19-1, Miscellaneous Changes

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Revision 19-1; Effective May 1, 2019

The following changes were made:

Chapter Title Change
1 CRS Program Overview Updates CRS contact information.
1.2 Referrals to CRS Adds the referral form, process and contact information.
3.2 Language Services Adds Language Services Standard for providers.
3.4 Facility Safety Protocol
  • Updates when and where to report incidents to CRS.
  • Adds substance abuse, inappropriate behavior that may have participant dismissed from facility, and elopement.
4.5 Staff Training Adds Cardiopulmonary arrest (CPR), Basic Life Support (BLS) training and Fall Prevention.
4.6 Staff Qualifications Adds qualification of Community Independence Supports (CIS).
5.1 Overview Updates when and where to report incidents to CRS.
5.3 CRS Service Number Adds ombudsman’s number and CRS email because CRS does not have a direct phone line.
5.4 Grievance Procedure Updates ombudsman’s contact information.
6.4 Invoices
  • Updates to match updated TAC §20.487.
  • Adds CRS Program responsibility.
6.5 Use of Comparable Benefits or Third Party Billing Adds amount CRS pays if a participant is using their insurance's out of network provider.
7.2 Quality Reviews Adds services that are billed and paid based on services and contracted rate.
8 Compliance and Quality Review for Traumatic Brain Injury Changes Utilization Review to Compliance and Quality Review.
8.2 Review Types
  • Notes changes to types of review names.
  • Adds purchasing review.
8.4 Prospective Reviews Changes title to Clinical Reviews and adds detail of what a clinical review covers.
8.5 Concurrent and/or Retrospective Reviews Changes title to Purchasing Reviews and adds detail of what a clinical review covers.
9.1 Overview
  • Adds changes and updates to provider’s admission policies and procedures including that they need to be reported to CRS when complete.
  • Moves referral information to Chapter 1, Section 2.
9.2 Intake Process Adds information that providers must have participants sign an intake acknowledgement form and must place the form in the participant’s file.
10.2 Assessment
  • Adds information about discharge planning utilizing the wraparound approach.
  • Adds mental health and substance misuse needs.
10.3 Development of Individualized Service Plan Adds this section.
10.4 Interdisciplinary Team Meetings
  • Adds the professional staff who are included in the IDT team and credentialing information needed.
  • Adds IDT team process including changing meetings to every 30 days, what needs reviewing for the participant and how to notify the IDT team.
10.5 Behavior Management Plans
  • Adds information about behavior management plans and what they address.
  • Adds information about who signs the informed conformed consent.
10.6 Emergency Restrictive Procedures Adds procedure for minors who receive chemical or physical restraints more than once within 30 days.
11.2 Required Documentation Adds that PM&R physician overseeing the participant’s care while in ICMRS is a separate service requiring pre-authorization.
11.3 Assessment, Planning and Interdisciplinary Meetings Adds Assessment, Planning and Interdisciplinary Meetings section.
11.4 Billing Guidelines Updates billing guidelines and when invoices must be submitted.
12.1 Overview Clarifies what outpatient therapy services refer to and where they are referenced.
12.3 Assessment, Planning and Interdisciplinary Meetings
  • Adds Assessment, Planning and Interdisciplinary Meetings section.
  • Notes that outpatient services differ from Post-acute rehabilitation services (PARS) non-residential services.
12.4 Billing Guidelines Updates billing guidelines and when invoices must be submitted.
13.1 Overview Adds link for updated rates.
13.2 Required Documentation Adds information for providers about required documentation.
13.3 Assessment and Planning
  • Changes title to Assessment, Planning and Interdisciplinary Meetings.
  • Moves part of this section to Chapter 10, Section 2.
13.6.1 Licensure and Accreditation Changes Department of Aging and Disability Services to Texas Health and Human Services.
13.6.7 Utilization Review Removes this section.
13.6.7 Exceptions and Limitations Updates therapeutic passes.
13.7 Non-Residential Adds post-acute rehabilitation non-residential services to also include case management, community independence supports, medical team conferences.
13.7.1 Licensure and Accreditation Changes Department of Aging and Disability Services to Texas Health and Human Services.
13.7.3 Billing Guidelines Adds uploading into CRS Data Reporting System.
14.1 Overview Adds information about meeting treatment goals.
14.2 Durable Medical Equipment Adds this section.
14.3 Home Modification Adds this section.
14.4 Required Documentation Adds requirements for receiving durable medical equipment.
14.5 Billing Guidelines Updates billing guideline requirements for providers for ancillary goods and services and DME.
14.6 Exceptions and Limitations Updates this section with what is covered under the CRS program as well as when competitive bids are required.
15.1 Overview Adds information about discharge planning.
15.3 Termination from Program Adds information about providers documenting attempted interventions.
Appendix A Definitions Adds the following terms:
  • Abuse
  • Ancillary services
  • Assistive Technology
  • Authorized representative
  • Certified Brain Injury Specialist (CBIS)
  • Community Independence Supports (CIS)
  • Comparable benefits
  • Competitive bid
  • Compliance
  • Glasgow Coma Scale (GCS)
  • Texas Identification Number (TIN)
Edits the following terms:
  • Mental restoration services to mental health counseling
  • Paraprofessional
Removes the following:
  • Utilization Review
Appendix B Post-Acute Rehabilitation Core Services Modality and Staff Qualifications
  • Changes code numbering.
  • Changes Mental Restoration to Mental Health Counseling.
  • Changes Modality and Staff Qualifications for PARS Non-Residential.
Appendix C Base Services and Tier Structure Changes title to PARS Residential Base Services and Tier Structure
Appendix D Service Record for CRS Data Reporting System Adds clarification text.