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We at Twogether Consulting want to wish you the best for the Holiday Season!

A new report from the journal Pediatrics encourages doctors to push kids with disabilities to take part in activities they like. The story is HERE.

ABLE December 2021 webinar image

Put a Texas ABLE Account on Your Holiday Wish List

Tis the season for giving, so why not put a Texas ABLE account on your holiday wish list? Learn more about the Texas Achieving a Better Life Experience (Texas ABLE®) Program, the state's tax-advantaged savings plan for eligible Texans with disabilities at our upcoming webinar on Dec. 8.

We’ll cover the basics of the Texas ABLE Program and provide answers to questions such as these: 

  • What are ABLE accounts?
  • What are the features and benefits of the Texas ABLE Program?
  • Who is eligible to open or be the beneficiary of a Texas ABLE account?
  • How can I use the money in a Texas ABLE account?
  • How do I open a Texas ABLE account?
  • How do I contribute and withdraw from a Texas ABLE account?

You’ll also learn details about how family and friends can use the eGift tool to contribute for holidays and other special occasions.

Register today.

If you have any questions regarding the webinar, please contact us at

For more information about the Texas ABLE Program, visit You also can contact one of our customer service team members at 844-489-2253 or by email. Customer service hours are Monday through Friday, 8 a.m. to 5 p.m. CT, excluding holidays.

Texas ABLE logo

The Texas ABLE® Program (“Program”) is administered by the Texas Prepaid Higher Education Tuition Board. Orion Advisor Solutions, Inc. is the program manager. The Program and the Board do not provide legal, financial, or tax advice and participants in the Program should consult a legal, financial, or tax advisor before investing. Fees and charges for the most recent quarter are available on our website at:

An account could lose money including the principal invested. No part of an account is a deposit or obligation of, or is guaranteed or insured by, the Board, the state of Texas, or any agency or agent thereof. Interests in the Program have not been registered with or approved by the SEC or any state. Investors should carefully consider the tax consequences, impact on benefit eligibility, Medicaid recapture, investment objectives, risks, fees, charges, and expenses associated with the Program. The Board may suspend, modify, or terminate the Program or change investment approaches, offerings, and/or underlying investment funds at any time and without the consent of account owners, authorized legal representatives, or beneficiaries. The Program Disclosure Statement and Participation Agreement contains this and other important information about the Plan and may be obtained by visiting or calling 844-4TX-ABLE (844-489-2253). Investors should read all Program documents carefully before investing. 

CARE Migration To TMHP HCS &TxHmL

iOL Portals - Create a custom face of your business, to suit your needs | Illusions Online

Very Important !!!!  HCS & TxHmL Providers:  Migration of CARE to TMHP

“Beginning March 1, 2022, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers, local intellectual developmental disability authority (LIDDA) agencies, and financial management services agencies (FMSAs) billing on behalf of consumer-directed services (CDS) employers will submit claims and forms to the Texas Medicaid & Healthcare Partnership (TMHP). It’s important that HCS and TxHmL program providers, LIDDAs, and FMSAs set up their accounts as soon as possible to avoid any delays in payment after March 1, 2022. Program providers, LIDDAs, and FMSAs are strongly encouraged to set up the following accounts if they have not already done so:
  • Claims Submission Account
    • TexMedConnect or
    • Electronic Data Interchange (EDI)
  • Long-term Care (LTC) Online Portal
  • TMHP Learning Management System (LMS)”

To read more, please click on the link below:  Don’t Delay!!!!

Your Weekly Tax Tip

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Postpone Taxes with a Like-Kind Exchange
The real estate boom creates opportunity
Tip Image
Tip Category: Miscellaneous
The tax law provides a valuable tax-saving opportunity to business owners and real estate investors who want to sell property and acquire similar property at about the same time. This tax break is known as a like-kind or tax-deferred exchange. By following certain rules, you can postpone some or all of the tax that would otherwise be due when you sell property at a gain.
The like-kind exchange rule
A like-kind exchange involves swapping assets that are similar in nature. Since the passage of the Tax Cuts and Jobs Act in December 2017, like-kind exchanges are now generally limited to exchanges of property. Typically, an equal swap of property is rare. Some amount of cash or debt must change hands between two parties to complete an exchange. Cash or other dissimilar property received in an exchange may be taxable.
Real estate exchanges
By using a like-kind exchange you can effectively leverage money you would need to pay for capital gains taxes and depreciation recapture tax into the next property. And with a real estate exchange, it is unusual to find two parties whose properties are suitable to each other. This isn’t a problem because the rules allow for three-party exchanges. Three-party exchanges require the use of an intermediary. The intermediary coordinates the paperwork and holds your sale proceeds until you find a replacement property. Then he forwards the money to your closing agent to complete the exchange.
Not for the faint of heart
The like-kind exchange rules are very strict. For this reason, it is always best to hire an expert to advise you prior to exploring this tax saving technique. But when done properly, exchanges let you trade up in value without owing tax on a sale. Even better, there’s no limit on the number of times you can exchange a piece of property.

