admission to a NF | Updates and makes minor edits throughout section. |
| 4100 | Eligibility for Habilitation Coordination Funded by Medicaid | Adds note about hospice services not affecting person’s eligibility for Habilitation Coordination or PASRR specialized services. |
| 4200 | Assignment of Habilitation Coordinator | Edits language. |
| 4300 | Program Overview | Changes title to Initial IDT and SPT Meeting. Edits language. |
| 4310 | Budgeting Concepts | Changes title to Attendance at Initial IDT and SPT Meeting. Edits language. |
| 4400 | Eligibility Income Budgeting | Updates and makes minor edits throughout section. |
| 4410 | Budgeting Steps | Edits language. |
| 4420 | Charts for Premium Amounts | Adds note about need for Habilitative Assessment Form 1064 even if the person has refused Habilitation Coordination. |
| 4500 | Developing Individual Profile and Habilitation Service Plan at First SPT meeting | Adds expectation that habilitation coordinators complete and send individual profile and habilitation service plan to SPT members within 10 calendar days following SPT meetings. Also adds expectation that habilitation coordinators ask NF to ensure all PASRR specialized services are in NF comprehensive care plans. |
| 4510 | Specialized Services Requiring an Assessment | Updates language. Clarifies when lack of IDT/SPT consensus to obtain an assessment for specialized services. Assessments are not completed for people refusing services or when there is no funding. |
| 4520 | Specialized Services that Do Not Require an Assessment | Edits language. |
| 4530 | Frequency and Duration of Habilitation Coordination | Edits language. |
| 4600 | Initiating IDD Habilitative Specialized Services after First SPT Meeting | Edits language. |
| 4700 | Providing Habilitation Coordination | Edits language. |
| 4800 | 2022 Income and Resources Reference Chart | Adds new section |
| 4810 | Determining Guardianship | Adds new section on determining guardianship for people in the PASRR program. |
| 4820 | Communication of Complaint Process | Adds new section about the complaint process in the PASRR program. |
| 4900 | Medicaid and Medicare | Adds new section related to Medicaid and Medicare. |
| 4910 | Medicaid Eligibility Guidelines | Adds new section. Includes chart of TOA and program codes to determine PASRR eligibility. |
| 4920 | Responsibility to Reestablish Medicaid Eligibility | Adds new section about LIDDA responsibility to help in reestablishing Medicaid eligibility for people in the PASRR program. |
| 4930 | Individual Does Not Have an MCO | Adds new section for people who need to select an MCO. |
| 4930.1 | Spousal Co-Payment | Adds new section to help a person who does not have an MCO assigned. |
| 4940 | Individual is Dual Eligible | Adds new section for a person who is dual eligible for both Medicaid and Medicare. |
| 5000 | Habilitation Coordination | Updates section. |
| 5100 | Required Face-to-Face Visits | Adds language about HHSC’s ability to waive face-to-face requirements if an emergency is declared. |
| 5200 | Assess/Reassess Habilitative Needs | Changes title to Assess or Reassess Habilitative Needs. Edits language. |
| 5210 | Reviewing Assessments | Edits language. |
| 5300 | SPT Meetings | Adds new expectation that habilitation coordinator must ensure all SPT members receive a notice of 10 business days to participate in meetings. |
| 5310 | First SPT Meeting | Updates revision notice and effective date. |
| 5320 | Quarterly SPT Meetings | Adds clarifications to timeline expectations about quarterly SPT meetings. |
| 5320.1 | Required Activities during a Quarterly SPT Meeting | Edits language. |
| 5320.2 | Documenting Summary of Quarterly SPT Meeting | Edits language. |
| 5320.3 | Replacement Medicaid Card | Edits language. |
| 5330 | Update SPT Meetings | Updates list. Include information for completing ANSA or address any outstanding issues |
| 5330.1 | Update SPT Meeting Because of a Change in Medical Condition or a Change in Service | Removes title of section. Information remained in section 5330. |
| 5330.2 | Update SPT Meeting For An Issue Not Addressed in Section 5330.1 | Removes title and section information. |
| 5340 | Annual IDT/SPT Meeting | Changes title to Annual IDT and SPT Meeting. |
| 5340.1 | Annual IDT/SPT Meeting | Changes title to Annual IDT and SPT Meeting. Edits language. |
| 5340.2 | HC Preparation for Annual IDT/SPT Meeting | Changes title to Preparation for Annual IDT and SPT Meeting. Edits language. |
| 5340.3 | IDT Agrees to Habilitation Coordination | Edits language. |
| 5340.4 | Refusal of Habilitation Coordination | Edits language. |
| 5340.5 | Annual SPT Meeting | Edits language. |
