CARE Basics for the HCS and TxHmL Interest Lists

CARE Basics for the HCS and TxHmL Interest Lists

CARE Basics for the HCS and TxHmL Interest Lists

Texas Health and Human Services

10/26/2016

Welcome!

Welcome to the Client Assignment and Registration System (CARE) Basics for the Home and Community Services (HCS) and Texas Home Living TxHmL Interest Lists training.

In this training, you will learn how to add or delete information to existing CARE consumers who are on the HCS and TxHmL interest lists. These interest lists enable Health and Human Services (HHS) to offer HCS and TxHmL as resources become available.

Local intellectual and developmental disability authority (LIDDA) staff also conduct biennial contacts with primary correspondents for each individual whose name is on its HCS or TxHmL interest list to ensure the primary correspondent's contact information is current and the individual remains interested in the HCS and TxHmL programs.

Navigation Tips

Before we get started, please review the following navigation tips:

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On each page throughout the training you will find a drop down "contents" menu on the left hand side of your screen. You may proceed directly to any section by clicking on the appropriate section title in the table of contents drop-down in the upper left of your screen. At the top and bottom of each page you will see options to "return to top," "previous page" and "next page". Selecting "return to top" will take you to the top of the current screen. "Previous page" will take you to the previous page. "Next page" will take you to the next page in the training.

Please select words or links underlined and in dark blue text to open helpful resources.

Please note that you will need to scroll down to access content on some pages in this training.

At the end of the course you will find a test which will cover what you've learned in the course. You must score 80% on the test in order to print the certificate of completion.

Tips for Taking WBTs

To maximize the benefit you receive from participating in this WBT, please consider each of the following tips:

Protected time is critical to ensuring your success in taking a WBT. Therefore, let colleagues know you are taking the WBT. Close the door or put up a sign requesting that you not be disturbed.

Set aside approximately one hour to work on the course. During that time, forward your telephone if possible, and turn off your cell phone.

Sitting at your computer for even an hour without breaks can cause fatigue and eyestrain. Therefore, try to take a short stretch break at least every 15 minutes.

You may exit the course at any time by clicking on the "X" button; however, if you exit the course, your progress will not be saved and you will have to find the page where you left off or start over. You are not able to start where you left off if you exit the course.

Objectives

This course was designed to provide a basic overview of the CARE database for the HCS and TxHmL Interest Lists.The computerized interest list information is collected and managed using the CARE system.

After the completion of this course, you will be able to:

recognize the Questionnaire for HCS/TxHmL interest lists (Form 8577);

identify if an individual already exists on the interest list and avoid duplication;

create and data enter an individual's personal information to the CARE system; and

change/transfer and remove an individual from the HCS/TxHmL interest list.

Accessing CARE

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Your LIDDA will have either an IT administrator or other designated person to help you obtain the appropriate level of CARE access. LIDDA staff must complete the following HHS Enterprise Application Access Request forms:

Client Assignment & Registration System (CARE) Access Request Form (Form IS030)

DADS Waiver Programs Local Authority Access Request Form (Form IS090M)

Computer Use Agreement (Form HR0314)

These forms are mailed to:

HHS Enterprise Security Management - Texas Health and Human Services Commission

701 W. 51st Street, C720

Austin, Texas 78751

LIDDA staff can contact Field Support at 1 (888) 952-4357 if they have questions about completing the forms and obtaining CARE access. HHS IT will notify LIDDA staff when their access has been approved and will be given a CARE User ID.

LIDDA staff log into CARE by entering their User ID and password.The image below shows the CARE Log-on Screen.

Decode Tables

The tables in this document are used to obtain codes and decode values used in the CARE system. Click the following link to view the decode tables in a separate page.

CARE Decode Tables

http://www2.mhmr.state.tx.us/655/CIS/Training/CAREguide.html

Registering an Individual in CARE

Registering an individual in CARE generates a CARE ID for the individual. This can be done several ways:

Registering using CARE Screen 325

Batching into CARE from a LIDDA's local system (This is the method most LIDDAs use today.)

