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Twogether Newsletter
Issue 6.1.22

June 5-12, 2022, the 2022 Special Olympics USA Games will unite more than 5,500 athletes and coaches from all 50 states and the Caribbean and 125,000 spectators during one of the country’s most cherished sporting events. We all have reasons to shine. For Special Olympics athletes, one of those reasons is the love of sport. Special Olympics athletes display remarkable abilities not only on the field, but in all areas of life. By celebrating their dedication and perseverance, we become champions for a more inclusive world. A world where we all Shine As One. Read More...
Be the Light: Elizabeth Bonker’s 2022
Valedictorian Speech at Rollins College Commencement
Rollins College’s 2022 Valedictorian Elizabeth Bonker, who is affected by non-speaking autism and communicates solely by typing, urges her fellow graduates to use their voices, serve others, and see the value in everyone they meet in her valedictory address. Read more about Elizabeth's story:
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. 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

Your Tax Tip From:

Pegue-Dennis, CPA P.C.

Protect Your Business with a Smart Email Policy

Protect Your Business with a Smart Email Policy image
With an estimated 306 billion emails sent and received each day worldwide, electronic communication is clearly an essential business tool. But in the same way email makes business more efficient, all those data packets traveling in and out of your company’s email system pose potential risks to your business.

Know the risks

While leaks of your company’s confidential or proprietary information via employee email are always a danger, messages carelessly worded that create legal headaches for businesses are more common. A recent study showed that nearly one in four outgoing emails contains content that pose legal, financial or regulatory risk for your business.

  • Insert a legal footer. At the bottom of all emails, place a static confidentiality statement for legal protection.
  • Create an email policy. Create an email policy and have your legal team review it. Then work to monitor compliance within your organization. Emails are never places to promise pricing or tax information. Purchase orders and tax returns are where this information belongs.

Protect your business

In addition to creating a working policy here are ideas to consider as part of your policy or as ideas to better protect your business.

  • Notify employees that the email system is the property of the company and may be subject to monitoring at the company’s discretion.
  • Require that personal emails be sent only from employees’ personal accounts, from their personal devices, and not from a business email address on the company’s computer. By the same token, employees should not use their personal email accounts to send messages related to the business.
  • Explain best practices for avoiding scams and thwarting cyberattacks, including not clicking on links or downloading documents from unknown senders.
  • Prohibit messages that are obscene, discriminatory, harassing or inappropriate, and clearly state the consequences for any violations.

Instituting a comprehensive email policy is only part of an effective protection plan. Monitoring and enforcing those rules and periodic training for all employees are also essential components.

View next article 
Financial Spring Cleaning for Your Business

Back to May 2022 Newsletter Contents

This newsletter is provided by

Pegue-Dennis, CPA P.C.
"A Certified Public Accounting Firm"
1320 Prudential Dr
Dallas, TX 75235
Office 1: 469-708-4272  Office 2: 214-559-6900
Text: 469-701-2170

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!

Ryan is our new contact for Texas
We are looking for new sponsors/
advertisers for the newsletters!

Please contact Meghan for more information!
Twogether Trainings


Webinar: “Common Nursing Issues Resulting
In Survey Violations” (HCS/TxHmL)
Date: June 23, 2022
Time: 10:00 AM-12:00PM
Q&A: Noon-12:15pm
Cost: $65

For:  Program Managers, Administrators, Case Managers/Care Coordinators, Nursing Staff
Presenter:  Julie Blacklock & Guest RN 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!
– HCS/TxHmL Interpretive Guidance Booklet (Review of Specific Nursing Sections)
–Examples of Some of the Most Current & Common Violations Related To Nursing
–Prevention Ideas & Discussion
-(POC’s) Plan of Correction Ideas & Discussion
-Important Policies, Procedure & Training To Develop & Implement
and much more


Webinar: “Pop-Up” Live Training Nursing Series:
HCS (Dallas, Tx) Limited Seating
Twogether Consulting is happy to announce that we have a limited invite we are sending out to HCS/TxHmL Providers who would like to attend our Nurse Training Series.  We will be presenting this training session live at Sheraton Hotel & Conference Center, in Dallas Tx.  “A Place of Grace” has been kind enough to sponsor the location and invite other HCS/TxHmL Providers the chance for Nurses, Program Managers, and/or QA staff the opportunity to attend our first “live” nurse training series in quite some time.  Space is very limited.  So please contact us as soon as possible if you are interested in having any of your staff attend.  

Below are some specifics about the training including, the exact location in Dallas where the training will take place, as well as some restaurants and hotels in the area, and the agenda.   Please contact Meghan Jones for registration ASAP, with limited seating.

