Medical & Community Supports
- Last Updated: Thursday, 18 May 2017 20:20
As family members, we often think we can care for our children forever. But as we age, our children get bigger and may need support we can no longer provide. This is where long term services come in. There are a variety of long term support services for individuals with disabilities and ways to access those services.
HEALTH & HUMAN SERVICES COMMISSION(HHSC) - The State Agency responsible for many Federal & State programs that help people.
Your Texas Benefits:
Call 211 or visit Your Texas Benefits - Click on Should I Apply. This is a good place to start understanding what services & supports your child or family may be eligible for. You will find Medicaid, CHIP, Family Services, Suplemental Nutritional Assistance Program (SNAP or Food assistance), and Temporary Assistance for Needy Families (TANF). If you are using this website to complete the medicaid application for your child - Make sure you answer the questions as if your child was answering the questions.
There were 4 agencies under HHSC - yet only the first two remain subsidiaries of HHSC - All other responsibiliies have folded into one the one agency.
2) Department of State Health Services (DSHS) - Mental and Behavioral Health for Children and Adolescents. There is a Youth Empowerment Waiver (YES) for youth children under age 19 with severe emotional disturbances.
3) Aging & Disability Services HHSC is the agency responsible for administering programs to serve Texans with disabilities.
The main number for DADS is 855-937-2372. You will be asked to enter your zip code and this will direct you to the closest Aging and Disabilty Resource Center who can answer your questions. In the Houston area - This is Care Connection.
What You Need to Know about HHSC explains the process
The Quality Reporting System is a searchable data base where you can find and compare providers of long-term services and supports. These include nursing facilities, home health agencies, adult day care and others. You can also see reports on specific providers and any possible violations.
Many of the services that a person with a disability receives can be Consumer Directed Services (CDS) - which allows more flexibiity for families and sometimes higher pay rates (especially with HCS waiver). While many case managers will encourage you to choose a provider vs CDS due to the quantity of paperwork involved - Please call Family to Family Network BEFORE you make a decision and we can guide you.
If you have a low income, you or your child are possibly eligible for traditional medicaid. Often times your child is also receiving Supplemental Security Income (SSI). Despite being eligible for Medicaid - You must still register your child for the "interest lists" for Medicaid Waivers (long term supports). If your child is under age 20 and receives medicaid and has a disbility - You will be required to move to STAR-Kids as of Nov. 1, 2016. If your child is over 20 - they are probably on STAR-Plus.
You also need to ask if your child might be eligible for Personal Care Services while he/she waits for the waiver supports. Call 888-276-0702.
Childrens Health Insurance Program (CHIP)
CHIP covers families who have too much income to qualify for Medicaid, but cannot afford to buy private insurance. Your child must be under age 19.
Medicaid Buy In Program
If you Make TOO much money for traditional medicaid or CHIP, but need health insurance for your child, the State of Texas has a Medicaid Buy In Program. If your child is under age 20 and has a disability, they will move to STAR Kids in Nov. 1, 2016.
STAR Kids is a new Medicaid managed care program that will provide medicaid benefits, begining Nov. 1, 2016, to children and adults with disabilities age 20 and younger. This program is mandatory for any child with a disability who is under age 20 and is on Medicaid because they receive SSI, particpate in a Medicaid buy in program, or if they participate in a waiver program (DBMD, MDCP, YES, CLASS, HCS, or TxHL)
This is a medicaid managed care program for individuals with disabilities over age 21. There are some exceptions - See the website.
Community First Choice (June 1, 2015)
This is NOT a Medicaid waiver program, but an entitlement program for personal attendance/habilitation services through your Medicaid Star Plus program. Your child MUST already be Medicaid eligible. For many - this means your child is an adult and receiving SSI/Medicaid(STAR Plus) and you are waiting for a waiver slot.
For more information on seeking services through this program - please contact your Managed Care Organization or MCO (Amerigroup, Molina, OR United HealthCare). The MCO will do an initial assessment and refer you to the local Intellectual and Developmental Disability authority (LIDDA) for a Determination of Intellectual Disability (DID), Level of Care, and Functional Assessment. The Local authority will complete the DID and a level of care assessment and submit the level of care assessment to the Dept of Aging & Disability services (DADS). DADS will either approve or disapprove the level of care. If approved - the LIDDA will perform a functional assessment to determine the services needed and give this to the MCO. The MCO will authorize services and the LIDDA will provide service coordination (case management).
Medicaid Waiver programs are a key part of long term support for people with disabilities. While the services are for those who are medicaid eligible, your child will automatically become medicaid eligible as the Waiver programs do not include parent income (all except TxHL). To understand the different waivers, this Comparison of Medicaid Waiver Programs is helpful.
In Texas, there is a waiting list to receive Medicaid waivers that is years long (5-12 years), so it is important to add your child's name to the Medicaid Waiver interest lists as soon as possible or search benefits here:https://yourtexasbenefits.hhsc.texas.gov/programs/health/disability-or-65plus/long-term-care
For more information on medicaid waivers, download this valuable resource from the UT Center For Disability Studies - Family Resource Guide or
Comprendiendo el Apoyo Familiar y Abriendo Puertas para el Futuro.
Home & Community Services (HCS), Tx Home Living (TxHL) Waiver Programs - persons with intellectual and developmental disabilities
To register for Medicaid Waiver Programs "Interest Lists" (HCS, Tx Home Living, etc.) contact the following local authority agency for your county. Note the Tx Home Living budget is capped currently at $17,000 per year.
The Harris Center for Mental Health and Intellectual/Developmental Disabilities 713-970-7799 (to get on waitlist); 1-713-970-7000 (Help Line);
1-866-970-4770 (24 hr Crisis line);
9401 Southwest Freeway, Houston, TX 77074
Texana (serving Austin, Colorado, Fort Bend, Matagorda, Waller & Wharton Counties)
281-239-1300, 281-239-1363, 1-800-633-5686 (Crisis Line)
Various locations depending on your county.
Tri-County Services (serving Montgomery, Liberty, and Walker Counties)
936-521-6200, 281-432-3076, 936-291-5800, or 1-800-659-6994 (24 hr Crisis line)
Gulf Coast Center (serving Brazoria and Galveston Counties)
1-800-643-0967 (intake for MR services), 1-877-226-8780 (intake for MH services), 1-86-729-3848 (24 hour Crisis line)
Community Living Assistance and Support Services (CLASS), Medically Dependent Childrens Program (MDCP), Deaf Blind Multiple Disabilities (DBMD), Community Attendant Services (CAS), and Personal Attendant Services (CMPAS) Programs - for persons with physical or medical disabilities:
For these programs, please call the Health & Human Services Commission - to find the office closest to you - https://www.dads.state.tx.us/contact/search.cfm or call 1-855-937-2372.
For more information on Personal Care Services - https://hhs.texas.gov/services/aging/long-term-care/personal-care. Please call 855-937-2372
Please note - if you move, please call the agency and update your information so that the agency can find you when a waiver spot becomes available.
For most of the services - There will be an assessment for services - Remember to answer as if you were not there to do something for your child or the level of support you may give (Can they do something independently?). Here are links to various Assessments
4) Previous Programs of Department of Assistive and Rehabilitative Services (DARS) - Moved to HHSC as of Sept. 1, 2016
- Vocational Rehabilitative Services (helping with work) for youth and adults with disabilities
Other Agencies that Might Help
Disability Rights Texas
This is local Protection and Advocacy agency - they have established priority areas that they focus on.
1500 McGowen, Suite 100, Houston, Texas 77004
(713) 974-7691 (Voice/TDD), Fax (713) 974-7695
Intake:(800) 252-9108 (Voice/TDD) or online
Texas Parent to Parent
This statewide non-profit agency provides training and has a program that matches parents with other parents for support. They are extremely knowledgeable on the family centered medical home model, as well as helping parents set up a Care Notebook.
3710 Cedar St, Box 12, Austin, TX 78705
866-896-6001 (toll free)
The Arc of Texas
This statewide agency creates opportunities for individuals with disabilities to actively participate in their communities; they have many local chapters.
8001 Centre Park Dr #100, Austin, TX 78754
1-800-252-9729 (toll free)
Parents need to:
1) Ensure that if their provider says a service is not available - Request that a Exception Request Form be completed and submitted
2) Ask for copies of your budgets and request regular reports on how your money is being spent
3) Do not sign anything you do not agree to
4) Get everything in writing
WHAT IF I DISAGREE WITH MY SERVICE PLANNING TEAM (pdf)