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Texas Home and Community-Based Supports and Services

Disability Rights Texas Handout

Last updated: 4/7/2017
Publication Code: n/a

Texas Home and Community-Based Supports

This handout is available in Braille and/or on audio tape upon request.

COMMUNITY LIVING AND ASSISTANCE AND SUPPORT SERVICES (CLASS)

CLASS provides home- and community-based services to people with related conditions as a cost- effective alternative to placement in an intermediate care facility for individuals with an intellectual disability or a related condition (ICF/IID). A related condition is a disability, other than an intellectual disability, that originated before age 22 and that affects a person’s ability to function in daily life.

Note: This service may not be available right away. Your name may be placed on an interest list. You will be contacted when services are available. If you are a current nursing facility resident and want to transition to the community using CLASS services, you will not have to be placed on an interest list.

A. What services are available?

In the CLASS program, the Consumer Directed Services (CDS) option is available to individuals who choose to self-direct one or more of the following program services:

When individuals select the CDS option, they are required to use Financial Management Services (FMS) and may access support consultation at https://hhs.texas.gov/laws-regulations/handbooks/community-living-assistance-support-services-provider-manual/class-pm-section-4000-consumer-directed-services-cds [1].

B. Who can get services?
C. How do I apply for services?

Call toll-free to 1-877-438-5658. Please be prepared to provide Social Security and Medicaid numbers, type of disability, age of the onset of the disability, date of birth, address and telephone number of the person needing services.

II. HOME AND COMMUNITY-BASED SERVICES (HCS)

Note: This service may not be available right away. Your name may be placed on an interest list. You will be contacted when services are available. Certain individuals transitioning from or at risk of entering an institution may qualify for transition or diversion services without waiting.

The Home and Community-based Services (HCS) program provides individualized services and supports to people with intellectual disabilities who are living with their families, in their own homes or in other community settings, such as small group homes where no more than four people live. The local authority provides service coordination.

A. What services are provided?

In the HCS program, the Consumer Directed Services (CDS) option is available only to those who live in their own home or family home. Individuals who receive foster/companion care, Residential Support or Supervised Living are not eligible to use the CDS option.

The HCS services currently available for self-direction are:

When individuals select the CDS option, they are required to use Financial Management Services (FMS) and may access support consultation. https://hhs.texas.gov/laws-regulations/handbooks/home-community-based-services-handbook/section-13000-consumer-directed-services [2].

B. Who can get services?
C. How do I apply for services?

Contact your Local Intellectual and Developmental Disabilities Authority (LIDDA) https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/local-idd-authority-lidda [3]

III. TEXAS HOME LIVING

The Texas Home Living (TxHmL) program provides selected essential services and supports to people with an intellectual disability or a related condition who live in their own home or their family’s home.

A. What services are available?

In the TxHmL program, the Consumer Directed Services (CDS) option is available for all services.

B. Who can get services?
C. How do I apply for services?

Contact your Local Intellectual and Developmental Disabilities Authority (LIDDA) https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/local-idd-authority-lidda [3]

IV. DEAF BLIND WITH MULTIPLE DISABILITIES (DBMD)

Note: This service may not be available right away. Your name may be placed on an interest list. You will be contacted when services are available. If you are a Texas nursing facility resident you may qualify with our being on an interest list.

The Deaf Blind with Multiple Disabilities (DBMD) program provides home and community- based services to people who are deaf blind and have another disability. This is a cost-effective alternative to an intermediate care facility for individuals with an intellectual disability or related conditions (ICF/IID). The DBMD program focuses on increasing opportunities for consumers to communicate and interact with their environment.

A. What services are provided?

You can access the following services through the consumer-directed option:

B. Who can get services?
C. Where can I get services?

The program is available statewide.

D. How do I apply for services?

Call 1-877-438-5658 and ask for the DBMD program. Please be prepared to provide the Social Security and Medicaid numbers, type of disability, age of the onset of the disability, date of birth, and address and telephone number of the person who needs services.

V. MEDICALLY DEPENDENT CHILDREN PROGRAM (MDCP)

Note: This service may not be available right away. Your name may be placed on an interest list. You will be contacted when services are available. If you are a nursing facility resident, you may qualify without going on an interest list. If you are medically fragile and qualify for a short term nursing facility stay, you may qualify without going on an interest list.

The Medically Dependent Children Program (MDCP) provides services to support families caring for children who are medically dependent and encourages the transition of children in nursing homes back to the community.

