| funds associated with participation
during the reporting period in question have been recouped by HHSC,
or its designee, the vendor hold associated with the report will be
released.
(5) Provider-initiated amended Attendant Compensation
Reports and cost reports functioning as Attendant Compensation Reports.
Reports must be received before the date the provider is notified
of compliance with spending requirements for the report in question
in accordance with subsection (s) of this section.
(i) Report contents. Each Attendant Compensation Report
and cost report functioning as an Attendant Compensation Report will
include any information required by HHSC to implement this attendant
compensation rate enhancement.
(j) Completion of compensation reports. All Attendant
Compensation Reports and cost reports functioning as Attendant Compensation
Reports must be completed in accordance with the provisions of §§355.102
- 355.105 of this subchapter (relating to General Principles of Allowable
and Unallowable Costs; Specifications for Allowable and Unallowable
Costs; Revenues; and General Reporting and Documentation Requirements,
Methods, and Procedures) and may be reviewed or audited in accordance
with §355.106 of this subchapter (relating to Basic Objectives
and Criteria for Audit and Desk Review of Cost Reports). All Attendant
Compensation Reports and cost reports functioning as Attendant Compensation
Reports must be completed by preparers who have attended the required
cost report training for the applicable program under §355.102(d)
of this subchapter. For the ICF/IID program, cost reports functioning
as Attendant Compensation Reports must also be completed in accordance
with the provisions of §355.456 of this chapter (relating to
Reimbursement Methodology). For the HCS and TxHmL programs, cost reports
functioning as Attendant Compensation Reports must also be completed
in accordance with the provisions of §355.722 of this chapter
(relating to Reporting Costs by Home and Community-based Services
(HCS) and Texas Home Living (TxHmL) Providers).
(k) Enrollment. Providers choosing to participate in
the attendant compensation rate enhancement must submit to HHSC a
signed enrollment contract amendment as described in subsection (f)
of this section. Participation is determined separately for each program
specified in subsection (a) of this section, except that for providers
delivering both RC and CBA AL/RC services in the same facility, participation
includes both the RC and CBA AL/RC programs and for providers delivering
both HCS and TxHmL services, participation includes both the HCS and
TxHmL programs. For PHC, participation is also determined separately
for priority and nonpriority services. For ICF/IID, participation
is also determined separately for residential services and day habilitation
services. For HCS and TxHmL, participation is also determined separately
for the non-day habilitation services category and the day habilitation
services category as defined in subsection (f)(2)(B) of this section.
Participation will remain in effect, subject to availability of funds,
until the provider notifies HHSC, in accordance with subsection (x)
of this section, that it no longer wishes to participate or until
HHSC excludes the contract from participation for reasons outlined
in subsection (u) of this section. Contracts or component codes voluntarily
withdrawing from participation will have their participation end effective
with the date of withdrawal as determined by HHSC. Contracts or components
codes excluded from participation will have their participation end
effective on the date determined by HHSC.
(l) Determination of attendant compensation rate component
for nonparticipating contracts.
(1) For the PHC; DAHS; RC; CLASS--DSA; CBA--HCSS; DBMD;
and CBA--AL/RC programs, HHSC will calculate an attendant compensation
rate component for nonparticipating contracts as follows.
(A) Determine for each contract included in the cost
report database used in determination of rates in effect on September
1, 1999, the attendant compensation cost center from subsection (c)
of this section.
(B) Adjust the cost center data from subparagraph (A)
of this paragraph in order to account for inflation utilizing the
inflation factors used in the determination of the September 1, 1999
rates.
(C) For each contract included in the cost report database
used to determine rates in effect on September 1, 1999, divide the
result from subparagraph (B) of this paragraph by the corresponding
units of service. Provider projected costs per unit of service are
rank-ordered from low to high, along with the provider's corresponding
units of service. For DAHS, the median cost per unit of service is
selected. For all other programs, the units of service are summed
until the median unit of service is reached. The corresponding projected
cost per unit of service is the weighted median cost component. The
result is multiplied by 1.044 for PHC, CLASS--DSA, CBA--HCSS, and
DBMD; and by 1.07 for RC, CBA--AL/RC, and DAHS. The result is the
attendant compensation rate component for nonparticipating contracts.
