ABL- adaptive behavior level
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
Medicaid funded
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)
Service delivery option that allows recipients more control
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)
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