A. What services are provided?

The MDCP services currently available for consumer- direction are:

When individuals select the CDS option, they are required to use Financial Management Services (FMS) and may access support consultation.

B. Who can get services?
C. How do I apply for services?

Call 1-877-438-5658 to get on the interest list.

VI STAR+PLUS WAIVER

STAR+PLUS is a Texas Medicaid managed care program for people who have disabilities or are age 65 or older. People in STAR+PLUS get Medicaid healthcare and home and community based services and supports through a managed care organization’s health plan that they choose in their service deliver area.

Long-term services and support includes things like:

Another feature of STAR+PLUS is service coordination. A STAR+PLUS staff member works with the member, the member’s family and the member’s doctors and other providers to help the member get the medical and long-term services and support they need.

A. Who can get services?

To get services through STAR+PLUS you must:

(1) be approved for Medicaid, (2) live in a STAR+PLUS service area, and (3) be one or more of the following:

The following people can’t be in the STAR+PLUS Waiver program:

Important notes for those covered by Medicare:

B. What services are provided?

The following is an overview of the services STAR+PLUS offers. Medicaid managed care plans must have a service coordinator visit with the member within 30 days of enrolling in the program. The coordinator must find out the member’s needs and develop a plan of care.

Long-term services and supports can include:

Other services under the STAR+PLUS Home and Community-Based Services Waiver include:

The Star + Plus services currently available for consumer-direction are:

C. How do I apply for services?

Call 1-877-438-5658 and ask for the Star + Plus Waiver program.

VII. COMMUNITY FIRST CHOICE

A. What is Community First Choice?

Community First Choice (CFC) provides certain services and supports to individuals living in the community who are enrolled in the Medicaid program and meet CFC eligibility requirements. Services and supports may include:

In Texas, CFC may be available to people enrolled in Medicaid, including those served by:

Individuals may use the Consumer Directed Services (CDS) option for certain CFC services.

CFC as a state plan Medicaid service is available to individuals with a need for habilitation, personal assistance or emergency response services who receive services in the following HHS Medicaid waiver programs:

CFC is also available through managed care organizations for individuals who meet eligibility criteria. Information about https://hhs.texas.gov/services/health/medicaid-chip/programs/community-first-choice [4]

B. Who can get Community First Choice services?

To be eligible for Community First Choice services an individual must:

C. Community First Choice Services

Community First Choice Services include:

D. Texas began the Community First Choice program on June 1, 2015. This means:

VIII. COMMUNITY ATTENDANT SERVICES

Community Attendant Services (CAS) is a non-technical, non-skilled service providing in-home attendant services to people who need help with personal care tasks. CAS is available to eligible adults and children whose health problems cause them to be functionally limited in performing activities of daily living.

A. What services are provided?
B. Who can get services?
C. How do I apply for services?

Contact your local Texas Health and Human Services (HHS) office [5]. 855-937-2372

IX. PRIMARY HOME CARE

Primary Home Care (PHC) provides non-technical, non-skilled, in-home attendant services to people who have an approved medical need for assistance with personal care tasks. PHC is available to eligible people whose health problems cause them to be functionally limited in performing activities of daily living according to a practitioner’s statement of medical need. Attendants provide PHC services.

A. What services are provided?
B. Who can get services?
C. How do I apply for services?

Contact your local Texas Health and Human Services (HHS) office [5]. 855-937-2372

X. CONSUMER MANAGED PERSONAL ATTENDANT SERVICES

Under the Consumer Managed Personal Attendant Services (CMPAS) program, the Texas Health and Human Services Commission (HHSC) contracts with licensed agencies to provide personal assistance services to people with physical disabilities who are mentally and emotionally competent and willing to supervise their own attendant or who have someone who can supervise the attendant for them.

Licensed personal assistance services agencies determine eligibility and the amount of care needed, develop a pool of potential personal assistants, and provide emergency back-up personal assistants.

A. What services are provided?
B. Who can get services?
C. How do I apply for services?

Contact your local Texas Health and Human Services (HHS) office [5]. 855-937-2372

D. Where can I get services?

Services are available in these counties.

XI. FAMILY CARE

Family Care is a non-skilled, non-technical attendant care service available to eligible adults who are functionally limited in performing activities of daily living. Services are provided by an attendant and do not require the supervision of a registered nurse.

A. What services are provided?
B. Who can get services?
C. How do I apply for services?

Contact your local Texas Health and Human Services (HHS) office [5]. 855-937-2372

XII. HOME-DELIVERED MEALS

The Home Delivered Meals program provides a nutritious meal delivered to the person’s home to ensure he or she gets at least one healthy meal per day.

