During the COVID-19 pandemic, flexibilities were put in place to allow nursing assessments to be provided by telehealth (synchronous audio-visual technology). Certain parts of this flexibility are being made permanent effective May 1, 2022. Other parts will end when the COVID-19 Public Health Emergency ends.
This revised guidance applies to:
- Community Living Assistance and Support Services
- Deaf-Blind with Multiple Disabilities
- Home and Community-based Services
- Texas Home Living
For people enrolled in the above waiver programs:
- HHSC will allow focused nursing assessments to be done through telehealth (synchronous audio-visual technology) permanently effective May 1, 2022. HHSC will make updates to waiver handbooks with this policy. This interim guidance serves as official HHSC policy until the handbook revision.
- The flexibility for comprehensive nursing assessments to be completed through telehealth (synchronous audio-visual technology) will end when the COVID-19 PHE ends. HHSC is notifying providers now so they can prepare to resume in-person activities as soon as the COVID-19 PHE ends. HHSC will notify providers of the date when the COVID-19 PHE ends as soon as the federal government determines the end date.
Per standards of care, all telehealth nursing assessments must be done within the scope of the nurse’s license:
- They must and be clinically appropriate, safe, and agreed to by the client receiving services, or by the legally authorized representative of the client.
- The program provider must not direct a nurse to complete an assessment using telehealth (synchronous audio-visual technology) if the nurse deems it inappropriate.
- Telehealth (synchronous audio-visual technology) may require participation of a parent or caregiver to assist with the assessments.
- Providers must be able to defer to the needs of the person receiving the assessment. This allows the mode of service delivery (audio-visual or in-person) to be accessible, person and family-centered, and primarily driven by the client’s choice and not provider convenience.
- The use of telephone (audio-only) is not permitted for nursing assessments.
In the fee-for-service Medicaid 1915(c) waiver programs listed above, nursing services must be provided in accordance with:
- Texas Occupations Code, Chapter 301 (Nursing Practice Act)
- 22 TAC Chapter 217 (relating to Licensure, Peer Assistance, and Practice)
- 22 TAC Chapter 224 (relating to Delegation of Nursing Tasks by Registered Professional Nurses to Unlicensed Personnel for Clients with Acute Conditions or in Acute Care Environments)
- 22 TAC Chapter 225 (relating to RN Delegation to Unlicensed Personnel and Tasks Not Requiring Delegation in Independent Living Environments for Clients with Stable and Predictable Conditions)
Email one of the below policy mailboxes with questions about this alert: