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Revision 17-1; Effective November 1, 2017
All individuals who receive Community Living Assistance and Support Services (CLASS) program services and Community First Choice (CFC) Personal Assistance Services/Habilitation (PAS/HAB) must choose a direct services agency (DSA) with a valid provider agreement that operates in the catchment area in which the individual lives. Individuals who receive services through the CLASS program may request to transfer to another DSA at any time.
A DSA provides CLASS program services, CFCPAS/HAB services, and CFC emergency response services (ERS) to the individual as outlined in their Individual Plan of Care (IPC), the Individual Program Plan (IPP) for that service, and Individual Program Plan Addendum (IPP-A). An individual may elect to have some or all CLASS program and CFC services delivered by the DSA. Select services may be chosen for self-direction by the individual or legally authorized representative (LAR) using the Consumer Directed Services (CDS) option. For a complete list of CLASS and CFC services available using the CDS option, refer to Section 4000, Consumer Directed Services (CDS).
As outlined in this section, the individual's selected DSA is required to perform the following tasks on behalf of an individual in CLASS on an ongoing basis:
- provide required documentation to HHSC as is necessary to assess and renew the level of care for the individual;
- participate in developing a PAS/Habilitation Plan - CLASS/DBMD/CFC for individuals receiving CFC PAS/HAB services through the DSA to outline the individual's CFC PAS/HAB needs and complete documentation of that plan;
- participate in developing an IPC that addresses all of the individual's needs that will be met through the provision of CLASS or CFC services;
- participate in developing the IPP-A using person-centered planning processes for each individual;
- provide all CLASS and CFC provider-managed services according to the IPP-A and the IPP;
- monitor the DSA's service provision processes to ensure all services are delivered by qualified service providers in accordance with the IPP-A and IPP; and
- coordinate with the CMA and other service providers as necessary to ensure IPP-A and IPC revisions are initiated as necessary in response to changes in the individual's needs.
CLASS program and CFC services, as a whole, enhance an individual's integration in the community and prevent admission to an institution while maintaining and improving independent functioning.
3110 Base of Operation
Revision 17-1; Effective November 1, 2017
CLASS program and CFC providers must have a base of operation that includes a physical location and normal operating hours in each geographic catchment area for which they have a contract to provide CLASS program and CFC services.
- A base of operation is a place in which business, clerical or professional activities are conducted. Each base of operation must:
- maintain individual records for the CLASS program contract in the catchment area;
- maintain personnel records for personnel who provide CLASS program and CFC services to individuals served in the catchment area;
- be staffed by qualified employees who have completed CLASS program training and can readily become familiar with the individuals being served in the catchment area; and
- maintain adequate staff to provide services and to supervise the provision of services within the catchment area.
- Providers must identify the base of operation's normal operating hours. If the base of operations is closed during its normal operating hours or between the hours of 8:00 a.m. and 5:00 p.m. Monday through Friday, the provider must:
- post a notice in a visible location outside the base of operations to provide information regarding how to contact the person in charge; and
- leave a message on an answering machine or similar electronic mechanism to provide information regarding how to contact the person in charge.
3120 DSA Staff Training Requirement
Revision 17-1; Effective November 1, 2017
3121 Initial Training for Direct Contact Staff
Revision 17-1; Effective November 1, 2017
Direct contact for the purposes of this manual means face-to-face contact with a CLASS individual a minimum of one time per calendar year. A DSA program director(s) and any DSA staff person who has direct contact with an individual receiving services through the CLASS program must complete one of the following within 60 calendar days of the employee beginning to work with the CLASS program:
- In-person CLASS Provider Training provided by HHSC.
- Training developed by the DSA that includes, at a minimum:
- CLASS program overview;
- person-centered planning;
- philosophy and values of community integration;
- overview of related conditions and CLASS program eligibility criteria;
- service planning team (SPT) process;
- utilization review process;
- consumer directed services; and
- individuals' rights and responsibilities including:
- fair hearing process;
- DSA's complaints process;
- mandatory participation requirements; and
- abuse, neglect and exploitation characteristics and reporting information.
