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Twogether Newsletter
Issue 7.15.22


National Disability Independence Day on July 26th commemorates the signing of the Americans with Disabilities Act (ADA) on July 26th, 1990.
The ADA provides protection from employment discrimination as well as better access to goods, services, and communications for people with disabilities.
The day not only celebrates the anniversary of the ADA but it also serves several other purposes. First, the law first broke down barriers individuals with disabilities faced every day. It also marked a timeline of change that soon developed. Over time, common barriers such as narrow doors and small bathroom stalls became accessible to wheelchairs. Other examples include braille signs and crosswalks for the vision impaired. The changes improved mobility and safety. Read More

First person with Down Syndrome to complete Austin Marathon will participate in Boston Marathon

Kayleigh Williamson was chosen by Adidas to run in the Boston Marathon. She will be the second runner with a cognitive disability to participate.

AUSTIN, Texas — In February, Kayleigh Williamson became the first person with Down syndrome to complete the Austin Marathon. Now, she will be the second person with a cognitive disability to participate in the Boston Marathon.

According to a release, Adidas chose Williamson to join the Boston run under bib number 321. It's all part of the "Runner 321" program developed in partnership with Adidas and the Boston Marathon to challenge marathons around the world to designate bib 321 for a runner with a cognitive disability who wants to participate. 

Williamson made history earlier this year when she completed the Austin Marathon. She was joined by supporters, her mother and her former trainer for the run. Williamson completed the run with a time of 6 hours, 43 minutes and 51 seconds. 

The Austin City Council a month later issued a proclamation honoring Williamson and declaring Feb. 20, 2022 "Kayleigh Williamson Day."

A Note From Julie
I know it has been a difficult last few months for HCS/TxHmL providers, with all the new changes that have taken place and there are more to come. Please send us feedback on how it is going with the new switch from CARE to TMHP system. I have received many calls with questions, concerns, and complaints. If you have specific questions about billing/ claims problems in TMHP please feel free to email them to me so we can also find solutions. Please check for TMHP updates on our website. We need your feedback so we can try to help follow up on HCS/TxHmL provider issues and needs. Thanks.
You can also email us comments at
Twogether Newsletter Sponsors
Pegue-Dennis, CPA P.C. 
Office 1: 469-708-4272 

June Client Update Newsletter

The last thing you may want to do during the summer is start thinking about your 2022 tax return! The best way to lower your tax bill for next year, however, is to start looking for tax cutting strategies as soon as possible. In this month’s newsletter, read about some tax planning tips to help you lower your 2022 taxes. Also read about tax implications if you have a side hustle, money management tips for couples, and how to make your child’s summer break a tax break! Please feel free to forward the information to someone who may be interested in a topic and call with any questions you may have.

Start Your Tax Planning NOW!

Keeping your taxes as low as possible requires paying attention to your financial situation throughout the year. Here are some tips for getting a head start on tax planning for your 2022 return:

  • Start Your Tax Planning NOW imageCheck your paycheck withholdings. Now is a good time to check your tax withholdings to make sure you haven’t been paying too much or too little. The IRS has an online tool that will help you calculate how much your current withholdings match what your final tax bill will be. Visit
    Action step: To change how much is withheld from your paycheck in taxes, fill out a new Form W-4 and give it to your employer.
  • Defer earnings. You could potentially cut your tax liability by deferring your 2022 income to a future year via contributions to a retirement account. For 2022, the 401(k) contribution limit is $20,500 ($27,000 if 50 or older); $6,000 for both a traditional and Roth IRA ($7,000 if 50 and older); or $14,000 for a SIMPLE IRA ($17,000 if 50 and older).
    Action step: Consider an automatic transfer from either your paycheck or checking account to your retirement account so you won’t have to think about manually making a transfer each month.
  • Plan withdrawals from retirement accounts to be tax efficient. Your retirement accounts could span multiple account types, such as traditional retirement accounts, Roth accounts, and taxable accounts like brokerage or savings accounts. Because of this you should plan for your withdrawals to be as tax efficient as possible.
    Action step: One way to structure withdrawals is to pull from taxable accounts first, and leave Roth account withdrawals for last. Another approach would be to structure proportional withdrawals from all retirement accounts that would lead to a more predictable tax bill each year.
  • Net capital gains with capital losses. If you have appreciated investments you’re thinking about selling, take a look through the rest of your portfolio to see if you have other assets that you could sell for a loss and use to offset your gains. Using the tax strategy of tax-loss harvesting, you may be able to take advantage of stocks that have underperformed.
    Action step: Make an appointment with your broker to look over your portfolio to see if there are any securities you may want to sell by the end of 2022.