Editor's Note

I received a note from Bankrate, a leading financial advisor. It brought up something that I feel could be a very common problem for people with special needs, and I think it should be looked at. Here is the note, and links.

About 1 in 4 adults in America have a physical or mental disability, which can result in financial instability and difficulty working. Our experts at Bankrate created a guide that informs readers on how to accumulate savings for people with disabilities. It includes:
  • How to save money without impacting benefit asset limits
  • Ways to ensure a financially secure future
  • Savings accounts for individuals with disabilities

Here is the link:

New Provider (HCS/TxHML) Training: “I Got My Contract, Now What Do I Do?” Part II @ WebinarDec 30 @ 9:30 am – 11:30 am

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

We have rescheduled this session from 12/14/21




Date: Dec. 30th, 2021              (Part I from Dec. 8th, 2021 is now available as a recording)

Time:  9:30 am-11:30am

Cost: $75/person

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,

-Putting Service Delivery Logs/Notes in place,

For More Info, Click HERE
“Nursing Documentation & Billable Services” (HCS/TxHmL) @ Webinar
Jan 10 @ 9:30 am – 12:00 pm



“Nursing Documentation & Billable Services”


(Short Version 2.5 hrs)


Date: January 10th, 2021

Time: 9:30 AM-12:00 PM

Cost:  $55 per person

Presenter:  Julie Blacklock/IDD Waiver Consultant & Guest RN

: For: Nurses, Medical Appt. Scheduler’s, Program Administrators, Program Directors, & other Medical Staff Applicable Programs: HCS & TXHmL



-Billing Definitions

-Billable Units in the CARE system

-Tracking My Billable Nursing Units (Utilization Monitoring:  Do I have enough?  Do I have too much?)

-What’s Billable

-What’s Not Billable

-What Do I Document? (Health Status Changes, F/U to medical appts., incidents, hospitalizations, illnesses, med. errors,  behavioral events, etc…)

**What Are Surveyors looking For vs. What Are Billing Auditors Looking For?

-Sample Narratives or Nursing Service Delivery Logs

 You will also receive a variety of Sample Forms you may need to utilize for Nursing/Medical in your program. Whether you are a brand new nurse, a seasoned HCS nurse, a Program Director, etc… there is something for everyone who attends! *All attendees will receive a manual with handouts, recommended forms, and resources.

For More Info, Click HERE

Julie's Updates 
(As seen on the Updates tab on


Dec 17, 2021

December 17th, 2021 The link doesn't inform providers about current information but will provide future information about ARPA funds, and will be available on the newly created HHSC Grants webpage. Press Release: Governor Abbott, HHSC Announce $128 Million To Support Staffing Needs At Rural Hospitals, Nursing Facilities | Office of the Texas Governor | Greg Abbott HHSC Grants Webpage: COVID-19 in Healthcare Relief Grants | Texas Health and Human Services According to the HHSC Provider Finance...

read more

Dec 17, 2021

Please go to for more information and registration. Click on  "the calendar" of the Webinar you want to attend.  ********We also have pre-recorded webinars you can purchase for use at your facility.  Please contact Meghan Jones at: for more information, registration, and payment.     December 2021 Expectations of The Nurse in HCS/TxHmL- Part II (Updated Version) HCS New Provider Training:  Now I Got My Contract, What Do I Do-Part...

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Dec 17, 2021

Our free webinar session recordings previously recorded are currently posted on our "Gotostage" page. Free Webinars!! January 2021 Free Webinar  “1099 Contractor Concerns” Presented by ADP Payroll & HR" Twogether Consulting is happy to have ADP Payroll & HR Services again as a resource for IDD providers in our free webinar series for the month of January 2022! Free Webinar Series Hosted By: Twogether Consulting...

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Dec 14, 2021

December 14th, 2021 Message from HHSC to the IDD SRAC Day Habilitation/Employment Services Subcommittee "We wanted to make all of you aware of some guidance released by HHSC Long-Term Care Regulatory (LTCR) on Friday, December 10th regarding the new Individualized Skills and Socialization service that will be replacing day habilitation.  As you may know, the 87th Legislature approved HHSC moving forward with recommendations contained in the Rider 21 report, Transition of Day Habilitation...

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Dec 14, 2021

December 14th, 2021 Very Important News! The due dates for the SB 809 Monthly COVID-19 Reports have changed. Previously the reports were due on the 15th of the month following the month which the report covered.  They are now due on the 1st of the second following month.  Example:  The report covering November is now due January 1, 2022 rather than December 15, 2021. See updated message on HHSC's webpage below. The initial report located here includes funding and cost data covering the period...

read more

Dec 12, 2021

December 12th, 2021 ISS (Individualized Skills and Socialization)   Changes to Day Habilitation (DH) programs are coming for HCS/TxHmL!  The link below contains a discussion concerning the implementation of a recommendation in the Rider 21 Report (General Appropriations Act for FY 2020-2021, 86th Session) related to the monitoring of DH programs which will transition to the provision of ISS. To view, the report go to: ...

read more

Dec 1, 2021

Dec. 1st, 2021 Judge Doughty, U.S. District Court, Western District of Louisiana, blocked enforcement of the CMS Interim Final Rule (which among other LTC programs, applies to ICFs/IID) regarding the vaccine mandate nationwide. Below are links to several articles regarding the ruling. Important Information: Links #1 and #3 provide access to the 32 page court ruling. Link #2 is an article about some Texas legislators calling for a 4th Special Session to enact legislation to ban the COVID-19...

read more


Participate as an Exhibitor at the 2022 Therap National Conference, February 1 – 2 – 3 | Register Now!

