The post Navigating Government Benefits for Loved Ones with Special Needs (Presentation) appeared first on The Misty Carol Project.

It’s not too late to secure tickets to the event on February 18th. Head on over to Eventbrite by clicking here or on the flyer below. RSVPing helps our hosts know how many people to expect and to plan accordingly. Have questions? Don’t hesitate to contact info@themistycarolproject.org.

The post [Listen] Mike Discusses Upcoming Event: Navigating Gov’t Benefits for Loved Ones with Special Needs appeared first on The Misty Carol Project.

One determining factor for qualifying for state-funded services

ABLE Account

Tax-advantaged asset-building account for individuals with disabilities under the Achieving a Better Life Experience Act of 2014, also called a 529 A account

Allow for individuals with disabilities to save and invest money without losing eligibility for certain public benefits programs (like Medicaid, SSI)

Earnings in your ABLE account are not subject to federal income tax, so long as you spend them on “qualified disability expenses”

There are some disadvantages (such as Medicaid payback upon death, contribution limit, etc)

ADL– activities of daily living

Eating, toileting, grooming, dressing, and bathing

Behavioral Supports– specialized interventions to help people with behaviors that prevent or interfere with inclusion in the home and family life or community life

CDS- Consumer Direct Services

The program is the result of Senate Bill 1586, 76th Texas Legislature, which allows a voucher payment option that empowers people to make personal decisions related to the delivery of personal assistance and respite services within their current home and community-based program.

Is Medicaid funded and allows service delivery option recipients more control.

Caregivers can hire their own employees to provide care in-home and are responsible for:

• Recruiting, hiring, and training employees (can include family and friends)
• Setting schedules and submitting timesheets
• Selecting a financial management service agency (FMSA)

To learn more about CDS in Texas click here.

CFC PAS/HAB -Community First Choice Personal Attendant Services and Habitation

Medicaid state-funded service available to people in the Star+Plus waiver program only if they are receiving Supplemental Security Income (SSI) or SSI- related Medicaid

Provides an option to hire an attendant and they will pay for the child to be cared for in their home (ex. Pay up to 52 hrs/week at a rate of $11/hr; parent is the employer and must find the attendant to hire)

CHIP– Children’s Health Insurance Program

Health insurance program for low-income Texas residents ages <18 yo who do not qualify for Medicaid

CLASS– Community Living Assistance and Support Services (Wavier Program)

Under Dept of Aging and Disability (DADS)

which provides individuals with disabilities access to the resources they need to live and work as independently as possible within the community (provides a case manager to coordinate services

Must call to be placed on the list (approximately 15-year wait in Texas)

CFC- (Medicaid) Community First Choice Services

Basic attendant (personal assistance) and habilitation services are available to Medicaid recipients with individuals who meet an institutional level of care

CFC Personal assistance services

Help with activities of daily living, activities related to living independently in the community, and health-related tasks

CFC Habilitation

Developing skills necessary for people to accomplish activities of daily living, activities related to living independently in the community, and health-related tasks

CIS- Crisis Intervention Specialist

Helps access crisis respite and develop crisis prevention plans

Work with local Mobile Crisis Outreach Team (MCOT) during crisis events

CME- certificate of medical examination

Required for guardianship

A physician determines the person’s mental and physical capabilities and their opinion if the person has the capacity to make his or her own decisions

CRCG- Community Resource Coordination Groups

County-based groups of local partners and community members that work with parents, caregivers, youth, and adults to identify and coordinate services and supports, including behavioral health, basic needs, and caregiver support. They help people whose needs can’t be met by one single agency and who would benefit from interagency coordination.