Tax planning can potentially result in a lower bill from the IRS if you start taking action now. Please call if you have questions about your tax situation for 2022. Read More

We are looking for new sponsors/
advertisers for the newsletters!

Please contact Meghan for more information!

Guardian Pharmacy of Dallas-Fort Worth


For people with I/DD, taking medications as prescribed is essential to managing chronic conditions, minimizing adverse effects, and improving their overall health. Many often have a tough time with medication adherence whether it is one prescription or more, which is most often the case. In fact, 80% of individuals with I/DD are prescribed five or more medications; more than 60% have 10 or more1. Juggling numerous medications can be problematic for these individuals, many of whom have trouble performing even the basic activities of daily living and face cognitive, physical, and communication challenges. While the residents rely on direct support professionals, nurses, medication technicians and other employees for medication help, staff who serve them often face challenges ensuring compliance on a daily basis. This complication, coupled with the fact that residents have varying levels of functionality and medication needs, adds to the complexity, stress and demands of the job. These are just a few factors that have created a staff retention problem. Additional key challenges include:
• Staff Training: Constant turnover can hinder an organization’s ability to properly train staff. While every ICF and supported living provider understands that well-educated staff members make fewer mistakes, most cannot afford to offer training to new employees on an ongoing basis. If the organization is not engaged with an LTC pharmacy that provides this training, they often have to outsource it, which can be expensive.
• Poor Pharmacy Support & Communication: I/DD organizations have unique needs that should involve constant interaction and industry expertise from a pharmacy partner. This level of commitment requires 24/7 pharmacy support and communication. Without it, members of the I/DD staff can be left in situations where they feel overwhelmed and uncertain of the right decision. Sadly, too many organizations experience insufficient assistance from their pharmacy, with some not knowing the appropriate pharmacy contact for every situation, including the best person to answer daily questions and provide after-hours and emergency services.

• Lack of Access to Newer Technologies: Technology can play a tremendous role in the accuracy and efficiency of medication management, but with so many program options in the market, organizations may have a hard time researching and understanding which systems are best to meet their immediate and future needs. Additionally, many are still using paper MARs, increasing the workload of the organization’s staff and the risk of human transcription error.

If you work with a pharmacy that specializes in medication compliance, you can minimize medication errors and billing complaints, leading to greater individual and staff happiness. Selecting the LTC pharmacy partner that shares the same level of enthusiasm and empathy you have for the residents you serve is equally as important. Build a relationship with a pharmacy that views meeting the needs of individuals with I/DD the same way you do – as a privilege and source of pride.
With Guardian Pharmacy Texas, you get the best of both worlds – Experience and Compassion. 
 If you have any questions, please see contact information below.
Contact Kevin Kirkpatrick 
Office: 817-633-6688 | Cell: 972-742-3003
Guardian Pharmacy Texas

**If you sign up for services with Guardian and mention "Twogether Consulting" to Kevin Kirkpatrick, you could receive up to 6 months of "paper"
MARS (Medication Administration Review Sheets) for FREE!

Therap | Person-Centered. Data-Driven.

Electronic Billing Solution for TMHP | Therap Services


Thursday, August 25, 2022  |  2:00 PM (CT)

Register Now!


This will be an hour long webinar discussing Electronic Claim submission to TMHP. We will review the ease of use of our Billing Module starting from documentation entry to payment reconciliation.

The following topics will be discussed in the webinar:

  • Your Comprehensive Electronic Billing Solution for TMHP
  • Easy Compliant Claims Submission
  • Easy Billing Solution for your organization to support workflows from Intake to Reconciliation

An Easily-Adoptable System that Supports:

  • Texas documentation forms: 4117, 4118, 4119, 4120, 4121, 4122, 4123 and more
  • Texas specific unit Calculation Rules
  • Authorization Tracking & Utilization Reporting
  • Automatic Payment Posting & Reconciliation

Save Your Seat!

