From the Office of the Governor, Greg Abbott
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Governor Abbott Surges Additional COVID-19 Resources To El Paso. Governor Greg Abbott today announced that the Texas Department of State Health Services (DSHS) and the Texas Division of Emergency Management (TDEM) are surging additional medical personnel and equipment to the El Paso region to assist with the community's COVID-19 response. DSHS is deploying over 460 medical personnel to the region this week, and the agencies are sending a Texas Emergency Medical Task Force ambulance bus, medical incident support team, five ambulances, and mobile medical unit to assist first responders. DSHS is also deploying 48 patient monitors, 25 medical beds, and 30 oxygen concentrators to support area hospitals.
These resources build upon the medical personnel and personal protective equipment (PPE) previously deployed by TDEM and DSHS last week, more than doubling the number of personnel on the ground in El Paso to help care for COVID-19 patients.
TDEM has provided millions of pieces of PPE to support El Paso’s COVID-19 response. Currently, El Paso’s emergency response warehouses are stocked with over 4.8 million masks, over 629,000 gowns and coveralls, over 400,000 gloves, over 38,000 face shields, and additional PPE that has been provided by TDEM.
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Department of State Health Services
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COVID-19 Case Count. The Texas Department of State Health Services (DSHS) is working closely with the Centers for Disease Control and Prevention (CDC) in responding to the new coronavirus disease 2019 (COVID‑19) that is causing an outbreak of respiratory illness worldwide. State case counts can be found by accessing the DSHS COVID-19 Dashboard.
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1 older cases recently reported by labs were included in the statewide total but excluded from statewide and Dallas County new confirmed cases (522).
104 older cases recently reported by labs were included in the statewide total but excluded from statewide and El Paso County new confirmed cases (1,161).
10 older cases recently reported by labs were included in the statewide total but excluded from statewide and Franklin County new confirmed cases (7).
9 older cases recently reported by labs were included in the statewide total but excluded from statewide and Galveston County new confirmed cases (41).
206 older cases recently reported by labs were included in the statewide total but excluded from statewide and Harris County new confirmed cases (637).
2 older cases recently reported by labs were included in the statewide total but excluded from statewide and Hopkins County new confirmed cases (1).
1 older cases recently reported by labs were included in the statewide total but excluded from statewide and Nacogdoches County new confirmed cases (9).
41 older cases recently reported by labs were included in the statewide total but excluded from statewide and Walker County new confirmed cases (11).
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Multisystem Inflammatory Syndrome in Children (MIS-C) – Oct. 19, 2020. DSHS has confirmed 51 cases of Multisystem Inflammatory Syndrome in Children. MIS-C is a rare but serious complication associated with COVID-19. The condition causes different body parts to become inflamed, including the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs. Children with MIS-C may have fever and various symptoms, including abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extra tired. The cause of MIS-C has not been determined. However, many children with MIS-C had the virus that causes COVID-19 or had been around someone with COVID-19.
Parents and caregivers should contact their child's health care provider if a child shows symptoms of MIS-C. Providers should report suspected cases to their public health department.
While the cause of MIS-C has not been identified, the best way to protect your children against the condition is to take precautions to prevent anyone in your household from getting COVID-19.
MIS-C at a glance:
- Age range: 9 months-18 years old (median: 9 years old)
- Sex: 30 Male (59%), 21 Female (41%)
- Race/Ethnicity: 27 Hispanic (53%), 17 Black (33%), 4 White (8%), 1 Asian (2%), 2 Unknown (4%)
- Onset date range (fever): 4/22/20 – 10/06/20
- Hospital and ICU admission: 51 Hospitalized (100%), 40 ICU admission (78%)
- Outcome: 48 Discharged (94%), 1 Died (2%), 2 Still hospitalized (4%)
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Public Health Region |
Number of Cases |
1 (Panhandle) |
1 |
2/3 (North Texas) |
22 |
4/5N (East Texas) |
2 |
6/5S (Southeast Texas) |
8 |
7 (Central Texas) |
12 |
8 (South Texas) |
6 |
Total |
51 |
Multisystem Inflammatory Syndrome in Children (MIS-C) |
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Health and Human Services Commission
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HHSC Publishes Reporting Guidance for Long-Term Care Providers – Point-of-Care Antigen Testing (PL 20-46). HHSC has published Provider Letter 20-46 Reporting Guidance for Long-Term Care Providers – Point-of-Care Antigen Testing (PDF) for nursing facilities and assisted living facilities.
The provider letter outlines responsibilities related to reporting COVID-19 test results for providers conducting point-of-care antigen tests within their facilities. This letter is not intended for use by providers who do not conduct COVID-19 POC tests within their facility. Providers who do not conduct COVID-19 POC tests within their facility may refer to PL 20-37.
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Managing the COVID-19 Crisis in Surging Areas - Webinars for ALF Providers. This webinar will emphasize the importance of identifying the root cause of COVID-19 spread in a facility. Useful examples and tips that can be used in response to the pandemic will also be shared.
The purpose of this webinar is to:
- Inform and prepare assisted living facilities in a specific area of Texas where COVID-19 is surging
- Review area specific data, and community and area resources
- Highlight specifics of the Assisted Living Facility COVID-19 Response Plan
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HHSC 2020 COVID-19 Impact Survey - Your Participation Matters. As a contracted provider of services for the Texas Health and Human Services Commission, the duties and responsibilities of your organization are vital to the health and safety of the Texans we serve, especially during the ongoing global pandemic. HHSC understands the global pandemic is affecting providers in many ways, including impacts to revenues received, costs incurred and provider utilization. To fully assess all the impacts of the pandemic on HHSC providers, we request you complete an upcoming survey that will inform our agency of the financial, utilization and process impacts to your organization due to COVID-19. All survey responses will remain anonymous.
By taking this survey, you will help HHSC develop policies and secure funding that aims to mitigate the short-term and long-term impact of COVID-19 on providers.
On Oct. 26 your organization will receive an email that will include a link to the online survey.
We encourage you to forward these communications to the appropriate person or persons in your organization familiar with the financial and utilization information for your billing provider (as defined by NPI/TPI), so they can respond to this survey.
Your participation is voluntary and valued. We look forward to your feedback. Please contact HHSC Rate Analysis for questions about the survey.
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COVID-19 Update to Temporary Change in HCS and TxHmL Policy for Service Providers of Respite and CFC PAS/HAB. HHSC is lifting the prohibition on service providers of respite and CFC PAS/HAB from living in the same home as the person receiving Home and Community-based Services and Texas Home Living program services. This will provide access to needed services for people living in their own or family’s home. A person’s spouse or a minor child’s parent is still prohibited from being a paid service provider of these services due to prohibition guidelines found in the following:
This is a temporary policy change. It is effective March 27, 2020 through Nov. 30, 2020.
Program providers must complete the required background checks for all service providers. They must follow:
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COVID-19 Update to Telehealth Guidance on CLASS Professional and Specialized Therapies. The following CLASS professional and specialized therapy services are available by telehealth.
This is effective Mar. 15 through Nov. 30, 2020.
- Physical therapy
- Occupational therapy
- Speech and language pathology
- Recreational therapy
- Music therapy
- Behavior support
- Dietary services
- Cognitive rehabilitation therapy
Acceptable telehealth formats are synchronous audiovisual interaction or asynchronous store and forward technology. Use these with synchronous audio interaction between the client and the distant site provider.
The Office of Civil Rights has relaxed HIPAA requirements to allow use of video for telehealth services. Texas Medicaid recognizes OCR’s HIPAA enforcement discretion as it relates to telehealth platform requirements.
Therapies must have a treatment plan. The goals and outcomes must support being provided through telehealth. Revision of therapy hours may be added to an IPC and authorized by HHSC per the process outlined in
IL 20-12 (PDF).
Therapies not eligible for delivery by telehealth are:
- Massage therapy
- Hippotherapy
- Therapeutic horseback riding
- Aquatic therapy
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Update to COVID-19 Guidance for FFS Service Coordinators and Case Managers. Fee-for-service Medicaid 1915(c) waiver case managers and service coordinators may suspend face-to-face service coordination visits.
This is a temporary policy change.
It extends through Nov. 30, 2020.