(D) The attendant compensation rate component for nonparticipating
contracts will remain constant over time, except in the case of increases
to the attendant compensation rate component for nonparticipating
contracts explicitly mandated by the Texas legislature and for adjustments
necessitated by increases in the minimum wage. Adjustments necessitated
by increases in the minimum wage are limited to ensuring that these
rates are adequate to cover mandated minimum wage levels.
(2) For ICF/IID DH, ICF/IID residential services, HCS
SL/RSS, HCS DH, HCS SHL/CFC PAS HAB, HCS respite, HCS supported employment,
HCS employment assistance, TxHmL DH, TxHmL CSS and CFC PAS HAB, TxHmL
respite, TxHmL supported employment, and TxHmL employment assistance,
for each level of need (LON), HHSC will calculate an attendant compensation
rate component for nonparticipating contracts for each service as
follows:
(A) For each service, for each LON, determine the percent
of the fully-funded model rate in effect on August 31, 2010 for that
service accruing from attendants. For ICF/IID, the fully-funded model
is the model as calculated under §355.456(d) of this chapter
(relating to Reimbursement Methodology) before any adjustments made
in accordance with §355.101 of this subchapter (relating to Introduction)
and §355.109 of this subchapter (relating to Adjusting Reimbursement
When New Legislation, Regulations, or Economic Factors Affect Costs).
For HCS and TxHmL, the fully-funded model is the model as calculated
under §355.723(d) of this chapter (relating to Reimbursement
Methodology for Home and Community-based Services and Texas Home Living
Programs) before any adjustments made in accordance with §355.101
and §355.109 of this subchapter for the rate period.
(B) For each service, for each LON, multiply the percent
of the fully-funded model rate in effect on August 31, 2010 for that
service accruing from attendants from subparagraph (A) of this paragraph
by the total adopted reimbursement rate for that service in effect
on August 31, 2010. Effective September 1, 2019, the result is multiplied
by 1.044 for HCS SHL/CFC PAS HAB, HCS respite, HCS supported employment,
HCS employment assistance, TxHmL CSS and CFC/PAS HAB, TxHmL respite,
TxHmL supported employment, and TxHmL employment assistance and by
1.07 for HCS SL/RSS, HCS DH, TxHmL DH and ICF Residential and ICF
DH. The result is the attendant compensation rate component for that
service for nonparticipating contracts.
(C) The attendant compensation rate component for nonparticipating
contracts will remain constant over time, except in the case of increases
to the attendant compensation rate component for nonparticipating
contracts explicitly mandated by the Texas legislature; and for adjustments
necessitated by increases in the minimum wage. Adjustments necessitated
by increases in the minimum wage are limited to ensuring that these
rates are adequate to cover mandated minimum wage levels.
(D) Effective July 1, 2017, the attendant compensation
rate component for nonparticipating contracts for HCS SHL/CFC PAS
HAB and TxHmL CSS and CFC PAS HAB is equal to $14.52 per hour.
(E) Effective September 1, 2019, the attendant compensation
rate component for nonparticipating contracts for HCS SHL/CFC PAS
HAB is calculated using cost data from the most recently audited cost
report multiplied by 1.044.
(F) Effective January 1, 2020, the attendant compensation
rate component for nonparticipating contracts for HCS SL/RSS is calculated
using cost data from the most recently audited cost report multiplied
by 1.07.
(3) Effective upon service claims being made billable
through the Texas Medicaid & Healthcare Partnership, HHSC will
calculate an attendant compensation rate component for nonparticipating
contracts for each of the following services per subparagraphs (A)
and (B) of this paragraph: HCS in-home DH, HCS out-of-home DH, HCS
in-home respite (HCS IHR), HCS out-of-home respite (HCS OHR) in a
respite facility, HCS OHR in a setting where HCS SL/RSS is provided,
HCS OHR in a setting where host home (HH)/companion care (CC) services
are provided, HCS OHR in a camp, HCS OHR in a DH Cont'd... |