Registering through WebCARE

Note: Ensure the individual's date of birth is accurate. An estimate of the date of birth is NOT acceptable.

CARE Screen 325: Register Client: Client ID

Matching Client Characteristics

If the data entered in CARE screen 325 matches an individual already registered in CARE, then a screen (seen below) is displayed that shows the match and allows the LIDDA to:

add the individual's information to their already existing CARE ID number.

Correspondent Data

The last registration screen in 325 (seen below) is displayed to enter correspondent information and other fields.

Purpose of the HCS and TxHmL Interest Lists

The HCS and TxHmL interest lists collect data about individuals who request to be on the HCS and TxHmL interest lists.

Additionally, these interest lists enable HHS to offer those individuals HCS and TxHmL services as resources become available on a first come, first served basis.

Each LIDDA maintains the HCS and TxHmL interest lists for its local service area. HHS maintains the statewide HCS and TxHmL interest lists, which are compiled from every LIDDA's interest lists.

Interest List Process

Documenting and Maintaining a Record of an Individual's Preferences for Services and Supports

Upon a request for services, the LIDDA provides the Explanation of Intellectual and Developmental Disability Services and Supports document and invites the individual, legally authorized representative (LAR), or family member (i.e., primary correspondent) to identify their preferences.

The LIDDA documents the individual's service preferences using the Identification of Preferences (Form 8648). A LIDDA must then take appropriate action in response to the preferences identified.

Adding an Individual to the HCS and/or TxHmL Interest List

If the primary correspondent requests HCS or TxHmL services or identifies HCS or TxHmL Program services as a preference on the Identification of Preferences form, the LIDDA will:

complete the Questionnaire for HCS/CLASS Interest Lists (Form 8577) and enter the form's data into CARE screen W27, unless the LIDDA determines from the CARE record that the form has already been completed and;

add the individual's name on the interest list for HCS and/or TxHmL as applicable in CARE screen W21.

Individual with Two or More Interest List Records

If one individual has two or more interest list records because of multiple CARE ID numbers, the LIDDA must contact CARE Field Support (1-888-952-4357) and request the CARE ID records be merged into one. The LIDDA must ensure the individual's earliest HCS and/or TxHmL interest list "begin date" is retained in the merged record.

Begin Date for HCS or TxHmL

The HCS or TxHmL interest list "begin date" is the date the primary correspondent requested or chose HCS or TxHmL.

This date is the "Date of Discussion" on the Identification of Preferences form.

For HCS only:

For an individual under 22 years of age living in an Intermediate Care Facility (community or state supported living center (SSLC)), the individual's name is automatically added to the HCS interest list by CARE with the ICF admittance date as the "begin date," unless the individual's name had already been added to the HCS interest list before admittance to the ICF program.

For an individual under 22 years of age living in a Nursing Facility (NF) who may have an intellectual or developmental disability, the individual's name is added by CARE Field Support to the HCS interest list with the NF admittance date as the "begin date," unless the individual's name had already been added to the HCS interest list before admittance to the NF.

Questionnaire for HHS HCS/CLASS Interest Lists

The Questionnaire for HHS HCS/CLASS Interest Lists (Form 8577), also referred to as the "Travis Questionnaire", is used when interviewing an individual, LAR, or family member who has requested that the individual to be registered on the HCS interest list. LIDDA staff use the completed form to enter the information in CARE.

The Travis Questionnaire entry screens W27 are used to enter a questionnaire record in CARE if a record does not exist. If an individual is already registered on the HCS interest list and has; therefore, previously completed the questionnaire, then the error message, "12416 - Travis Questionnaire Already On File" will display.

Process for CARE Interest List Record - Add/Change/Transfer/Delete

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Adding an Initial Interest Record

1. When creating the initial interest list record for an individual, the basic identifying information is entered in the CARE W21 screen.