Visit Our Texas State Page

For any questions, please contact:

Susan Allen Ryan Siedhoff
Therap Services Website Therap Services Facebook page Therap Services Twitter Therap Services LinkedIn herap Services Youtube Channel

© Therap Services 2003 - 2022. All Rights Reserved.

Twogether Trainings

New Provider (HCS/TxHML) Training: “I Got My Contract, Now What Do I Do?”
Part I

Date: August 4th, 2022  
(Part II is on August 11th, 2022)
Time:  2:00pm-4:00pm
Cost: $75
How to Write a Contract and Examples by ApproveMe
For:  Owners, Program Managers, Case Managers/Care Coordinators, Nursing Staff, Quality Assurance Staff
Presenter:  Julie Blacklock/IDD Waiver Consultant 
You will receive a confirmation email and handout as well as a link to register with “Gotowebinar” to attend the session, once we receive payment.  Please click on your registration link right away to receive reminders for the session!
-Resources at HHSC (Health & Human Services Commission)
– What Is HCS?  What is TxHmL?
Marketing for Consumers
-Basic Start-Up Process Packet-How To Set Up Consumer Charts (Paper or Electronic).
– Interacting with the Local IDD Authority (LIDDA)
-Consumer Admissions:  LIDDA Vs. The Provider (Enrollments & Transfers)
LIDDA Vs. Provider: Temporary Discharge (Suspension), Permanent Discharge (Termination)

(Webinar) “Study & Prep Session For
HCS Provider Applicant Test”

Date: August 9th, 2022  
Time:  6:00pm-8:30pm
Cost: $175
Free Study Cliparts, Download Free Study Cliparts png images, Free ClipArts  on Clipart Library
For:  Program Owners & Program Managers but others from your program are welcome (i.e. Case Managers, Care Coordinators and Nurses). This is, however, primarily for the person listed as the “Program Manager” for the HCS Provider Applicant, who will actually be taking the test.   This session is primarily for HCS Provider Applicants, but we will be discussing a little of TXHML as well, for those of you who are taking this test.  We will try to provide a session specifically for TxHmL in the near future. 

If you are unable to attend the live webinar practice session or if you miss part of the live webinar, this session will be recorded.  We will send a copy of the recorded webinar to all registrants within 24 hrs of the training. 

We also have a pre-recorded session from our last live webinar, for anyone who can’t wait for this live session in Feb. 2021.  Please contact us at if you need to purchase a link to a pre-recorded session for study use.

“Go To Webinar” link will be sent to you with handouts after we have received payment!
Please be sure to complete registration by contacting Meghan Jones at:
-Description of HCS & TxHmL Waivers and Basic Terminology Needed
-Tips for Preparing For The HCS Provider Certification Test.  
-Important Sections of the HCS Handbook & HCS/TxHmL Interpretive Guidance Booklet ,
-Frequently Asked Questions found on the HHSC HCS/TxHmL home pages.  
-Frequently Cited TAC Codes  (HCS & TxHmL)
-How to Access  Important Information on the HHSC Website: Joint Training Opportunities, HCS/TxHmL Waiver Training, Resources, Contact Information, etc.. 
-Information on Person-Centered Training Opportunities and The Importance of This Training
-What Happens After I Pass My Test?
-HCS Practice Test during the session, so that you may become comfortable with the type of questions that may be asked during the PAT testing session

New Provider (HCS/TxHML) Training: “I Got My Contract, Now What Do I Do?”
Part 2

Date: August 11th, 2022  
 (Part I from August 4th, 2022 is now available as a recording)
Time:  2:00pm-4:00pm
Cost: $75
How to Write a Contract and Examples by ApproveMe
For:  Owners, Program Managers, Case Managers/Care Coordinators, Nursing Staff, Quality Assurance Staff
Presenter:  Julie Blacklock/IDD Waiver Consultant 
You will receive a confirmation email and handout as well as a link to register with “Gotowebinar” to attend the session, once we receive payment.  Please click on your registration link right away to receive reminders for the session!
-Setting Up SSI
-Monitoring Medicaid Eligibility & Problems That May Arise,
-Intro To Billing Requirments
-Putting Service Delivery Logs/Notes in place,
-Contracting Services On The IPC, and
-Discussion of How To Start Billing/Reimbursement Process.  
Some Discussion of TMHP System
Upcoming Conferences 

Save the Date:
Quality in Long-Term Care Conference

HHS, along with The University of Texas Steve Hicks School of Social Work, will host the 
2022 Quality in Long-Term Care Conference in-person.
Renaissance Austin Hotel
Aug. 11–12
The conference is free to attend. Online registration opens Wednesday, June 15.
This year’s theme, “Resilient, Responsive and Ready,” was selected due to Texan’s:
  • Resiliency.
  • Ability to recover quickly from the challenges of the pandemic.
  • Responsiveness to the ever-changing ways of working in the new normal in their professions and being ready for whatever comes next.
Continuing education credit for multiple disciplines will be provided for this event.
Email UT Steve Hicks School of Social Work for more information about this event.
Mark Your Calendar!
 Don't miss the opportunity to learn from experts in the field, regulators and colleagues & refresh our commitment as to why we do what we do.
 Attached please find Marketing Opportunities to include sponsorship and exhibiting. All conference-related information can also be accessed on PPAT's website at
Registration – A registration form is attached and can be completed and submitted by email to Forms can also be submitted by mail to the PPAT Office at 8711 Burnet Road, Ste. E-53, Austin, TX 78757 or faxed to 512-458-3078. Online Registration will be available soon!
Hotel Reservations - Click on the link to reserve your room:   2022PPATConfHotelReservations  
Conference Session topics will be forthcoming.
2022 Conference Registration Form  
2022 Conference Forms All
We Look Forward to Seeing You in September!

   The 16th Annual AccessAbility fest will kick-off, October 1st at 9:00 AM featuring numerous exhibitors with music, performances, activities, demonstrations, information, products, programs and services that promote independence and inclusion where individuals with disabilities live, learn, work and play. 
Advanced registration is encouraged.  Participation is FREE! 

more info here

    Saturday, October 01, 2022 (9:00am - 2:00pm)

        In-Person abilitySTRONG Parade @ Hemisfair (downtown San Antonio)
        Followed by the AccessAbility fest
Entry Fees: 
        None.  This event is FREE and Open to the Public.  

Event Topic Areas: 
1) Benefits Management / Financial Planning, 2) Community Education & Public Awareness, 3) Education, 4) Employment, 5) Faith & Spirituality 6) Legislative & Legal, 7) Health & Nutrition, 8) Residential Options, 9) Support Services,  10) Recreation-Socialization, 11) Transportation, 12) Therapy & Rehabilitation, 13) Products: DME Other, and several other areas of interest as they are identified



New Dates, New Location.

The only historic beachfront hotel on the Gulf Coast of Texas, The Grand Galvez, is undergoing renovation just in time to host AAIDD Texas Chapter's 46th Annual Convention!
They're bringing back the luxury and sophistication, with a nod to the original design of 1911 and a refreshed elegance throughout. Renovations include everything from guest rooms to common areas to the beautiful grounds, and provide a casual opulence sure to please. Mark your calendars for November 15 - 18, 2022 and we'll see you at the GRAND GALVEZ!

Job Postings
Contact Meghan if you would like
to feature a job posting in our next newsletter!
1 Care Premier Services LLC
Registered Nurse (RN) Home and
Community-Based Services (HCS) Program
Houston, TX 77060

RN position available!

For more information, click on this Indeed link

A Home and Community-based Services (HCS) Provider

Seeking an RN on a contract basis for an HCS Program. The RN MUST HAVE HCS EXPERIENCE. The RN will complete nursing assessments annually and as needed, medication training, delegations to unlicensed staff, special needs training, medical specific training, review medical documents, and provide triage/post hospital assessments when needed to individuals residing in the group home setting.

Primary responsibilities include:

· Nursing Assessments (annually and as needed)

· RN Delegations

· Staff Trainings

· Annual Meetings

· Face-to-face assessment/post hospital visits

· New med/1st dose

· On-call

· Immediate follow-up following physician’s appointments with nursing assessment revision if necessary

· Medication monitoring Medication reconciliation/monthly cycle meds

Must have HCS experience.

$40 per billable hour

Job Types: Full-time, Part-time, Contract

Salary: $40.00 per hour

Kate Wills
President/Executive Director
A Home and Community-based Services (HCS) Provider
Office:  281-482-3163
Cell:  713-670-4673
Fax 1:  281-482-3162 
Fax 2: 713-481-6206
Do you know an awesome college-aged person that would be a great fit to work at
camp and with our campers? SEND THEM OUR WAY!
Perks of camp include, but aren't limited to...
Competitive Salary
Internship Credits
Room/Board for 10-weeks
Unlimited S'mores
Epic Adventures
Lasting Memories
Job Skills
Camper Smiles
Fun and Laughter
Lifelong Friendships 

Twogether Updates

July 10th, 2022 Date: October 1st, 2022 (San Antonio, Tx)  2022 AccessAbility fest & abilitySTRONG Parade REGISTRATION IS NOW OPEN! It's time to REGISTER!  At disABILITYsa, we are excited to host the 16th Annual AccessAbility fest and abilitySTRONG Parade on Saturday, October 1st, 2022 at Hemisfair. Early bird discounts end on August 15th, 2022! * Sponsorship Opportunities * Exhibitor Registration * Parade Entries * Program Partners * Information Only * and more! * You will have more

Juliy 11th, 2022 Our good friend at IntellectAbility, Patrick Lane has provided a link where providers or anyone else interested can register for online Person-Centered Thinking training.  FYI-this is a requirement in the HCS/TxHmLTAC rules for all persons who are a part of the development of the Implementation Plan (IP), to have this training within the first 2 year of hire. Staff Member and Service Provider Requirements The session is a $275 per person. This is a 3-day series of more

July 11th, 2022 Hurry, Hurry this onference is filling up quickly! HHS, in collaboration with The University of Texas Steve Hicks School of Social Work, will host an informative two-day, free conference on quality in long-term care. 2022 QLTCC “Resilient, Responsive and Ready” Aug. 11–12 Renaissance Austin Hotel 9721 Arboretum Blvd. Austin, TX 78759 Register for the conference. Continuing education credits for multiple disciplines will be provided for this event from nationally more

July 11th, 2022 Error in HHSC Reminder Notice re:  Due Date for June 2022 SB 809 Data Earlier today, HHSC issued a reminder notice about the COVID-19 monthly reporting requirement (SB 809). The notice inadvertently stated that July 2022 data was due August 1, 2022. The notice should have stated that the June 2022 data will be due August 1, more

July 11th, 2022 Provider Letter 2022-13, Version 2: Petition To Suspend Essential Caregiver Visits HHSC issues PL 2022-13, Version 2 with additional information regarding how a facility or program provider may petition HHSC to suspend in-person essential caregiver visits.  Read PL 2022-13, Version 2 here. "A facility or program provider may petition HHSC to suspend in-person essential caregiver visits for no more than 7 consecutive calendar days if in-person visitation poses a more

COVID-19 Resources July 11th, 2022 July 7, 2022 MCS COVID-19 Stakeholder Information Session Thank you for your interest in listening to the July 7 Texas Medicaid CHIP COVID-19 Information Session. The audio from this session can be found here. Email us for transcript The presentation can be found here. Future meeting notices and information will continue to be shared on these sites, so please check back regularly. COVID-19 Provider Information COVID-19 Client Information For more

Thought this was great info. and wanted to share- From IntellectAbility Long-haul COVID in People with IDD "People with intellectual and developmental disabilities (IDD) are at a greater risk of infection and poorer COVID-19 related health outcomes than the general population. Prevalence of comorbidities, living in congregate settings, and difficulties practicing preventative measures contribute to this risk; however, the inability to effectively communicate symptoms of illness may be the more

July 4th, 2022 The Provider Finance Department (PFD) Open Enrollment Portal experienced technical difficulties. Those issues have been resolved. The portal is now available for providers to complete Open Enrollment for the Attendant Compensation Rate Enhancement and Direct Care Staff Enhancement programs and Liability Insurance Rate Add-ons for Nursing Facilities. The PFD portal is available. Please click here to access the portal. The PFD portal will be open from July 1, 2022 to August 1, more

