Electronic Form Submissions Pilot Provider Participation Request

Attention:

• Adult Foster Care (AFC) Providers
• Assisted Living/Residential Care (AL/RC) Providers
• Community Attendant Services (CAS) Providers
• Community Based Alternatives (CBA) Providers
• Consumer Directed Services Agencies (CDSAs)
• Day Activity and Health Services (DAHS) Providers
• Emergency Response Services (ERS) Providers
• Family Care (FC) Providers
• Home Delivered Meals (HDM) Providers
• Medically Dependent Children Program (MDCP) Providers
• Primary Home Care (PHC) Providers
• Transition Assistance Services (TAS) Providers

Effective December 2011, Texas Department of Aging and Disability Services (DADS) will implement a pilot project allowing the above referenced providers and Consumer Directed Services Agencies (CDSAs) to transmit and receive forms and documentation electronically from DADS regional offices specified below:

Houston office - 1332 E. 40th location

• Harris County
  • CDSAs

Waco office -- 801 Austin Ave.

• McLennan  County
• CDSAs

Midland office -- 901 W. Wall

• Community Service Providers: 
  • Midland, Ector, and Martin Counties
• CBA Providers only:
  • Andrews, Borden, Gaines, Glasscock, Martin, Midland and Upton Counties
• MDCP Providers only: 
• Andrews, Borden, Crane, Crockett, Dawson, Ector, Gaines, Glasscock, Howard, Loving, Martin, Midland, Pecos, Reagan, Reeves, Scurry, Terrell, Upton, Ward, and Winkler Counties
• CDSAs

Odessa office -- 3016 Kermit Hwy.

• Ector County
• CDSAs

Pecos office -- 324 South Cypress St.

• CCAD Providers
  • Loving, Reeves, and Ward Counties
• CBA Providers:
  • Loving and Reeves Counties
• CDSAs

The current policies for submitting forms related to initial assessments, reassessments, changes, agency transfers, and other information to DADS remains the same. The pilot only changes the way in which these forms and documents are sent to and from providers and DADS regional staff.

The pilot is expected to last six months. DADS will notify providers if the duration of the pilot changes. If providers participate in this pilot and then decide they no longer wish to participate, they must send an email to DADS at PDO@dads.state.tx.us anytime during the pilot.

DADS requires providers interested in participating in this pilot to:

• have Internet service;
• establish and maintain at least one email address to which DADS will transmit electronic forms and documents;
• have a back-up email address;
• be able to submit and receive all forms and documents electronically;
• send documents electronically using encryption software;
• scan and upload forms that require signatures;
• use Form 2067, Case Information, when submitting forms and documents to DADS;
• participate in an evaluation at the conclusion of the pilot;
• participate in conference calls, which may be held during the pilot; and
• follow DADS policy regarding submitting forms and documents electronically.

If you are a provider of one of the above DADS programs that serves individuals in one of the selected counties in the pilot and would like to participate in the pilot, please complete the EDS Pilot Participation Request Form and return it to PDO@dads.state.tx.us by close of business on Tuesday, October 4, 2011.

For questions regarding the content of this notice, please contact DADS Policy Development and Oversight at PDO@dads.state.tx.us.