CSIL- Community Services Interest List (also called waivers)

Waiting lists are 15 years in Texas, first come-first serve (so apply asap)

CLASS, HSC, TxHmL, MDCP, STAR+PLUS HCBS (Home and Community Based Services Program)

https://www.hhs.texas.gov/about/records-statistics/interest-list-reduction

https://www.hhs.texas.gov/sites/default/files/documents/laws-regulations/forms/2113/2113.pdf

Allocations are based on available state funding; when a person’s name comes to the top of the list, then a state office or Local Intellectual or developmental Disability Authority Representative will contact you—so update contact info as needed!

DADS– Department of Aging and Disability

Government agency that manages the waiver programs

Day Habitation– normally provided in a group setting and includes personal assistance (Waiver Program for <21 yo)

Under Dept of Aging and Disability (DADS)

DID– Determination of Intellectual Disability

• Under Local authority (Hill Co. MHDD)
• Required to qualify for services

Durable Power of Attorney

(Financial Power of attorney) used to make plans for the care of your finances, property, and investments in the event you can no longer handle your financial affairs yourself

ECI- Early Childhood Intervention

HHSC program to assist families in helping children under age 3 with disabilities and delays in development to reach their full potential

FMSA– Financial Management Services Agency

Selected by a caregiver when using consumer-directed services (CDS) to help with managing the hired employees (who help with caring for a person with IDD)

Guardianship

A legal tool that allows a person to make decisions for another person.  It removes the civil rights and privileges of a person by assigning control of a person’s life to someone else. 

Requires a physician to complete a certificate of medical examination (CME) to determine the person’s mental and physical capabilities and their opinion if the person has the capacity to make his or her own decisions

Must use an attorney for both parties; Must be court-ordered.

Must be renewed each year with the court, can be expensive

State law requires guardians to visit the person every six months and report to court once a year

Can be broken into two types: guardian of the person and guardian of the estate; may obtain a limited (partial) guardianship (may choose own residence, or protect the right to marry, drive, vote, consent to medical care, etc.)

GR– General Revenue

Under local authority (Hill Co. MHDD)

GR-funded services are primarily intended to help people remain in their own or their family’s home

GR services are provided by or through a LIDDA (Hill Co. MHDD)

HCS- Home and Community-Based Services

Medicaid Waiver Program

Must call to be placed on the list (approx. 15 years wait)

Provides services to people with IDD (with IQ < 75) who live with their family, their own home, host home/companion care setting, or residence with no more than 4 people who also receive services.

Services meet a person’s needs so a person can live in a community

Service coordination provided by LIDDA (Hill Co. MHDD)

Can provide 24-hr residential services and supports in small group home setting or in a foster home setting

Consumer Direct Services available

HHS– Health and Human Services

HIPP- Health Insurance Premium Payment

• A program that may reimburse you if you have your child enrolled in other health insurance

ICF/IDD– Intermediate Care Facilities for individuals with an intellectual disability or related conditions for people who are Medicaid eligible

24-hour residential and habilitation setting; based on individual plan of care

No waiting list or interest list for this program

Medicaid Program with two categories

• State Supported Living Centers (SSLC)
  • Serve people with significant medical or behavioral health needs in a residential campus-based community (13 locations in TX)
• Community-based ICF/IDD
  • 6-bed home or larger

IDD– Intellectual and developmental disability

LA– Local Authority (or LIDDA)

Hill Country MHDD for Hays Co

LAR– Legally Authorized Representative

Letter of Intent

A non-binding document that passes vital information about a person with disabilities to future caregivers

Info on the child’s benefits, resources, medical history, treatment plans, meds, daily needs, favorite activities, sleeping and eating preferences, doctors, etc.