The DSA could choose to conduct training at its location to meet the above requirements within 60 days of hiring the service provider. DSA staff that develop the curriculum used for initial training must have attended and successfully completed the CLASS Provider Training. The DSA must have a record to verify that the trainer has attended the CLASS Provider Training. The DSA may choose to send new employees to CLASS Provider Training at the next opportunity offered by HHSC to further reinforce training provided by the DSA.
Documentation of completion of required training must include, at a minimum:
- CLASS Provider Training completion certificate with the name of the employee, signed by HHSC; or
- written documentation of completion of the DSA's training that includes:
- training topics covered;
- method of training (i.e., reading, video, discussion, etc.);
- name(s) and qualifications of instructor(s);
- name of the trainee;
- date the training was completed;
- signature and date of the instructor(s); and
- signature and date of the trainee verifying completion.
If a DSA develops curriculum to meet CLASS training requirements, the curriculum and training materials used must be maintained by the DSA and available to HHSC employees during a contract monitoring review. DSA staff that develop the curriculum used for initial training must have attended and successfully completed the CLASS Provider Training. Verification of the DSA training instructor's completion of CLASS Provider Training must be maintained and available to HHSC employees during a contract monitoring review.
3121.1 Initial Training for CFC PAS/HAB or CLASS Transportation-Habilitation and Respite Service Providers
Revision 17-1; Effective November 1, 2017
The DSA must ensure CFC PAS/HAB or CLASS habilitation and respite service providers:
- receive in-person training in the habilitation activities necessary to meet the needs and characteristics of the individual to whom the service provider is assigned.
- Training must occur in the individual's home with full participation from the individual, if possible; and
- Form 3599, Habilitation Service Provider Orientation/Supervisory Visits, is used to document this orientation as stated in the directions for the form; and
- complete two hours of habilitation training, developed by the DSA, before providing services to an individual in the CLASS program that includes at a minimum:
- CLASS program overview;
- overview of related conditions to include:
- the definition of a related condition; and
- examples of a related condition.
- Receive an explanation of commonly performed tasks regarding CFC PAS/HAB.
- Understand an individual's rights and responsibilities including:
- DSA's complaints process;
- mandatory participation requirements; and
- abuse, neglect and exploitation characteristics and reporting information.
- Providers of CLASS transportation-habilitation, prevocational and respite services must successfully complete hands-on training in cardiopulmonary resuscitation (CPR) and choking prevention before delivering services, and maintain training status as current while providing CLASS transportation-habilitation services. The training must include an in-person evaluation by a qualified instructor verifying the service provider's ability to perform these actions.
- If requested by the individual or LAR, providers of CFC PAS/HAB must complete hands-on training in cardiopulmonary resuscitation (CPR) and choking prevention that includes an in-person evaluation by a qualified instructor verifying the service provider's ability to perform these actions. Maintaining training status of CPR training and choking prevention as current is determined by the individual or LAR.
The information specific to related conditions above is contained in the list of ICD-10 approved diagnostic codes for persons with related conditions is located on the HHSC website at: /sites/default/files/documents/doing-business-with-hhs/providers/health/icd10-codes.pdf.
Annual evaluations by the supervisor that take place with the individual/LAR ensures that the needs of the individual are being met. Form 3599 is used to document this evaluation, as stated in the instructions for the form. Documentation of transportation-habilitation, prevocational, and respite service provider training outlined above or any training of CFC PAS/HAB provider requested by the individual or LAR must include a signed certificate of completion stating:
- training topics covered;
- method of training (i.e., reading, video, discussion, etc.);
- name(s) and qualifications of instructor(s);
- name of the trainee;
- date the training was completed;
- signature and date of the instructor(s); and
- signature and date of the trainee verifying completion.
3122 Initial and Annual Training for All DSA Staff
Revision 17-1; Effective November 1, 2017
Within 60 calendar days of the employee beginning to work with the CLASS program and every 12 months, all DSA staff must receive training on:
- Abuse, Neglect and Exploitation (ANE) Prohibited Against Individuals
- review of the statute on abuse, neglect and exploitation at Human Resources Code, Chapter 48, §48.002 (2, 3 and 4);
- signs and symptoms of ANE;
- reporting requirements of ANE; and
- how to report abuse, neglect and exploitation to DFPS at www.dfps.state.tx.us/Contact_Us/report_abuse.asp.