2. The basic identifying information must include a Texas address for the individual. A primary correspondent is not required to have a Texas address. The individual must reside in Texas to be registered on the HCS or TxHmL interest list, unless the individual and family have moved out of Texas due to active military service.

3. Although the individual's date of birth is not entered in the CARE W21 screen, the LIDDA must ensure that the individual's date of birth is accurate in CARE Screen 325. It may NOT be an estimated date of birth.

4. Enter "HCS" and/or "TXHL," as applicable, in the Service Type field, with the "Date of Discussion" on the Identification of Preferences form being entered in the Date Begin field and the Status Date field. A "1" is entered in the Status field to indicate "interested."

5. Using the CARE W21 form, the LIDDA must also enter information that relates to the individual's current living arrangement and how soon services and supports are desired.

If the individual is living at home, additional information is required relating to the age of the main caregiver (estimates are acceptable) and whether a move out of the home will be required within one year. The response codes for these questions are provided on the CARE W21 form.

For HCS only: There are two additional questions on the CARE W21 form related to "Preferred HCS Living" that ask if the individual is interested in Foster Companion Care (i.e., Host Home/Companion Care) or an HCS Group Home. These require an answer of "Y" or "N" for yes or no.

Individuals Under 22 years of Age Being Admitted into an ICF or Nursing Facility (For HCS Only)

If the individual is under 22 years of age being admitted into an ICF or NF, the LIDDA must inform the LAR that state statute requires the individual's name to be on the HCS interest list. The LIDDA must also give the LAR the option of declining the biennial contact. That information is then entered on the CARE W21 screen in the Yes/No box following the question "Biennial contact declined?" If the LAR answers "yes" to decline a biennial contact, then the LIDDA does not conduct a biennial contact with the LAR.

Note: CARE allows a LIDDA to post or correct a date on an HCS interest list record to a date that is between the current date and 75 days prior to the current date. This action is referred to as "backdating." Attachment J of the Performance Contract provides instructions for requesting HHS to backdate an HCS or TxHmL begin date earlier than 75 days.

Let's Review

Before continuing to the next page, please complete the following learning check. To begin the learning check, click on the title below, and then scroll down to complete each question.

Learning Check 1

When to Change the Status of an Individual's HCS or TxHmL Interest List Record

Once an individual is registered with a Status 1 (Interested), the LIDDA does not change the status unless one of the following occurs:

The primary correspondent voluntarily withdraws the individual's name from the HCS or TxHmL interest list - change to Status 5. (Note:This request must be in writing and signed by the primary correspondent);

the primary correspondent cannot be located or does not respond during the LIDDA's biennial contact and the individual's family is not temporarily out of state due to active military service - change to Status 6;

the individual declines an offer, dies, military family; or

the individual or LAR moves to the local service area of another LIDDA - change to Status 9.

When to Transfer an Individual's Interest List Record

When a LIDDA is informed that an individual with a Status 1 (Interested) or Status 2 (Pending) on the HCS or TxHmL interest list is moving or has moved to another LIDDA's service area, then the transferring LIDDA:

changes the individual's county of residence in CARE (screen 440) as appropriate;

contacts the receiving LIDDA about the transfer and faxes or securely emails a copy of all of the individual's completed Identification of Preferences forms to the receiving LIDDA; and

transfers the individual's interest list record (CARE W21) by changing the Status to "9."

The receiving LIDDA must maintain a hard copy or an electronic copy of all of the individual's completed Identification of Preferences forms sent by the transferring LIDDA in accordance with the retention requirements described in this manual. A Status 9 and a new status date are automatically assigned by the CARE system. An individual's begin date for HCS or TxHmL does not change when the individual's interest list record is transferred to another LIDDA.

When to Delete an Individual's Name from the HCS or TxHmL Interest List

A LIDDA removes an individual's name from the HCS or TxHmL interest list if the request is in writing, signed and dated by the primary correspondent. The LIDDA may provide a new Identification of Preferences (Form 8648) for the primary correspondent to complete.

