HCS Information

Q: What is the TPC Service Area and do I need to choose a Provider currently in that area?

A: The TPC Service Area includes the following counties: Armstrong, Carson, Collingsworth, Dallam, Deaf Smith, Donley, Gray, Hall, Hansford, Hartley, Hemphill, Hutchinson, Lipscomb, Moore, Ochiltree, Oldham, Potter, Randall, Roberts, Sherman, and Wheeler. You may choose any provider on the TPC’s Local IDD Authority Community Waiver Contract List. If you are moving outside of the TPC’s Service Area, your Service Coordinator can provide a list for the Local IDD Authority where you are moving.

Q: What are the names and contacts for other Medicaid Waiver Providers in the TPC Service Area?

A: The names and contacts are on the TPC Local IDD Authority Community Waiver Active Provider List provided by your Service Coordinator.

Q: Who will guide me through the transfer process?

A: Your Service Coordinator.

Q: How do I make a final choice after I talk to Providers on the phone?

A: Narrow your choice down to your top picks. Call and talk to their references. Visit their service sites (group home, Individual Skills and Socialization facility) and talk to staff (nurse, group home manager, employment coach). Make a final decision after you complete this second round of interviews.

Q: When I contact Medicaid Waiver Providers, what questions will they ask me?

A: They will ask you where you live, what services you receive currently from TPC and what services you want from the new Provider, what is your Level of Need, what help do you need from staff, and what health issues you may have.

Q: Can my Service Coordinator recommend a Provider for me to choose?

A: No. Your Service Coordinator can help you make calls, arrange tours, answer questions, and research providers of interest to you. Service Coordinators can share information with you but may not share their opinion with you.

Q: If I choose a Provider, can that Provider choose not to serve me?

A: The HCS program has rules that a Provider must serve you if you choose them. However, there may be reasons that you may want to consider a different Provider. A good example is when a person wants to live in a group home, but the Provider does not have a group home immediately available. Another example is when a person wants to attend a specific Individualized Skills and Socialization (ISS) site, and the physical ISS site is at maximum occupancy level. And finally, a Provider may ask the state to set a limit, or “Cap”, on the number of people who can be served by their agency, and they are at their limit when you ask to enroll in their program.

Q: What happens after I choose a new Provider?

A: Your TPC Service Coordinator will take the following steps:

• Assist you, your new provider, and TPC Waiver Provider to agree to an effective date of the transfer (2 to 4 weeks after you choose your provider)
• Schedule a Transfer Person Directed Planning (PDP) Meeting (at least 2 weeks prior to the effective date of the transfer)
• Invite the people you want to attend the meeting and complete a new Individual Plan of Care effective the date of the transfer.
• Conduct the Transfer PDP Meeting
• Send you copies of the transfer PDP and IPC
• Send your new provider TPC documents that will help make your transition to the new provider a smooth one.

Q: When will my services begin with the new Provider?

A: Your services will begin on the effective date of your Transfer IPC. This will be about 2-4 weeks after your transfer meeting. Ask your Service Coordinator if you are uncertain.

Q: Will I continue to have a Service Coordinator after the transfer process?

A: Yes. As a participant in the HCS Waiver Program, you will have a Service Coordinator employed by the Local IDD Authority, which is TPC for the upper 21 counties of the Texas Panhandle.

Q: What services will my new HCS Provider offer?

A: Your new HCS Provider follows the same rules as TPC’s HCS program and must deliver, or contract with an entity to provide, all services in accordance with the HCS billing guidelines. A new provider will provide the same services which may include the following:

• Adaptive Aids
• Specialized Therapies: Audiology, Behavior Support, Cognitive Rehabilitation Therapy, Dietary, Occupational Therapy, Physical Therapy, Social Work, Speech
• Dental
• Employment: Employment Assistance, Employment Readiness, Supported Employment
• Residential: Host Home Companion Care, Residential Support Services, or Supervised Living
• Individualized Skills and Socialization (ISS)
• Minor Home Modifications
• Nursing
• Respite
• Transportation
• Community First Choice (Habilitation Training and Personal Assistance Service)

Q: Will TPC continue to provide Day Habilitation and ISS Services?

A: Yes. Ask your new provider to contract with TPC to provide the Day Habilitation and ISS services on your Individual Plan of Care. Your new provider may email contactus@txpan.org or call (806) 358-1681.

Q: What if I am not satisfied with my new provider?

A: You may report your concern to your Service Coordinator and request assistance with reaching a resolution. Additionally, you may change your provider at any time following your transfer by telling your Service Coordinator that you want to transfer.

Q: How do I report a concern or make a complaint?

A: Who you contact will depend on what the concern or complaint is regarding:

• Complaint about an HCS provider or ISS facility: 1-800-458-9898, HHSC Regulatory
• Complaint about unfair treatment: 1-800-252-8104, HHSC Ombudsman
• >Complaint about a Service Coordinator or the Transfer Process: (806) 351-3400, Vania Beavers, TPC Rights Protection Officer