 Early Registration Cost $325/person- Closes June 15th, 2022

Dates:  June 29th and 30th, 2022.
Times:  Day 1:  9:30AM-4:30PM, Day 2:  9AM-4PM 
Cost:  $350/ per person (for the 2 days total).   You may pay via PayPal invoice with PayPal, Credit or Debit Card, or our business Venmo account and also by check
Handouts:  Training Manuals will be provided as well. 
Location:  Sheraton Hotel By The Galleria (Conference Room)  Dallas, TX
4801 Lyndon B Johnson Fwy, Dallas, TX 75244
We will be posting a link in the near future, for a discounted rate for those of you wanting to reserve a hotel room at the Sheraton or you may ask when you call the hotel.  Please let them know you are attending a training in their conference room with Twogether Consulting as the presenters if you call. Hotel Ph:  (972) 661-3600    

Topics: Day 1
“Expectations of The Nurse”  Part I
-Intro To HCS & TxHmL Waivers
-Rules & Regs
-Roles & Responsibilities: RN Vs. LVN
-Developing The Nursing IP
-Health Status Monitoring, Updating Nursing Care Plan,
-Med Errors, Incident Reports, Delays In Service and F/U 
“Expectations of The Nurse” Part II
-RN Delegations & Other Determinations

Topics: Day 2
New Interpretive Guidance Booklet: Discussion of Survey Expectations Concerning Nursing
“Completion & Description of  The CNA: Form 8584” (RN’s)

Job Postings
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

Mark I Residential HCS

Mark Henson-CEO/Owner

Ph:  512-789-4079

Location:  Austin, Texas

Starting Pay:  $50,000

Position: Case Manager (Need immediately, approximately 20 client caseload/primarily
medically fragile individuals in Group Homes)

Job Qualifications:

Previous experience in case management working with individuals with intellectual and developmental disabilities, preferred, but will consider other experience with IDD services.  i.e.. HCS, TxHmL or ICF program or other DD programs. Degree in Social Services or Psychology required if you do not have experience. Must be comfortable working with individuals with high medical needs. Contact us for more information.

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 

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
Contact Meghan if you would like
to feature a job posting in our next newsletter!
Twogether Updates

May 30th, 2022 The May 31 HCBS ARPA Stakeholder Update webinar has been cancelled. HCBS providers will be notified once the webinar has been more

May 25th, 2022 Tip So a provider mentioned that it might be a good idea to just have a stamp made that says "ENTERED" on the top and underneath it the letters "DLN" with a box next to it to write in the DLN #. This way, every time someone enters their ID/RC's and IPC's,  into TMHP for renewal, revision, etc.. and then you click  "submit" you can write down the "DLN" on the document.  The provider will have to know what DLN # goes with which more

May 30th, 2022 LTC Online Portal Dashboard Accessibility Issue Resolved An accessibility issue with the Long-Term Care Online Portal Dashboard has been resolved. "I have received quite a few calls about this issue.  And unfortunately, that made it also very difficult to get a status on claims billed for many providers. So hopefully the issue is now truly resolved." From HHSC: "Home and Community-based Services and Texas Home Living waiver programs providers and local intellectual more

May 30th, 2022 Don't Forget! American Rescue Plan Act (ARPA) Home and Community-Based Services (HCBS) Provider Retention Payments Attestation and Initial Reporting Initial report is due by July 1, 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 more

May 30th, 2022 In Case You Don't Have Enough To Worry About..... HHSC Publishes Information on Preparing for Fee-for-Service Claims Billing Closeout IL 2022-31 IL 2022-31 (PDF) is posted to the HHS site. Just some thoughts: Understand, that this also might mean a period of time where regular payments will be delayed a few weeks, right when the fiscal year closeout occurs at end of August.  Hopefully not, but it has been an issue in past years with CARE. Please be sure to take care of more

May 30th, 2022 The extension for temporary policy for In-Home DH goes through June 30th, 2022 now.  COVID-19: HHSC Publishes In-Home Day Habilitation Information for Program Providers (IL 2022-32) IL 2022-32 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) more

May 30th, 2022 HHSC has revised HCS and TxHmL Survey Operations Transformation (PL 21-26) HHSC revised PL 2021-26 to reflect updates to the HCS or TxHmL Program Manager and Assistant Regional Director contact list. Read PL 2021-26 here.   September 5th, 2021 Now Called Billing Requirements Not Billing Guidelines!!!! HHSC Publishes Revision 21-3 of the HCS and TxHmL Program Billing Requirements and CFC Billing Requirements HHSC Publishes Revision 21-3 of the HCS and TxHmL Program more