The primary correspondent:

checks the box indicating that they want the individual's name to be removed from the HCS or TxHmL interest list; and

signs and dates the form.

If the primary correspondent requests, in writing, that an individual's name be removed from the HCS or TxHmL interest list or completes and signs the Identification of Preferences (Form 8648) indicating that they want the individual's name to be removed from the HCS or TxHmL interest list, the LIDDA will remove the individual's name from the appropriate interest list by entering a Status "5" and a Status Date that is the date the form or request was signed. The LIDDA must maintain indefinitely a hard copy or an electronic copy of the written request or new Identification of Preferences (Form 8648) indicating the individual's name be removed from the HCS or TxHmL interest list.

Biennial Contact

The LIDDA is required to make at least one contact with the primary correspondent for each individual whose name is on its HCS and/or TxHmL interest lists with a Status 1 (Interested). This contact is required to verify and update the information posted on the CARE W21 screen and must be completeted during the biennium term of the current LIDDA Performance Contract. The contact is also required to verify and update the primary correspondent's contact information.

There is one exception for the biennial contact: individuals under 22 years of age receiving services in an ICF or nursing facility whose LARs do not want a biennial contact. Since state statute requires the individual's name to be on the HCS interest list, HHS provides the LARs of these individuals with the option of declining the biennial contact. That information is then entered on the CARE W21 screen in the Yes/No box following the question "Biennial contact declined?" If the LAR answers "yes" to decline the biennial contact, then the LIDDA does not conduct a biennial contact with the LAR.

Preparation for Contact

The LIDDA must ensure the individual's record contains documentation supporting the primary contact's request that the individual's name be added to the HCS and/or TxHmL interest list or an explanation of why the documentation does not exist (e.g., the individual's name was added to the HCS interest list automatically when the individual was under 22 years and residing in an institutional setting or another LIDDA has the documentation because the other LIDDA registered the individual on the interest list).

Efforts for Contacting the Primary Correspondent

Telephone or face-to-face contact with the primary correspondent is preferable.

If an individual whose name is on the HCS and/or TxHmL interest list is currently receiving some services or supports through the LIDDA, the biennial contact with the primary correspondent could be conducted face-to-face at the service site.

For individuals not currently receiving services or supports, a combination of telephone and mail contacts might be necessary in order to arrange for a discussion for the biennial contact.

Note: If the individual's family has temporarily moved out of Texas due to active military service, and the individual's family wants the individual's name to remain on the interest list, the family must provide non-Texas contact information to enable the LIDDA to make the biennial contact.

The following steps may be helpful in finding an individual or primary correspondent who has been difficult to locate:

Check CARE screens 192 and 193, which provide Medicaid Recipient Information, including the address used to mail the Medicaid card (which is under "DHS Case Address").

Check CARE screen 397, which provides the individual's address as well as that of possible contact persons, along with open assignments.

Check the Community Service Interest List (CSIL) system, which contains contact information for individuals on HHS other Medicaid waiver interest lists.

If the individual resides in an ICF or NF, call the ICF or NF and request the name of the LAR's address and phone number.

If the individual is receiving LIDDA community services and supports, contact the service coordinator or the individual directly.

Let's Review

Before continuing to the next page, please complete the following learning check. To begin the learning check, click on the title below, and then scroll down to complete each question.

Learning Check 2

Documenting the Discussion

The biennial contact must include a confirmation of the primary correspondent's continued interest of HCS services, and TxHmL services if applicable, for the individual. Contact information for the primary correspondent must be verified or updated as well. The LIDDA must inform the primary correspondent that it is the primary correspondent's responsibility to notify the LIDDA of any contact information changes.

The LIDDA must gather the information indicated on the CARE W21 form in the section titled "Required Reporting for MR." The information relates to the individual's current living arrangement and how soon services and supports are desired. If the individual is living at home, additional information is required relating to the age of the main caregiver (estimates are acceptable) and whether a move out of the home will be required within one year.