This temporary policy applies to:
- Community Living Assistance and Support Services
- Texas Home Living
- Deaf-Blind with Multiple Disabilities
- Home and Community-based Services
- General Revenue Service Coordinators
- Community First Choice Service Coordinators
- Pre-admission Screening and Resident Review Habilitation Coordinators
Case managers, service coordinators, and habilitation coordinators are encouraged to complete visits due through Nov. 30, 2020. These can be done by phone, telehealth or telemedicine.
HHSC will release more guidance as information becomes available.
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Updated: In-Home Day Habilitation Information for Program Providers for COVID-19 (IL 2020-19). The Texas Health and Human Services Commission is temporarily waiving requirements in Sections 4320 and 3710 of the Home and Community-based Services Billing Guidelines and the Texas Home Living Billing Guidelines.
This is in response to COVID-19 and to provide access to needed day habilitation services.
HHS published a revision to this in IL 2020-19 In-Home Day Habilitation Information for Program Providers (PDF).
This information letter was previously issued on July 30, 2020.
It extends the temporary guidance through Nov. 30, 2020.
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HHSC: Assisted Living Facilities CLIA Waiver Information. As COVID-19 testing becomes more available, it will be important for assisted living facilities to apply for a Clinical Laboratory Improvement Amendment waiver as part of their overall preparedness efforts.
Facilities will need to apply for a CLIA waiver to offer and perform certain COVID-19 testing for staff and residents directly.
To obtain a CLIA Waiver for COVID-19 point of contact testing using a rapid POC diagnostic testing device, complete Form CMS-116 (PDF) available on the CMS CLIA website or on the HHSC Health Care Facilities Regulation - Laboratories webpage found under the Application header. Email the form to the regional CLIA licensing group via the HHSC HCF Regulation – Laboratories webpage.
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The Texas Education Agency published the following:
INSTRUCTIONAL CONTINUITY PLANNING
Asynchronous and Synchronous Instruction
WAIVERS, FINANCE & GRANTS
State Funding
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From the Office of the Comptroller: OCTOBER Fiscal Notes Release
Fiscal Notes: Uninsured Texans. In the recently released October edition of Fiscal Notes, the Comptroller’s office examines the issue of uninsured Texans, the economic consequences for the state, options available to those who have recently lost their insurance — and various policies that could extend health coverage to more of our most vulnerable citizens.
According to recently released U.S. Census data, the share of Texans without health insurance was 18.4 percent in 2019. And the job losses and economic turmoil brought on by the COVID-19 pandemic has only exacerbated the issue. |
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“One of the most painful effects of losing a job is the loss of employer-sponsored insurance, which offers health coverage for the majority of full-time U.S. workers,” said Texas Comptroller Glenn Hegar. “In Texas, COVID-related losses have worsened a perennial problem in our state — a problem that is costing the state’s economy. The Texas Alliance for Health Care reports that Texas’ high rates of ‘uninsurance’ cost our state economy hundreds of billions of dollars.”
This edition of Fiscal Notes also takes a look at state funds held outside the state Treasury, called “local” funds. These funds are controlled directly by state agencies and institutions of higher education outside the Texas Legislature’s regular budgeting and appropriations process, a characteristic that sometimes has made them controversial during budget negotiations.
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“Local Funds”: State Money Outside the Treasury - New Report Addresses Little-Known State Funds. In August 2017, Fiscal Notes reported on state funds held outside the state Treasury, also called “local” funds. These funds are controlled directly by state agencies and institutions of higher education outside the Texas Legislature’s regular budgeting and appropriations process, a characteristic that sometimes has made them controversial during budget negotiations.
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Local funds give agencies greater operating flexibility. But because they are largely exempt from the state’s usual budgeting and reporting mechanisms, they can pose various challenges concerning transparency, efficiency and oversight.
Regarding transparency, Associate Deputy Comptroller Phillip Ashley explains, “Local funds are typically not part of state budget deliberations, not part of the financial information we report to the Legislature and generally not part of our accounting system. In comparison to normal state funds, the Comptroller’s office has little information on funds held outside the Treasury.”
Local funds give agencies greater operating flexibility, but pose various challenges concerning transparency, efficiency and oversight.
Until recently, Texas had no single, readily available source for basic information on these local funds — even for how many exist or how much money they hold. A new biennial report, however, first issued by the Legislative Budget Board (LBB) in 2019, sheds some light on these funds and will provide vital information next year as the Legislature convenes
Read the full publication here. |
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