TEXAS HEALTH AND HUMAN SERVICES COMMISSION RATE ANALYSIS ...

TEXAS HEALTH AND HUMAN SERVICES

COMMISSION

RATE ANALYSIS DEPARTMENT

July 09, 2019

Proposed Payment Rates for the following

programs:

Residential Care

Primary Home Care

Community Attendant Services

Family Care

Day Activity & Health Services ¨C Title XIX Medicaid & Title XX

Community Living Assistance and Support Services In-Home

Respite

STAR Kids Waiver Proxy Rates

STAR+PLUS Home Community Based Services Waiver Proxy

Rates

Payment rates are proposed to be effective September 1, 2019

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SUMMARY OF PROPOSED PAYMENT RATES

Effective September 1, 2019

The Texas Health and Human Services Commission (HHSC) will conduct a public

hearing at 9:30 a.m. on July 9, 2019, in the Brown-Heatly Building Public

Hearing Room, located at 4900 N. Lamar Blvd., Austin, Texas, 78751. Public

comments will be received on proposed rate increases for the following

programs and services operated by HHSC:

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Residential Care (RC)

Primary Home Care (PHC) Non-Priority

Primary Home Care (PHC) Priority

Community Attendant Services (CAS) Non-Priority

Community Attendant Services (CAS) Priority

Family Care (FC) Non-Priority

Family Care (FC) Priority

Day Activity & Health Services (DAHS) ¨C Title XIX Medicaid & Title XX

Community Living Assistance & Support Services (CLASS) In-Home

Respite

HHSC will also be receiving public comments on the proposed increases to the

STAR Kids Waiver (STAR Kids) Proxy Rates and STAR+PLUS Home and

Community-Based Services Waiver (STAR+PLUS HCBS) Proxy Rates for the

following attendant services:

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STAR Kids Attendant with Registered Nurse (RN)

STAR Kids Attendant Delegation

STAR Kids Community First Choice Habilitation (CFC HAB)

STAR+PLUS HCBS Personal Assistance Services (PAS)

STAR+PLUS HCBS Respite Care

STAR+PLUS HCBS Habilitation (HAB)

HHSC will consider concerns expressed at the hearing prior to final rate

approval. This public hearing is held in compliance with the provisions Human

Resources Code ¡ì32.0282, and the Texas Administrative Code (TAC) Title 1,

¡ì355.105(g), which require a public hearing on proposed payment rates.

PROPOSAL. HHSC proposes to increase the attendant base wage to $8.11 for

the attendant cost component for: RC, PHC, CAS, FC, DAHS, and CLASS InHome Respite; STAR+PLUS HCBS PAS, Respite Care, and HAB Proxy Rates;

and STAR Kids Attendant; Attendant with RN Delegation, and CFC HAB Proxy

Rates, in accordance with the 2020-21 General Appropriations Act, H.B. 1,

86th Legislature, Regular Session, 2019 (Article II, Rider 45). These payment

rates are proposed to be effective September 1, 2019.

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METHODOLGY AND JUSTIFICATION. The proposed rates were calculated in

accordance with Title 1 of the Texas Administrative Code:

¡ì355.112, concerning Attendant Compensation Rate Enhancement;

¡ì355.502, concerning the Reimbursement Methodology for Common Services

in Home and Community-Based Services Waivers; and

¡ì355.505, concerning the Reimbursement Methodology for the Community

Living Assistance and Support Services Waiver Program;

¡ì355.507, concerning the Reimbursement Methodology for the Medically

Dependent Children Program.

¡ì355.509, concerning the Reimbursement Methodology for Residential Care;

¡ì355.5902, concerning the Reimbursement Methodology for Primary Home

Care;

¡ì355.6907, concerning the Reimbursement Methodology for Day Activity and

Health;

Please contact the Rate Analysis Department¡¯s Customer Information Center at (512)

424-6637 or by email at RAD-LTSS@hhsc.state.tx.us should you have any questions

regarding the information in this document.