For HCS only: There are two additional questions related to "Preferred HCS Living" that ask if the individual is interested in Host Home/Companion Care or an HCS Group Home. These require an answer of "yes" or "no." The date of the discussion is considered the "Biennial Contact Date."

The LIDDA must document the discussion by including written information in the individual's hard copy file or record that contact was made and that continued interest in HCS services, and TxHmL if applicable, was discussed.

Entering Information into CARE

The LIDDA must enter into CARE screen W21 the "Biennial Contact Date" along with pertinent information gathered during the discussion (e.g., updated contact information).

IMPORTANT: The status date does not change unless the status changes.

For individuals residing in an ICF or NF whose primary correspondent cannot be located

For an individual residing in an ICF or NF, if all of the above methods to contact the Primary Correspondent are unsuccessful, then the LIDDA should confirm that the individual continues to reside in the ICF or NF. The LIDDA should not change the Status 1 assignment. The individual's name must remain active on the interest list until HCS or TxHmL is actually offered.

Having documented the steps listed to reach the primary correspondent can suffice as a biennial contact. The date in CARE for the biennial contact is the date the LIDDA determined it was unable to contact the primary correspondent. The same steps as described in Efforts for Contacting the Primary Correspondent should occur in each biennium in order to contact the primary correspondent.

Unable to Contact Primary Correspondent

If efforts for contacting the primary correspondent do not result in a contact between the LIDDA and the primary correspondent or individual, then the LIDDA must document the steps taken to reach the primary correspondent and change the individual's HCS and TxHmL interest lists status to a Status 6 (Inactive) in the status field. The date in CARE for the biennial contact is the date the LIDDA changed the individual's Status 1 to Status 6.

The LIDDA must mail a letter to the primary correspondent at the last known address notifying him or her that the individual's status on the HCS interest list, and TxHmL interest list if applicable, has been changed to inactive unless the primary correspondent responds to the letter within 30 days. (A template of the letter is attached at Exhibit A in the HCS and TxHmL Interest Lists Manual.) The date on the letter must be the same date as the status date for the Status 6.

If the LIDDA receives a response from the primary correspondent, the LIDDA will revise the individual's HCS and TxHmL interest list record as appropriate to the primary correspondent's response (e.g., change the Status 6 to a Status 1; update the primary correspondent's contact information). The LIDDA will also update the biennial contact date to be the date the LIDDA received a response from the primary correspondent.

If the LIDDA does not receive a response from the primary correspondent, the individual's status remains a Status 6 (Inactive) until the individual is offered HCS or TxHmL services. If the primary correspondent contacts an LIDDA before the individual is offered HCS or TxHmL services to inquire about the individual's status on the interest list, the LIDDA will explain why the LIDDA changed the individual's status to a Status 6. If the primary correspondent wants the individual's status to be changed to a Status 1 because he/she wants to receive an annual contact, the LIDDA will change the individual's HCS or TxHmL interest list status to a Status 1.

Resources

CARE User Guides (LIDDA, HCS, TxHmL, Consumer Directed Services Agency (CDSA))

http://www2.mhmr.state.tx.us/655/cis/training/waiver.html

CARE Decode Tables

http://www2.mhmr.state.tx.us/655/CIS/Training/CAREguide.html

HCS/ TxHmL Interest List Manual

http://www.dads.state.tx.us/handbooks/lidda/InterestListManual/index.htm

LIDDA Performance Contract

https://www.dads.state.tx.us/providers/LA/perform_contracts/index.html

Final Quiz

Congratulations! You have completed the CARE Basics for the HCS and TxHmL Interest Lists training.

To complete the final quiz, open the quiz by selecting the "Final Quiz" title below, and scroll down to complete each question. Once you have successfully completed the final quiz with a score of at least 80%, please enter your name in the provided text field, print your certificate of completion, and save it for documentation purposes. If you score less than 80%, please select "retry" and retake the quiz until you score 80% or higher.

Final Quiz