LIDDA– Local IDD authority (or LA)

Hill Country MHDD for Hays Co

LMHA– Local Mental Health and Behavioral Health Authority

Hill Country MHDD for Hay Co

MCO- Managed Care Organization

MCOT- Mobile Crisis Outreach Team

Crisis specialists work with teams to help access crisis respite during crisis events

MDCP- Medically Dependent Children’s Program (Waiver Program <21 yo)

Under Dept of Aging and Disability (DADS)

Medicaid ICF/IID waiver programs–

home and community based that provide services and support for people with IDD or related conditions who live on their own or their family’s home or in another home-like setting

Called WAIVERS because certain ICF/IDD requirements are waived

Funding moves with a person within the state (can change providers within the same city or area of the state)

Enroll through LIDDA (Hill Co. MHDD)

Two types:

• Home and Community-based Services (HCS)
• Texas Home Living (TxHmL)

Medical Power of Attorney

Appoints a person to make decisions on your behalf in case of incapacitation (defined as the physical or mental inability to manage your affairs)

Gives legal authority to talk to doctors and manage medical decisions

MHDD– Mental Health Developmental Disability

Hill County MHDD serves Hays County

PHC- Primary Home Care

Nonskilled, personal care services for people with Medicaid whose chronic health problems impair their ability to perform activities of daily living.

POA– Power of Attorney

Medical

Durable or Financial

Representative Payee

A person who is appointed (like by Social Security Admin) to help a person with a disability to help manage their benefits/money

When SSI is received, a Representative Payee is appointed and must be on the bank account

• The account will need to be titled “Jane Doe as Representative Payee for John Doe”

Respite– planned or emergency short-term relief provided when the caregiver is temporarily unavailable

LIDDA (Hill Co. MHDD) may provide respite hours (but caregivers must find their own employee to hire)

Service Coordination

Service coordinator helps people access medical, social, educational, and other services and supports that help them achieve an acceptable quality of life and community participation

LIDDA (Hay MHDD) provides a service coordinator

STAR PLUS (and STAR PLUS KIDS) provide a service coordinator

Special Needs Trust

allows individuals with disabilities to have funds available for certain expenses while protecting eligibility for public benefits and access to care and services

SSLC– State-supported living center

one category of the Medicaid ICF/IDD program

provides 24-hour residential and habilitation services for people with a severe or profound intellectual disabilities or those with ID who are medically fragile or have behavioral problems

STAR+PLUS– Texas Medicaid managed care program for adults who have disabilities

Program switches from STAR+PLUS Kids at age 21

STAR+PLUS Kids– Texas Medicaid managed care program for children with disabilities, special needs, or chronic conditions who are age 20 or younger

Automatically enrolled after being approved for SSI (and Medicaid)

Covers the cost of medications, primary care, and dental cleaning/checkups

Must use medical providers that are approved providers

Also includes adult day services, foster care, assisted living, personal attendant services, nursing services, therapies, medical supplies, and minor home modifications (** not sure this is in all cases)

Supported Decision Making

Alternative to guardianship that supports people to make their own decisions and stay in charge of their lives, while receiving any help they need to do so

Does not require an attorney, is less expensive

The process involves a person with a disability choosing someone they trust to serve as their supporter.  That person helps make decisions but doesn’t make the decision FOR the individual.

Supported employment–

• provided to a person who has paid employment to help him or her sustain that employment. Includes individual support services, supervision, and training

TWC- Texas Workforce Commission

Helps Texans with disabilities find jobs through vocational rehabilitation and ensure people with disabilities live independently in their communities

TxHML– Texas Home Living (Medicaid Waiver Program)

Provides essential services and supports so people with IDD (IQ <75) can continue to live with their families or in their own homes.

TxHmL services supplement but do not replace other programs

Service coordination provided by LIDDA (Hill Co. MHDD)

Limited to $17,000 per person per year

Consumer Direct Services available

VR-Vocational Rehabilitation

Counselors that work to help provide job training and support

Waivers- Medicaid ICF/IDD programs that provide services and support to people with intellectual disabilities or related conditions who live on their own or their family’s home or another home-like setting

Called “waivers” because certain Medicaid requirements are waived (for example: family income)

Texas has seven waivers, each with its own interest list. Consider placing your child on each interest list based on their diagnosis because you don’t know their future needs. (They can be declined) Some have a 15-year waiting list in Texas.