A. Who can get services?
B. How do I apply for services?

Contact your local Texas Health and Human Services (HHS) office [5]. 855-937-2372

XIII. DAY ACTIVITY AND HEALTH SERVICES

Licensed day activity and health services (DAHS) facilities provide daytime services to people who live in the community as an alternative to living in a nursing home or other Services, which usually are provided Monday through Friday, address physical, mental, medical and social needs. Sometimes, this is called adult day care or adult day services.

A. What services are provided?
B. Who can get services?
C. How do I apply for services?

Contact your local Texas Health and Human Services (HHS) office [5]. 855-937-2372

XIV. IN-HOME AND FAMILY SUPPORT

The In-Home and Family Support program provides direct grant benefits to people with physical disabilities and/or their families to choose and purchase services that help them to remain living in their own homes.

A. What services are provided?

B. Who can get services?
C. How do I apply for services?

Contact your local Texas Health and Human Services (HHS) office [5]. 855-937-2372

XV. PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY

The Program of All-Inclusive Care for the Elderly (PACE) provides community-based services to people who are frail and elderly who qualify for nursing home placement. PACE uses a comprehensive care approach, providing an array of services that costs less than comparable nursing home care.

A. What services are provided?

All necessary health-related services, including in-patient and outpatient medical care, specialty services like dentistry and podiatry, social services, in- home care, meals, transportation and day activity.

B. Who can get services?
C. Availability

PACE is available only in the ZIP Codes listed below.

D. How do I apply for services?

Contact the local PACE organization:

XVI. ADULT FOSTER CARE

Adult Foster Care (AFC) provides a supervised, 24-hour living arrangement in an adult foster home for people who are unable to continue living independently in their own homes because of a physical, mental or emotional limitation.

AFC providers and residents live in the same household and share a common living area. With the exception of family members, no more than three adults may live in the foster home unless the home is licensed as a Type C Assisted Living Facility or as a Type A Small Group Home. The person receiving services pays the provider for room and board.

A. What services are provided?
B. Who can get services?
C. How do I apply for services?

Contact your local Texas Health and Human Services (HHS) office [5]. 855-937-2372

XVII. DAY ACTIVITY AND HEALTH SERVICES

Licensed day activity and health services (DAHS) facilities provide daytime services to people who live in the community as an alternative to living in a nursing home or other institution. Services, which usually are provided Monday through Friday, address physical, mental, medical and social needs. Sometimes, this is called adult day care or adult day services.

A. What services are provided?
B. Who can get services?
C. How do I apply for services?

Contact your local Texas Health and Human Services (HHS) office [5]. 855-937-2372

XVIII. PRE-ADMISSION SCREENING AND RESIDENT REVIEW (PASRR)

All people who are planning to move to a partially federally funded nursing facility and who are suspected of having a mental illness, or a diagnosis of an intellectual disability or a related condition must receive a Pre-admission Screening and Resident Review (PASSR) screening. This includes private pay individuals.

People are assessed to see if they need specialized services. People who are not satisfied with their PASRR determination have the right to a fair hearing to appeal the determination.

A. What services are provided?

XIX. AREA AGENCIES ON AGING

The 28 local area agencies on aging (AAA) contract with the Texas Health and Human Services (HHC) to help people 60 and older and their caregivers find the information they need to locate and access community services.

A. What services are provided?
B. Who can get services?

You must be 60 or older, with priority for services given to:

Family members and/or other caregivers who are younger than 60 may receive support services on behalf of the person for whom they provide care.

C. How do I apply for services?

Contact your AAA by calling 855-937-2372

XX. AREA AGENCIES ON AGING TRANSPORTATION

A. Assisted Transportation

Assistance and transportation, including escort, is provided to people who are older and have difficulty, whether physical or cognitive, using regular transportation. Each “trip” includes the following:

B. Transportation

This service involves taking a person who is older from one location to another, but does not include any other activity. There are two types of transportation services:

C. How do I apply for services?

Contact your AAA by calling 855-937-2372


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Intake: 1-800-252-9108
Main Line: 512-454-4816

Disclaimer: Disability Rights Texas strives to update its materials on an annual basis, and this handout is based upon the law at the time it was written. The law changes frequently and is subject to various interpretations by different courts. Future changes in the law may make some information in this handout inaccurate.

The handout is not intended to and does not replace an attorney’s advice or assistance based on your particular situation.