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RESIDENTIAL CARE APARTMENT

PROPOSED PAYMENT RATES EFFECTIVE SEPTEMBER 1, 2019

Payment Rate

Apartment ¨C PROPOSED

Attendant

Service

Total

Percent

RATES EFFECTIVE SEPTEMBER

Cost Area

Support*

Increase

1, 2019

Nonparticipant

$10.89

$27.48

$38.37

0.29%

Participant ¨C Level 1

$10.94

$27.48

$38.42

0.29%

Participant ¨C Level 2

$10.99

$27.48

$38.47

0.29%

Participant ¨C Level 3

$11.04

$27.48

$38.52

0.29%

Participant ¨C Level 4

$11.09

$27.48

$38.57

0.29%

Participant ¨C Level 5

$11.14

$27.48

$38.62

0.29%

Participant ¨C Level 6

$11.19

$27.48

$38.67

0.29%

Participant ¨C Level 7

$11.24

$27.48

$38.72

0.28%

Participant ¨C Level 8

$11.29

$27.48

$38.77

0.28%

Participant ¨C Level 9

$11.34

$27.48

$38.82

0.28%

Participant ¨C Level 10

$11.39

$27.48

$38.87

0.28%

Participant ¨C Level 11

$11.44

$27.48

$38.92

0.28%

Participant ¨C Level 12

$11.49

$27.48

$38.97

0.28%

Participant ¨C Level 13

$11.54

$27.48

$39.02

0.28%

Participant ¨C Level 14

$11.59

$27.48

$39.07

0.28%

Participant ¨C Level 15

$11.64

$27.48

$39.12

0.28%

Participant ¨C Level 16

$11.69

$27.48

$39.17

0.28%

Participant ¨C Level 17

$11.74

$27.48

$39.22

0.28%

Participant ¨C Level 18

$11.79

$27.48

$39.27

0.28%

Participant ¨C Level 19

$11.84

$27.48

$39.32

0.28%

Participant ¨C Level 20

$11.89

$27.48

$39.37

0.28%

Participant ¨C Level 21

$11.94

$27.48

$39.42

0.28%

Participant ¨C Level 22

$11.99

$27.48

$39.47

0.28%

Participant ¨C Level 23

$12.04

$27.48

$39.52

0.28%

Participant ¨C Level 24

$12.09

$27.48

$39.57

0.28%

Participant ¨C Level 25

$12.14

$27.48

$39.62

0.28%

Participant ¨C Level 26

$12.19

$27.48

$39.67

0.28%

Participant ¨C Level 27

$12.24

$27.48

$39.72

0.28%

Participant ¨C Level 28

$12.29

$27.48

$39.77

0.28%

Participant ¨C Level 29

$12.34

$27.48

$39.82

0.28%

Participant ¨C Level 30

$12.39

$27.48

$39.87

0.28%

Participant ¨C Level 31

$12.44

$27.48

$39.92

0.28%

Participant ¨C Level 32

$12.49

$27.48

$39.97

0.28%

Participant ¨C Level 33

$12.54

$27.48

$40.02

0.28%

Participant ¨C Level 34

$12.59

$27.48

$40.07

0.28%

Participant ¨C Level 35

$12.64

$27.48

$40.12

0.27%

* Equals the total of Other Direct Care, Administration/Transportation and Facility costs less

Room and Board paid by the client.

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RESIDENTIAL CARE NON-APARTMENT

PROPOSED PAYMENT RATES EFFECTIVE SEPTEMBER 1, 2019

Payment Rate

Service

Total

Support*

Non-Apartment ¨C PROPOSED

Attendant

Percent

RATES EFFECTIVE SEPTEMBER

Cost Area

Increase

1, 2019

Nonparticipant

$10.89

$18.82

$29.71

0.37%

Participant ¨C Level 1

$10.94

$18.82

$29.76

0.37%

Participant ¨C Level 2

$10.99

$18.82

$29.81

0.37%

Participant ¨C Level 3

$11.04

$18.82

$29.86

0.37%

Participant ¨C Level 4

$11.09

$18.82

$29.91

0.37%

Participant ¨C Level 5

$11.14

$18.82

$29.96

0.37%

Participant ¨C Level 6

$11.19

$18.82

$30.01

0.37%

Participant ¨C Level 7

$11.24

$18.82

$30.06

0.37%

Participant ¨C Level 8

$11.29

$18.82

$30.11

0.37%

Participant ¨C Level 9

$11.34

$18.82

$30.16

0.37%

Participant ¨C Level 10

$11.39

$18.82

$30.21

0.37%

Participant ¨C Level 11

$11.44

$18.82

$30.26

0.36%

Participant ¨C Level 12

$11.49

$18.82

$30.31

0.36%

Participant ¨C Level 13

$11.54

$18.82

$30.36

0.36%

Participant ¨C Level 14

$11.59

$18.82

$30.41

0.36%

Participant ¨C Level 15

$11.64

$18.82

$30.46

0.36%

Participant ¨C Level 16

$11.69

$18.82

$30.51

0.36%

Participant ¨C Level 17

$11.74

$18.82

$30.56

0.36%

Participant ¨C Level 18

$11.79

$18.82

$30.61

0.36%

Participant ¨C Level 19

$11.84

$18.82

$30.66

0.36%

Participant ¨C Level 20

$11.89

$18.82

$30.71

0.36%

Participant ¨C Level 21

$11.94

$18.82

$30.76

0.36%

Participant ¨C Level 22

$11.99

$18.82

$30.81

0.36%

Participant ¨C Level 23

$12.04

$18.82

$30.86

0.36%

Participant ¨C Level 24

$12.09

$18.82

$30.91

0.36%

Participant ¨C Level 25

$12.14

$18.82

$30.96

0.36%

Participant ¨C Level 26

$12.19

$18.82

$31.01

0.36%

Participant ¨C Level 27

$12.24

$18.82

$31.06

0.36%

Participant ¨C Level 28

$12.29

$18.82

$31.11

0.35%

Participant ¨C Level 29

$12.34

$18.82

$31.16

0.35%

Participant ¨C Level 30

$12.39

$18.82

$31.21

0.35%

Participant ¨C Level 31

$12.44

$18.82

$31.26

0.35%

Participant ¨C Level 32

$12.49

$18.82

$31.31

0.35%

Participant ¨C Level 33

$12.54

$18.82

$31.36

0.35%

Participant ¨C Level 34

$12.59

$18.82

$31.41

0.35%

Participant ¨C Level 35

$12.64

$18.82

$31.46

0.35%

* Equals the total of Other Direct Care, Administration/Transportation and Facility costs less

Room and Board paid by the client.

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