July 5th, 2022 Since May 2, Home and Community-based Services and Texas Home Living program providers, local intellectual and developmental disability authorities, and financial management services agencies billing on behalf of Consumer Directed Services have been submitting claims and forms to Texas Medicaid and Healthcare Partnership. TMHP has received feedback from providers indicating more support is needed. Read the full more

July 5th, 2022 Joint Training Page Available for HCS and TxHmL Program Providers The HCS and TxHmL programs now have a Joint Training Opportunities page where providers can register for upcoming classes. Class size will be limited to maximize participation, but classes will be offered regularly. Providers should check the page often for updates. There will be recordings of special presentations available for viewing on-demand later. Missed a COVID-19 training? Many COVID-19 presentations more

July 5th, 2022  Information Validation on LTC Claims IL 2022-35 IL 2022-35 is posted on the HHS nursing facility and Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions webpages. Effective June 10, provider information on long-term care claims is being validated using data stored in the National Plan and Provider Enumeration System and the Texas Medicaid and Healthcare Partnership Provider Enrollment and Management System. This enhancement more

July 5th, 2022 COVID-19: HHSC Publishes In-Home Day Habilitation Information for Program Providers (Replaces IL 2022-32) IL 2022-36 is posted on the HHS webpage for Home and Community-based Services, Texas Home Living, local intellectual and developmental disability authority, and financial management services agency program providers. HHSC is temporarily waiving certain requirements in Section 3710, 4381.3, 4381.7(6) and 4381.7(7) of the HCS Billing Guidelines and TxHmL Guidelines. This more

July 5th, 2022 EVV Claims for HCS and TxHmL Will Deny for Dates of Service Starting Sept. 1 HHSC has extended the start date when Electronic Visit Verification claims for Home and Community-based Services and Texas Home Living will deny for no matching EVV visit. This will begin for the dates of service of Sept. 1, 2022, and after. The extension gives HCS and TxHmL program providers and financial management services agencies more time to improve their claims matching. Texas Medicaid more

July 4th, 2022 Don't Forget, Informal Comments on HCS & CFC Draft Rules Are Due by July 13th! Texas HHS is accepting comments from stakeholders on the following draft rules: Title 26, new Chapter 565, Home and Community-based Services Program and Community First Choice. The comment period ends July 13. Email comments to Long-term Care Regulation Policy and more

July 4th, 2022 American Rescue Plan Act (ARPA) Home and Community-Based Services (HCBS) Provider Retention Payments Initial report is due by August 15, 2022. The Texas Health and Human Services Commission (HHSC) implements American Rescue Plan Act (ARPA) Home and Community-Based Services (HCBS) Provider Retention payments. HHSC is providing funds to agency providers and consumer-directed services employers to support recruitment and retention efforts for direct care staff delivering more

July 3rd, 2022 Overview The Provider Finance Department (PFD) develops reimbursement methodology rules for determining payment rates or rate ceilings for recommendation to the Health and Human Service as Commission (HHSC) for Medicaid payment rates and non-Medicaid payment rates for programs operated by the Health and Human Services Commission (HHS) and the Department of Family and Protective Services (DFPS). PFD develops payment rates or rate ceilings in accordance with these rules and more

Helpful Resources

Why Train Person-Centered Thinking?

Person-Centered Thinking goes beyond a mindset. It’s a skill set.
Person-Centered Thinking skills and techniques are essential to achieving Person-Centered practices.

Person-Centered Thinking provides the foundational skill set empowering those who support others to deliver organized and consistent services with Person-Centered Practices. 


Click to View Our Upcoming Training Schedule and Register Today!

Virtual Person-Centered Thinking Training

Great For: All Staff

Duration: 3 days

Gain a proper perspective of the person
Find that often elusive balance of what is Important To and For the person
Ensure what is learned about the person is properly recorded and can be easily shared to inform Person-Centered Planning

Training Objective: A Person-Centered Thinking Training participant has a firm grasp of person-centered observation, problem-solving, and management skills, alongside a host of specialized tools and techniques. Participants will utilize these skills to create and edit comprehensive, effective Person-Centered Descriptions (PCDs) for the people your agency supports.


Learn more about IntellectAbility's tools and training services for supporters by visiting

Feel free to call us at 727-437-3201 or email us at
Contact us:
Twogether Consulting
P.O. Box 90426 Austin, TX 78709

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