- Rights and Responsibilities of Individuals
DSA staff that develop the curriculum used for initial and annual training must have attended and successfully completed the CLASS Provider Training. Verification of a DSA training instructor's completion of CLASS Provider Training must be maintained and available to HHSC employees during a contract monitoring review. If a DSA develops curriculum to meet CLASS training requirements, the curriculum and training materials used must be maintained by the DSA and available to HHSC employees during a contract monitoring review.
Any DSA staff person who is responsible for developing the IPP-A, a service IPP, or the, PAS/Habilitation Plan - CLASS/DBMD/CFC must complete person-centered service planning training approved by HHSC depending upon the staff date of hire. If the staff person was hired on or before June 1, 2015, the staff must complete the training by June 1, 2017. If the staff person was hired after June 1, 2015, the staff person must complete the training within two years after the hire date.
3123 Types of CFC PAS/HAB or CLASS Transportation-Habilitation Service Providers
Revision 17-1; Effective November 1, 2017
The two types of CFC PAS/HAB or CLASS transportation-habilitation service providers are:
- regular CFC PAS/HAB or CLASS transportation-habilitation service providers who perform all of the CFC PAS/HAB services available within their scope of competency; and
- special CFC PAS/HAB or CLASS transportation-habilitation services providers who may be used to initiate services or prevent a break in service.
3124 Qualifications of CFC PAS/HAB or CLASS Transportation-Habilitation Service Providers
Revision 17-1; Effective November 1, 2017
CFC PAS/HAB or CLASS transportation-habilitation services are performed by service providers who:
- are employed by the DSA;
- are not spouses of individuals and, if the individual is under 18, are not the parent;
- have a current, valid Texas driver's license; and
- maintain vehicle liability insurance in accordance with state law.
3125 Required Training for CFC PAS/HAB or CLASS Transportation-Habilitation Service Providers
Revision 17-1; Effective November 1, 2017
Before services begin, the CFC PAS/HAB or CLASS transportation-habilitation service provider must meet the supervisor or other staff member qualified to train the habilitation service provider in the specific needs of the individual at the individual's home. The CFC PAS/HAB or CLASS transportation-habilitation service provider receives a general orientation with the full participation of the individual, if possible, in the CFC PAS/HAB or CLASS transportation-habilitation activities necessary to meet the needs and characteristics of the individual to whom the service provider is assigned. Orientation of the service provider to the specific needs of the individual must be documented on Form 3599, Habilitation Service Provider Orientation/Supervisory Visits.
3125.1 Required Training for Certain Special CFC PAS/HAB or Special Transportation-Habilitation Service Providers
Revision 17-1; Effective November 1, 2017
Special transportation-habilitation service providers or special CFC PAS/HAB providers who have six continuous months of experience in delivering CFC PAS/HAB or CLASS transportation-habilitation services in any Medicaid program or a program that primarily serves individuals with intellectual disabilities can receive the orientation from the supervisor or other appropriate DSA staff by phone rather than in person.
The individual receiving CFC PAS/HAB services should participate in providing special CFC PAS/HAB providers any training on the activities necessary to meet the needs and characteristics of the individual and the specific needs of the individual at the individual's home. Orientation of the service provider to the specific needs of the individual must be documented on Form 3599, Habilitation Service Provider Orientation/Supervisory Visits.
After the first orientation to the special CFC PAS/HAB or special CLASS transportation-habilitation activities necessary to meet the needs and characteristics of an individual, the special CFC PAS/HAB or special CLASS transportation-habilitation service provider does not need to be reoriented if the individual's condition, tasks and hours remain unchanged. There are no limits on the length of time a special CFC PAS/HAB or special CLASS transportation-habilitation service provider may be used. The special CFC PAS/HAB or special CLASS transportation-habilitation service provider may serve the individual without retraining, as long as the individual's condition, tasks and hours remain unchanged. In addition, there are no restrictions with respect to the amount of time between the service provider's assignments.
3126 Documentation of Required Experience for Special Service Provider Exception
Revision 17-1; Effective November 1, 2017
Records provided by the employee, or records provided by a former or current employer that document the time the employee delivered direct care services, may be used to establish that a special CFC/PAS/HAB or special habilitation service provider meets requirements.