| 5350 | SPT Member that is a Provider of a Specialized Service | Edits language. |
| 5360 | Determination that Participation in SPT Meeting is Not Necessary | Edits language. |
| 5370 | Guidance for Convening SPT Meeting When an Individual or LAR Does Not Want to Attend | Edits language. |
| 5400 | Develop and Revise Habilitation Service Plan and Individual Profile | Edits language. |
| 5410 | Person-centered Planning | Replaces “Federal Poverty Income Limit (FPIL)” with “Federal Poverty Level (FPL)”. Updates for plain language. (MBI, MBIC) |
| 5420 | Discovery Process | Edits language. |
| 5430 | Developing Habilitation Service Plan and Individual Profile | Edits language. |
| 5430.1 | Specialized Services Requiring an Assessment | Edits language. |
| 5430.2 | Specialized Services that Do Not Require an Assessment | Edits language. |
| 5430.3 | Barriers to Transitioning to the Community or Selecting a Community Program Identified During CLO | Edits language. |
| 5430.4 | Charts for Premium Amounts | Edits language. |
| 5440 | Revising the Habilitation Service Plan and Individual Profile | Edits language. |
| 5440.1 | Revising the HSP Because an Assessment for an NF Specialized Service is Complete | Removes outdated information related to the replacement Medicaid card and aligns the MBI and MBIC sections. Adds related policy. (MBI/MBIC) |
| 5440.2 | Revising the HSP Because an Assessment for an IDD Habilitative Specialized Service is Completed | Edits language. |
| 5440.3 | Revising the HSP to Address Barriers Identified During CLO | Edits language. |
| 5450 | New Habilitation Service Plan for Next HSP Year | Edits language. |
| 5460 | 2022 Income and Resources Reference Chart | Edits language. |
| 5460.1 | Individual Profile | Edits language. |
| 5460.2 | Habilitation Service Plan | Edits language. |
| 5470 | Sharing the Habilitation Service Plan, Individual Profile and Habilitation Packet | Edits language. |
| 5480 | SPT Member Believes HSP or Individual Profile Does Not Accurately Reflect SPT Decisions or Information about the Individual | Edits language. |
| 5500 | Assisting with Access to Needed Specialized Services | Updates revision number and effective date. |
| 5510 | Initiating IDD Habilitative Specialized Services | Edits language. |
| 5520 | Monitoring the Initiation and Delivery of all Specialized Services | Edits language. |
| 5530 | Accessing Other Habilitative Programs | Edits language. |
| 5540 | Assisting Individual/LAR with Requesting a Fair Hearing for Denial of NF Specialized Services | Changes title to Assisting Individual or LAR with Requesting a Fair Hearing for Denial of NF Specialized Services. Edits language. |
| 5600 | Coordination | Edits language. |
| 5700 | Monitoring and Follow-up Activities | Updates language to include need for habilitation coordinator to include the perspective of the person and LAR when monitoring for progress or satisfaction. |
| 5800 | Community Living Options (CLO), Visits to Community Programs, and Educational Opportunities | Changes title to Community Living Options, Visits to Community Programs, and Educational Opportunities. |
| 5810 | Presenting CLO | Edits language. |
| 5810.1 | When CLO is Presented | Updates language for clarifications about CLO timeline and expectations if individual is not interested in habilitation coordination or transition to the community. |
| 5810.2 | Six-Month Base Schedule | Changes title to Six-month Base Schedule. Edits to clarify CLO timeline. |
| 5810.3 | CLO Materials Provided to Individual/LAR | Changes title to CLO Materials Provided to Individual or LAR. Edits language. |
| 5820 | Documenting CLO | Updates language to clarify that section 4 of CLO form 1054 should be filled out even if the individual is not interested in transition. |
| 5830 | HC Actions Following CLO | Changes title to Habilitation Coordinator Actions Following CLO. Edits language. |
| 5830.1 | Individual/LAR Wants to Transition and has Selected a Community Program | Changes title to Individual/LAR Wants to Transition and has Selected a Community Program. Edits language. |
| 5830.2 | Individual/LAR Wants to Transition, but has NOT Selected Community Program | Changes title to Individual or LAR Wants to Transition but has NOT Selected Community Program. Edits language. |
| 5830.3 | Individual/LAR Does Not Want to Transition, is Undecided or Desire of Individual/LAR Cannot be Determined | Changes title to Individual or LAR Does Not Want to Transition, is Undecided or Desire of Individual or LAR Cannot be Determined. Edits language. |
| 5840 | Exploring Community Programs | Edits language. |
| 5850 | Educational Opportunities | Edits language. |
| 5900 | Explanation of Rights | Changes title to Additional Habilitation Coordinator Responsibilities. |