Waivers are managed by the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS).

YES– Youth Empowerment Services

(Waiver Program for <19+ yo for psychiatric impairment)

The post List of Acronyms and Definitions appeared first on The Misty Carol Project.

Non-Medicaid service coordinator

Medicaid service coordinator

Medical coverage

Private Insurance

Medicaid/CHIP

Funding:

SSI

• Have to wait until 18 years old to apply
• When approved, will also be eligible for Medicaid

Local Authority for Hay County: Hill Country MHDD

Medicaid Waiver Programs: Star+Plus, CLASS, HCS, DBMD, TxHML, MDCP, YES

Respite/Provider Services

in Hays County- Hill Country MHDD https://www.hillcountry.org/

Transportation Services

CARTS https://www.ridecarts.com/

Vocational Programs

Texas Workforce Commission (same as Texas Workforce Solutions) https://www.twc.texas.gov/

Start my VR (link to site in order to apply for VR Services in Texas) https://twcgov.service-now.com/com.glideapp.servicecatalog_cat_item_view.do?v=1&sysparm_id=e05bd29c1bf5e41016a1caab234bcb94&sysparm_preview=true&sysparm_domain_restore=false&sysparm_stack=no

Day Habilitation Programs

More information to come soon.

Guardianship/Supported Decision-Making/Alternatives

Guardianship

• A legal tool that allows a person to make decisions for another person.  It removes the civil rights and privileges of a person by assigning control of a person’s life to someone else

Supported decision making

• Alternative to guardianship supports people to make their own decisions and stay in charge of their lives, while receiving any help they need to do so.

Medical Power of Attorney/ Durable Power of Attorney

Use of Representative Payee / Establishing a joint bank account

Management trust, Living Wills/Trusts, Special Needs Trust

Financial Planning

Estate Planning

• Letter of Intent
  • A non-binding document that passes vital information about a person with disabilities to future caregivers
• Special needs trust:
  • allows individuals with disabilities to have funds available for certain expenses while protecting eligibility for public benefits and access to care and services

When preparing to apply for SSI (must wait until 18^th birthday):

Write down everything.  Names, dates; ideally an ongoing journal of all phone calls, emails, and summary of events. Consider a timeline to establish a history of events for documentation.

Gather all documents related to the child. Put together a file system or binder. May need to request from each doctor, therapist, and hospital to make sure you have all the required documentation:

Medical Providers

All doctors, counselors, psychologists, psychiatrists, Hospitals, clinics

• names and contact info including phone, fax, address, email of the contact
• first, last and next appointments (especially for the last 5 years

Diagnosis codes

• doctor who diagnosed
• date of diagnosis

 Medications

• names and reason/diagnosis for a prescription
• any side effects
• start and end dates

Tests ordered and results (related to diagnosis)

Any crisis events or hospitalizations

• dates and locations
• summary including diagnoses

Documentation of when he/she was disabled prior to age 22

• Psych evaluations or doctors’ notes

Current Psychological exam is done in the past year to 6 months

School records

School attendance

• Addresses and contact person
• start and end dates
• Any reports related to diagnoses
• latest IEP or ARD

Additional Documents needed to apply for SSI/Medicaid:

Official Texas ID or passport

Social Security Card

Certified copy of the birth certificate

Any insurance cards: front and back

Create a Login and password for the social security online account for an adult child

Certified copy of Guardianship (if you are a legal guardian)

Height/Weight, hand dominance

Last 5 employer names, addresses, phone numbers

• Start and end dates-why ended
• Total monthly earnings (gross) for the past year by the date of the paycheck

Household arrangement

• Where does he/she live
• Does anyone live with him/her, if so their name, DOB, SSN, relationship
• If renting an apartment: name, address, phone of the landlord, cost of rent
• Does he/she cook and/or buy the food separately from the family (used to calculate expenses)
• All expenses where he/she lives (average monthly)
  • Food, mortgage/rent, property insurance, real property taxes, electricity, gas, sewer, water, garbage

