Dear Potential Applicant: An application to contract to provide Community Services through the Texas Department of Aging and Disability Services (DADS) is enclosed. A provider agency must complete this application to obtain a contract to provide services in the Community Services listed below: Community Based Alternatives/Home and Community (CBA/HCSS) Primary Home Care/Family Care (PHC/FC) Day Activity and Health Services (DAHS) Community Living Assistance and Support Services (CLASS) Deaf Blind with Multiple Disabilities (DB/MD) Medically Dependent Children Program (MDCP) Consolidated Waiver Program (CWP) *Bexar County Only Support Services A provider agency must complete a separate Form 3691, Application by DADS Region, for each region or catchment area and program or which it wishes to contract. The completed application must be returned to: Texas Department of Aging and Disability Services Community Services Contracts Unit (W-517) P.O. Box 149030 Austin, Texas 78714-9030 The enrollment process for contract applications usually takes approximately 30-60 days from the date your application is received by DADS. Your application will be processed in the order received. The effective date of the contract will be determined by DADS, but will be no earlier than the first day of the month following the month in which ithe application has been fully completed and executed. Some regions and programs have long consumer interest lists. Contracting with DADS does not guarantee that a provider agency will receive referrals. Note: You must have held the appropriate Home and Community Support Services Agency (HCSSA) license used to qualify for the contract for at least one year prior to applying for a PHC/FC, CWP, or CBA/HCSSA contract. The appropriate HCSSA license for PHC includes the Personal Assistance Services (PAS) category, and for CBA and CWP, it includes the category of Licensed Home Health (LHH). ______________________________________________________________________ Potential Applicant Page 2 Contracting Rules and Program Policies General Contracting Rules may be found in the Texas Administrative Code at the following website: http://info.sos.state.tx.us/pls/pub/readtac$ext.ViewTAC?tac_view=4&ti=40&pt=1&ch=49 The provider manuals, policy clarifications, information letters, CCAD Forms Manual, Cost Report information and CMS information letters can be found on the DADS website and related links. http://www.dads.state.tx.us/business/communitycare/index.cfm Star+Plus Managed Care The Managed Care STAR+PLUS program was implemented in Harris County on April 1, 1998. Harris County residents who receive Medicaid services can no longer receive services in the Community Based Alternatives/Home and Community Support Services (CBA/HCSS) program. Therefore, DADS is no longer enrolling CBA/HCSS providers to serve Harris County. To contract for STAR+PLUS, you may visit the website at: http://www.hhsc.state.tx.us/starplus/provider_info.html National Provider Identifiers The Health Insurance Portability and Accountability Act (HIPPA) of 1996 requires all health care entities to begin using National Provider Identifiers (NPI) on standard health care transactions by May 23, 2007. The NPI eliminates the need for health care providers to use different identification numbers to identify themselves when conducting transactions with multiple health plans. The NPI will become the standard unique health identifier for health care providers. All entities that meet the definition of health care provider, as described in Title 45 Code of Federal Regulations (CFR) § 160.103, can apply for an NPI. Historically Underutilized Businesses It is the DADS policy to encourage all eligible minority and woman-owned businesses to obtain certification as a historically underutilized business (HUB). HUB certification is free, and registration is valid for a four-year period. The HUB certification application may be downloaded from the Texas Building and Procurement website at: http://www.tbpc.state.tx.us/hub/index.html. If you are interested in applying for certification as a Historically Underutilized Business, please access the website for an application. If you have any questions, concerns, or need assistance with your HUB application, please contact a HUB program representative at (512) 463-5872 or toll free at 1-888-863-5881. Should you have any questions regarding the contracting process, you may contact the Community Services Contracts Unit at (512) 438-2080. Enclosures ______________________________________________________________________