Join us for our Virtual Conference!

We warmly welcome all service providers from around the world to Therap's National Conference being held on February 1-2-3, 2022. This will provide you a great opportunity to network virtually and share valuable experiences. This event will include sessions on Therap modules ranging from beginner to advanced user level.

Sign Up Today!

Register Now

Guarantee your spot at the 2022 Therap National Conference for only $49.00! This pricing ends on January 7, 2022. There will be User Presentations, State Specific Discussions, How-to-Sessions of Therap modules and more.

Fall 2021 Registration Fee (Non-Refundable) will End on January 7, 2022

Visit our 2022 Therap National Conference Webpage

Questions? Contact us via email:

Judge upholds civil rights of Texas students with disabilities with ruling against Gov. Abbott’s mask-mandate ban

 November 22, 2021
 Summer Mandell

A federal judge earlier this month ruled that Gov. Greg Abbott’s executive order banning mask mandates for public schools violates Section 504 of the Americans with Disabilities Act (ADA) and barred Attorney General Ken Paxton from enforcing the executive order.

In August, 14 elementary school students with disabilities were plaintiffs in a federal lawsuit against Gov. Greg Abbott and TEA Commission Mike Morath filed by Disability Rights Texas. The lawsuit claimed the prohibition of mask mandates in public and charter schools violate the ADA.

The plaintiffs range in age from 7 to 11 and were ineligible to receive a COVID-19 vaccine at the time of the lawsuit filing. People with disabilities are at a higher risk of being infected with the virus and experiencing severe complications, even death. Masks are essential to lower their risk of getting sick from COVID-19, especially around other students in close, indoor settings like a school.

Students with disabilities have the right to access a free, appropriate public education because of Section 504 of the ADA, the federal law that prohibits discrimination against students with disabilities and applies to any agency, including a school district, which receives federal money.

One plaintiff in the lawsuit, eight-year-old J.R., has ADHD, a growth hormone deficiency, and moderate to severe asthma. Her mother worries that J.R., who needs in-person instruction to succeed in school, is at greater risk of serious illness, hospitalization, and even death if she gets the virus.

“Having to make a choice between my daughter’s education or her life—what kind of choice is that?” J.R.’s mother says. “My child has the right to an education and to be safe at school. I shouldn’t have to choose.”

In response to the lawsuit when filed this summer, a spokesperson for Gov. Abbott said Abbott cares about disabled students and, “Since his accident that left him paralyzed, the Governor has worked throughout his career to protect the rights of all those with disabilities in Texas.”

In his ruling on the lawsuit, U.S. District Judge Lee Yeakel sided with the students and their claim that the ban on mask mandates would impede their civil rights under the ADA. “Plaintiffs here are at higher risk of contracting COVID that their non-impaired peers. But because GA-38 precludes mask requirements in schools, Plaintiffs are either forced out of in-person learning altogether or must take on unnecessarily greater health and safety risks than their nondisabled peers. The evidence presented by Plaintiffs establishes that Plaintiffs are being denied the benefits of in-person learning on an equal basis as their peers without disabilities. The court concludes that GA-38 violates the ADA and Section 504.2.”

In response to the ruling, Paxton tweeted that “my agency is considering all legal avenues to challenge this decision.” At this time, no appeal has been filed.


We are pleased to announce Yusaf Sterling as the newest contact at ADP here to provide assistance for the specific needs of IDD Providers (HCS,TxHmL, ICF, etc...)  
Don't forget to mention us (Twogether Consulting) if you are interested in receiving services from ADP Payroll & HR Services, as there are discounts available!  
For instance,  Initial 2-3 months free!

ADP  has also provided Twogether Consulting and our clients some new information that many of you may be interested in hearing about, regarding the
 Summary of the Executive Order from President Biden and what it means to employers. 

Below is the ADP link that discusses how they are helping companies track all of what they are expected to put in place, based on the new vaccine mandate

Here is the link to PDF Handout as well:   ADP's Informational Handout About the Vaccine Mandate From President Biden.  

For more information contact 
Yusuf Sterling/ Assistant Regional Director-Central Texas at:  919-308-7521
Katie DeMayo/Comprehensive Services Consultant-Central Texas at: 724-205-4716

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!
Copyright © 2021 Twogether Consulting, Ltd., All rights reserved.

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