Does he/she own a vehicle or pay for a vehicle

Does he/she own any stocks, bonds, mutual funds

Bank Information

• Account type, number, bank routing, where SSI check with be deposited
• Will need a “Representative Payee” account but you will not be able to open it until the SSI application is received and you receive a letter stating that you have been appointed as Representative Payee. The account will need to be titled “Jane Doe as Representative Payee for John Doe”

Determining Eligibility for IDD services and supports (State funded)

Step 1: Must live in the LIDDA’s service area (Hill Country MHDD covers Hay’s Co)

Step 2: Have a diagnosis of intellectual disability (*documented)

• A measure of a person’s IQ
• Determination of the person’s adaptive behavior level (ABL) and
• Evidence of the disability that originated before the person’s 18th birthday

Step 3: Have a diagnosis of autism spectrum disorder (*documented)

Step 4: Be a nursing facility resident who is eligible for specialized services for intellectual disability or related condition

Step 5: Be eligible for early childhood intervention services

*Documentation- assessments (including IQ and ABL) typically must be completed by Hill Co MHDD’s psychologist 

The post How to Design a Service Plan appeared first on The Misty Carol Project.

Designed to help with the services like personal care, nursing care, home/car modifications, respite care, and therapies

Texas has seven waivers, each with its own interest list. Consider placing your child on each interest list based on their diagnosis because you don’t know their future needs. (They can be declined) Some have a 15-year waiting list in Texas.

Waivers are managed by the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS).

Contact Hill Country MHDD (See Medicaid Waiver Comparisons) https://media.disabilityrightstx.org/wp-content/uploads/2020/04/14214926/Waiver-Services-Comparison-Table-2.2020f.Accessible.docx

https://www.hhs.texas.gov/about/records-statistics/interest-list-reduction

https://www.hhs.texas.gov/sites/default/files/documents/laws-regulations/forms/2113/2113.pdf

Allocations are based on available state funding; when a person’s name comes to the top of the list, then a state office or Local Intellectual or developmental Disability Authority Representative- WAITING LISTS ARE 15 YEARS so apply ASAP

• CLASS                         1-877-438-5658
• HCS                   Call Hill Co. MHDD
• DBMB                        1-877-438-5658
• TxHML                       Call Hill Co. MHDD
• MDCP                         1-877-438-5658
• YES                    Call Hill Co. MHDD

Contact info

• Hill Country MHDD Centers · 877- 466-0660 (crisis hotline as well)
• Hays County Youth Crisis Respite Center 512-667-9870 614 N. Bishop St. San Marcos, TX 78666

The post Waiver Lists/ Interest Lists/ Community Services Interest Lists (CSIL) appeared first on The Misty Carol Project.

Our growing organization was pleased to host 25+ attendees at the Wimberley Community Center between 12-3 p.m. A special thanks goes to Frank Moyer and The Wealth Store who provided hours of Q&A on special needs trusts and navigating the ins and outs of government assistance. 

Topics that Frank spoke on included:

• The difference between standard revocable and special needs trusts
• Why your family needs a special needs trust
• The key benefits of a special needs trust (security & control)
• How to guarantee your child qualifies for government aid regardless of how much $$ you make

You can learn more and connect with Frank by visiting The Wealth Store.

A special “thank you” goes to our volunteers Chris and Bonnie Delhomme, Erika Levingston, and Leslie Campbell who provided free special needs childcare during the event so parents and guardians could focus on the information being presented. As we convey on our website, none of what we do would be possible without the wonderful people who have joined together to support The Misty Carol Project.

Following are photos from the first event. We sure hope you can attend the next one!

The post Successful First Event, Big Thanks to Guest Presenter Frank Moyer appeared first on The Misty Carol Project.

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