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Twogether Newsletter
Issue 5.17.22

Mental Health Awareness Month, which is in May, is designed to highlight the importance of taking care of your mental wellness. It’s also a great time to share valuable resources and learn where you can get mental health support.
Learn More...
May is also mobility awareness month!
It's a time to bring attention to the millions of Americans who live with mobility limitations, the challenges they face, and how we can all come together to help create a more accommodating and equitable society for all.
A Note From Julie
30th Annual Developmental Disabilities
Nurses Association (DDNA) Education Conference
May 20-23rd, 2022 

Join Dr. Craig Escude and Lorene Reagan RN, MS for a presentation on May 22, 2022 entitled "What You Can Do to Address Social Determinants of Health for People with IDD".  n addition, Dr. Escudé along with colleagues from the Institute for Exceptional Care will host a listening session to learn from participants about their educational experience relating to healthcare in people with IDD. The information gained here will be used to shape the future of IDD healthcare. 
  On Saturday, May 21, 2022 from 5-6pm, visit Dr. Escudé at the poster session to learn about a study illustrating the effectiveness of the Curriculum in IDD Healthcare eLearn course in improving clinical competency in healthcare providers and students.

Annual Association on Aging with Developmental
Disabilities (AADD) Conference 
May 23-24th, 2022 

Dr. Craig Escude will deliver a keynote presentation and a breakout session on Clinical Pearls in IDD Healthcare at the Aging and Developmental Disabilities Conference on May 24, 2022. This presentation highlights "Clinical Pearls", bits of clinically helpful information often gained from experiences or observation.

PACSTX Conference 
November 1st & 2nd, 2022

Location:  Embassy Suites By Hilton Conference Center & Spa
1001 E. McCarty Ln, San Marcus, Tx 78666

AAIDD Texas Chapter 46th Annual Convention  
November 15th-18th, 2022

Location:  Grand Galvez   
2024 Seawall Blvd, Galveston, TX 77550
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! read more...

Twogether Newsletter Sponsors

Your Weekly Tax Tip From:

Pegue-Dennis, CPA P.C.
Office 1: 469-708-4272
Withholding Review Required Now
Avoid tax surprises with a simple review
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Tip Category: Planning

With tax season in the rear view mirror, now is the time to take a hard look at your federal and/or state withholdings to ensure next year's tax bill does not surprise you.

A review is more important than ever

There are a number of tax code changes that will impact the amount of tax you pay next year. So much so, that if you do not forecast your tax obligation now, you may be in for a very unpleasant surprise. This is true because:

No more advance payments for the Child Tax Credit. The one year requirement of the IRS to pay out half of the Child Tax Credit in advance is no longer in place. So you will not only need to plan for this change, it will also impact your tax return.

Child Tax Credits are lower. In addition, the Child Tax Credit amount for each child is rolling back to the 2020 dollar amount of $2,000. This could mean as much as $1,600 in lower credits for each of your children.

Dependent care credits are lower. The dependent care credit is also lower in 2022. So if both you and your spouse work and have daycare expenses, you will need to forecast the impact of this on this year's tax obligation.

New 1099-K reporting may require estimated tax payments. The IRS will be receiving millions of new informational tax forms reporting activity from those using digital payment platforms. So for those reselling event tickets, using sites like eBay, Esty and Amazon, you will now need to account for all this income. It may now require quarterly estimated tax payments throughout the year.

Be aware of life events. In addition, a change in your situation could create the need to review your withholdings. It could be due to a job change, selling or buying a home, getting married or divorced, or having a birth or death in the family. Whatever the cause, be aware of the potential change and put a sharp pencil to revising your withholdings.

High inflation is impacting everything. Finally, consider the impact of inflation on your situation. This is especially important if you have a small business as higher costs of labor and supplies could dramatically impact your pending tax bill.

Calculating and making adjustments

Using the IRS calculator. The IRS has an online tool to help you calculate how much you will need to withhold. In order to get an accurate reading, you need to have a copy of your latest paycheck or last quarterly estimated tax filing (Form 1040 ES) and a copy of your last tax return.

The IRS tool is here: IRS Withholding Calculator

Simply follow the tool's instructions and compare the tool's recommendation to your current withholdings.

Get expert help if necessary. The IRS recently changed the way it calculates recommended withholdings. While the intent is well intended, many are confused by the change. It is always a good idea to call to review your situation if you have any doubts. But do it now, while there is plenty of time in the year to build the proper withholding amount.

File a new withholding form with your employer. Whether you're paying too much or too little, you can fix it by filling out a new W-4 form and giving it to your employer. If you're filing quarterly estimated taxes, you can adjust your next quarter's estimate in a similar way.

In a perfect tax world, you would not owe too much nor get too large of a refund. Think of overpayments as an interest-free loan the government borrowed from you. Conversely, a shortfall means writing a large check when you file your tax return. That's a surprise few of us want.

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

Please contact Meghan for more information!
Twogether Trainings

“Updating Infection Control Policies: Applying Guidance Updates For COVID-19 Mitigation, Visitation, & Expansion Rules-ICF/IID”

Date: May 31st, 2022

Time: 10:00 AM-12:00PM

Cost: $40

For:  Program Managers, Administrators,
Case Managers/Care Coordinators, Nursing Staff

Presenter:  Julie Blacklock

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!

Copy of Rules Updated 04/18/22


HHSC has issued enhanced COVID-19 emergency rules. The rules require additional actions by the ICF program providers to mitigate the spread of COVID-19. We will be discussing each of these changes and ways to address them in your facility if you have not done so already.  Don’t forget, if you need help with your infection control policies we would be glad to help.  You can contact us at:

Topics (Concerning COVID-19):

-Discussion of revised ICF COVID-19 Provider Response Mitigation Rules for ICFs/IID 

-(Changes to pages 12, 18, 19, 20, 27, 28, 29, 31, 33, 34, and 38 )

-Screening- Updates (Changes as of 4/6/22)

Reporting Requirements for Positive Cases of COVID-19  (Changes as of 4/6/22)

Visitation Rules in the Facility and Homes (Changes as of 4/8/22)

Infection Control Policies– Do you have them? Are you addressing COVID-19 concerns? Have you kept up with updates to policies as guidance has changed?)

-Facilities without a CLIA Waiver-Requesting Binax Rapid Tests

-Policy Samples
-Correction Options

and much more


To complete registration and for any additional information or to arrange
payment by check you must contact:

Meghan Jones at: 

You may contact Meghan by phone at: (361) 649-5104   

Mailing address for checks:  
Twogether Consulting  P.O. Box 90426 Austin, TX 78709

Job Postings

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 16, 2022

COVID-19 in Healthcare Relief Grants Senate Bill (SB) 8, 87th Legislature, 3rd Called Session, 2021, appropriates funding for the Health and Human Services Commission (HHSC) to issue awards to support Texas healthcare providers affected by the COVID-19 pandemic. These awards include funding for Rural Hospitals, Nursing Facilities, Assisted Living Facilities (ALFs), home health agencies (HHA), Intermediate Care Facilities for Individuals with Intellectual and Developmental Disabilities more

May 16, 2022

More Help Available For Persons Entering IPC's Into TMHP! More information about submitting and revising Individual Plans of Care is available in the Long-Term Care Online Portal User Guides for Home and Community-based Services and Texas Home Living Waiver Programs. These user guides are available for the following programs that submit IPC forms 3608 and 8582 in the Texas Medicaid and Healthcare Partnership LTC Online Portal: HCS and TxHmL providers. Local intellectual and more

May 15, 2022

For Previously Recorded Webinars & FAQ's May 5th, 2022 HCS and TxHmL FAQ Updates Available May 9 and May 23 The Home and Community-based Services and Texas Home Living Waiver Programs Frequently Asked Questions document has been updated. HCS-TxHmL-FAQ-TMHP-TexasMedConnect Read the full alert here. September 21st, 2021 Updated HCS and TxHmL COVID-19 FAQ  HHSC has more

May 15, 2022

May 15th, 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 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? If more


May 8, 2022

May 8th, 2022 HHSC Publishes Revision 22-1 of the HCS and TxHmL Program Billing Requirements, CFC Billing Requirements Revision 22-1 is effective May 2. All revisions are outlined in the Revision 22-1 Section of each document. The Billing Requirements are located on the Long-term Care Providers webpage and Handbooks webpage and are outlined below: Home and Community-based Services Program Billing Requirements (PDF) Texas Home Living Program Billing Requirements (PDF) Community First more

May 8, 2022

May 8th, 2022  HCS and TxHmL Must Submit Claims and Forms to TMHP Beginning May 2, 2022 Home and Community-based Services (HCS) providers, Texas Home Living (TxHmL) providers, local intellectual and developmental disability authorities (LIDDAs), and financial management services agencies (FMSAs) billing on behalf of Consumer Directed Services (CDS) employers must submit claims and forms to Texas Medicaid & Healthcare Partnership (TMHP) beginning May 2, 2022, for dates of service on more

May 8, 2022

COVID-19 Resources May 8th, 2022 May 5, 2022 MCS COVID-19 Stakeholder Information Session Thank you for your interest in listening to the May 5 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 additional questions, more


May 8, 2022

May 8th, 2022 EVV Portal and Training Updates Texas Medicaid and Healthcare Partnership updated the Electronic Visit Verification Portal and related training materials on April 29. Refer to the EVV Portal and Training Updates notice on TMHP’s EVV webpage for more information. Email TMHP EVV Operations with questions March 7th, 2022 EVV Notice for HCS/TxHmL Program Providers The migration of Home and Community-based Services (HCS) and Texas Home Living (TxHmL) forms and claims entry to more

Helpful Resources

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.
Disability Dispatch: Disability rights updates from The Arc of Texas
Welcome to our New Board of Directors Members
Join us in welcoming our newest Board of Directors members, Courtney Pugh, Janniece Sleigh, and Renee Lopez! These leaders bring unique and vast experience to our organization's mission of advocating for the human rights and self-determination of Texans with IDD. Learn more about our Board of Directors backgrounds and expertise by visiting our website.
A white graphic of a face mask against an orange background framed in off white. The text as the top reads RECEIVE THREE FREE MASKS. Below the graphic of the mask aparagraph of purple text highlighted in off white reads “The Arc of Texas wants to ensure equitable access to high-quality masks for all Texans with IDD.” The Arc of Texas logo is in the bottom right hand corner.
Mask Mail-out Program
To help ensure equitable access to high-quality masks and continue to help control the spread of COVID-19, The Arc of Texas is committed to sending Texans with IDD 3 N95 face coverings free by mail. If you are a Texan with IDD, or are connected to someone who might benefit from this program, please complete our survey to receive your masks.

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

Contact us:
Twogether Consulting
P.O. Box 90426 Austin, TX 78709

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