| 5910 | Explanation of Rights | Clarifies program information. Adds related policy. (All Programs) |
| 5920 | Activities Related to Guardianship | Clarifies program information. Adds related policy. (All Programs) |
| 5920.1 | Individual Has a Guardian | Adds policy for electronic correspondence. (All Programs) |
| 5920.2 | Individual Does Not Have a Guardian | Adds new section with information for a person who does not have a guardian. |
| 6000 | Transition From NF to Community | Edits text. |
| 6110 | Assigning a Service Coordinator or Enhanced Community Coordinator | Updates language and clarifies timeline for assigning an SC/ECC is seven calendar days. |
| 6110.1 | Unassigning a Service Coordinator or Enhanced Community Coordinator | Updates and clarifies language. |
| 6120 | Working with the Relocation Specialist | Adds clarity that habilitation coordinator should ask person or LAR directly whether they object to MCO service coordinator attendance at meetings. |
| 6130 | Relocation Specialist and MCO SC Responsibilities | Updates and clarifies language. |
| 6140 | Enhanced Community Coordination Funds to Assist with Certain Costs Related to Transitioning | Edits language. |
| 6200 | Transition Planning | Adds new expectation for habilitation coordinators. Must give SPT members a 10-business day notice before SPT meetings. |
| 6210 | SPT Meeting Participation by Service Coordinator/Enhanced Community Coordinator and Habilitation Coordinator | Changes title to SPT Meeting Participation. |
| 6210.1 | Service Coordinator/Enhanced Community Coordinator Participation | Edits language. |
| 6210.2 | Habilitation Coordinator Participation | Edits language. |
| 6210.3 | Program Provider and Relocation Specialist Participation | Adds new section. Reminds habilitation coordinators to invite the community program provider and the RS t o all SPT meetings. |
| 6300 | Developing and Revising the Transition Plan | Directs SC/ECC to send Transition Plan to the SPT members within 10 calendar days after the SPT meeting. |
| 6310 | Transition Plan | Edits language. |
| 6320 | Barriers to Preventing a Transition to the Community | Updates revision number and effective date. |
| 6330 | Documents in an Individual’s Transition Packet | Updates revision number and effective date. |
| 6340 | Individual Profile | Edits language. |
| 6350 | Sharing the Transition Plan, Individual Profile, and Transition Packet | Adds expectation to send documents to SPT members within 10 calendar days after meetings. |
| 6360 | SPT Member Believes Transition Plan Does Not Accurately Reflect SPT Decision | Updates revision number and effective date. |
| 6400 | Pursuing the Selected Community Medicaid Program for Transition | Updates language and clarifies SC/ECC responsibilities. |
| 6500 | Transitioning to the HCS Program | Edits language. |
| 6510 | Criteria for Transitioning to the HCS Program | Edits language. |
| 6520 | Requesting a Targeted NF HCS Transition Slot | Clarifies process and updates language. |
| 6530 | Transitioning to the Community by Enrolling in HCS | Updates language and includes weekend trial visits. |
| 6600 | Transitioning to the Community by Enrolling in HCS | Edits language. |
| 6700 | Transition Day | Updates revision number and effective date. |
| 6800 | Post-transition to HCS Program | Changes title to Post-Transition to HCS Program |
| 6810 | Post-move Monitoring Visits | Changes title to Post-Move Monitoring Visits and clarifies timelines are based on calendar days. |
| 6820 | Monitoring Activities for One Year Post-move | Changes title to Monitoring Activities for One Year Post-Move and updates language. |
| 6900 | Post-transition into a Medicaid Community Program | Changes title to Post-Transition to a Medicaid Community Program and clarifies timelines are based on calendar days. |
| 7000 | Required PASRR Training | New Section specific to training requirements about PASRR. |
| 7100 | Required Training for a Habilitation Coordinator | Adds information related to training requirements for habilitation coordinators. |
| 7110 | Training Completed Prior to Habilitation Coordination | Adds information about the list of required trainings that need to be completed before habilitation coordination. |
| 7120 | Training Completed Within the First 60 Days of Habilitation Coordination | Adds information about list of required trainings that need to be completed within the first 60 days of habilitation coordination. Supervisors must sign off on all work until trainings completed. |
| 7200 | HHSC-developed Training | Changes title to HHSC-Developed Training. Adds information specific about HHSC trainings in the learning portal. |