May 30, 2022 COVID-19 Update to Temporary Change for Service Providers of Respite and CFC PAS/HAB In March 2020, HHSC implemented a temporary policy change for respite and Community First Choice Personal Assistance Services/Habilitation. This change allows service providers of respite and CFC PAS/HAB to live in the same home as the person receiving Home and Community-based Services or Texas Home Living program services. This change has given access to needed services for people living in more

May 30th, 2022 EVV Claims Matching for HCS and TxHmL Will Resume July 1 Electronic Visit Verification claims matching will resume for all Home and Community-based Services and Texas Home Living billing code combinations with dates of service of July 1, 2022 or after. HHSC will post another notice with more information and resources to avoid EVV claims mismatches before July 1, 2022. Email EVV Operations for questions about this notice. May 8th, 2022 EVV Portal and Training Updates more

May 29th, 2022 2022 Hurricane Season Emergency Preparedness with COVID-19 Long-term care providers in Texas are reminded to review their emergency preparedness and response plans before the Atlantic hurricane season begins, which runs June 1–Nov. 30. LTC providers should make updates, if necessary. Providers should factor in COVID-19 contingencies when reviewing their preparedness plans. For example, as applicable: Are your receiving facilities and transportation contracts still viable? more

May 23, 2022 Very Important! Please see information from TMHP below: Some Rejected Claims May Be Resubmitted Some Home and Community-based Services (HCS) and Texas Home Living (TxHmL) claims that were submitted to Texas Medicaid & Healthcare Partnership (TMHP) between May 2, 2022, and May 13, 2022, were rejected in error. HCS and TxHmL claims that were rejected with the following explanations of benefits (EOBs) may now be resubmitted for processing: Explanation of Benefits more

Upcoming Conferences 
Alternate text

Dismantling Systemic Barriers: Reenvisioning Equity and Inclusion

AAIDD has taken an innovative approach for this year's conference and will be holding one conference in two venues: in person and virtual. This will give you an opportunity to attend in-person (June 13-16), virtually (June 27-29), or both. 

Register Here

Reconnect with colleagues and friends at these networking events.

Don't forget to connect with speakers and colleagues in the live chat during the virtual component!


Student and Early Career Reception (Virtual) 
Tuesday, June 28
6:30 - 7:30 pm 


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!


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!

Helpful Resources
Texas Health and Human Services
Blue Gradient

Opportunity for Community Input on the 2022 Revised
Texas Promoting Independence Plan

HHSC Office of Disability Services Coordination (ODSC) is leading the development for the 2022 Revised Texas Promoting Independence Plan, as required by Senate Bill 367, 77th Legislature, Regular Session, 2011, and Executive Order RP-13. This transition aligns with ODSC’s cross-disability focus, value of stakeholder engagement, and mission to improve outcomes for people with disabilities through long-term solutions across the HHS system.

The vision is to develop a two-year strategic plan that capitalizes on the momentum from previous plans and focuses on a path that supports successful community living through targeted goals and prioritized strategies.

Community input is welcome on what targeted goals and prioritized strategies are important to include in the 2022 Texas Promoting Independence Plan. Email input to

ODSC is in the planning stage of hosting a summit in early August 2022 as another opportunity for community input. More details will be released once finalized.   

Email comments and questions to HHSC ODSC.

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ARPA Funding is Available for Staff Training

The 2021 American Rescue Plan Act (ARPA) has afforded states the opportunity to invest additional funding to address staff training and credentialing.  IntellectAbility is helping some providers with this process.

IntellectAbility offers a variety of training that may be appropriate for ARPA funding including Person-Centered Thinking Training and Services
The Fatal Five eLearn series, and additional eLearn courses.

Download Here

Download this free brochure to find out which Person-Centered Thinking tools and training are the best fit for your organization.

To find out more or receive a customized package of training services 

tailored to your organization's needs, please reach out to Grace at 

727-285-4764 or

The ARC's Disability Dispatch has some great articles and information this month, particularly concerning Waiver. HCS/TxHmL waivers. 
Please be sure to check it out, especially the following:

Disability Dispatch: Disability rights updates from The Arc of Texas
House Human Services Committee Testimony
Director of Public Policy & Advocacy, Ashley Ford submitted testimony to the House Human Services Committee on May 5, 2022. Her testimony provided recommendations on reducing interest lists and staffing shortages for waiver services.
Recommendations for reducing lists for waiver services included:
  • Expand Medicaid Buy-In
  • Implement TEFRA Option
  • Adjust TxHmL Eligibility
  • Bring Back In Home and Family Supports
  • Fund more HCBS
Recommendations for reducing associated staffing shortages included:
  • Allow Family Caregivers
  • Continue COVID-19 Flexibilities
  • Support Inflationary Adjustment
  • Elevate the Profession
Contact us:
Twogether Consulting
P.O. Box 90426 Austin, TX 78709

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