Overview
Klaras Center for Families, part of the Heart of Texas Behavioral Network (formerly Heart of Texas Region MHMR Center) is dedicated to providing comprehensive services to the children, adolescents, young adults and families in the most trauma-sensitive, culturally sensitive, safe healing environment. We are consistently looking for ways to improve the level of services we provide. Currently, we are looking specifically at developing programming that addresses the needs of a culturally diverse population and providing additional services and supports for suicide prevention, trauma informed care, bullying prevention, and mentoring as well as the utilization of peer providers and the inclusion of youth and family voice
WHAT IS THE YES WAIVER?
The YES (Youth Empowerment Services) Waiver is a 1915(c) Medicaid Home and Community-Based Services Waiver that provides a broad array of in-home services as well as other alternative community services and supports in intensive therapeutic and psychiatric rehabilitative services — all to assist children and adolescents with severe emotional disturbances to live in the community with their families.
Waiver services are provided in combination with services available through the Medicaid State Plan, other federal, state, and local programs the individual may qualify for, and the natural supports that families and communities provide.
Goals
- Reducing out-of-home placements and inpatient psychiatric treatment by all child-serving agencies;
- Providing a more complete continuum of community-based services and supports;
- Ensuring families have access to parent partners and other flexible non-traditional support services as identified in a family-centered planning process;
- Preventing entry into the foster care system and relinquishment of parental custody; and
- Improving the clinical and functional outcomes of children and adolescents.
Services
- Adaptive Aids & Supports
- Community Living Supports
- Family Supports
- Minor Home Modifications
- Non-Medical Transportation
- Paraprofessional Services
- Professional Services
- Respite
- Supportive Family Based Alternatives
- Transitional Services
The Youth Empowerment Services (YES) Waiver has approved Amendment Four that allows two new services to the current waiver service array. The amendment is in regards to Supported Employment and Employment Assistance, as well as, the HCBS transition plan. For further explanation, the amendment can be found at www.dshs.state.tx.us/mhsa/yes/. A paper copy will be available upon request.
The Youth Empowerment Services (YES) Waiver has approved, Amendment Seven Draft Final, that allows The YES program to provide home- and community-based services to children ages 3-18 that are at risk of institutionalization and/or out-of-home placement due to their serious emotional disturbance. For further explanation, the amendment can be found at http://www.dshs.state.tx.us/mhsa/yes/. A paper copy will be available upon request.
The Youth Empowerment Services (YES) Waiver has requested an amendment to our existing 1915(c) Waiver, that allows The YES program to provide home- and community-based services to children ages 3-18 that are at risk of institutionalization and/or out-of-home placement due to their serious emotional disturbance. For further explanation, the amendment can be found at http://www.dshs.state.tx.us/mhsa/yes/. The amendment is titled YES Amendment 9 DRAFT. A paper copy will be available upon request.
If you are caring for a child with a serious emotional disturbance and need help, please call the YES Waiver Inquiry line to add your child to the YES Waiver Inquiry List.
Phone: (254) 297-7002 Please leave a message providing your name and contact information and a staff member will contact you within 24 hours.
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Transition Age Youth (TAY)
TAY is a program specifically geared towards young adults ages 18 – 22. The program focuses on young adults that are experiencing a major life transition and also have a desire to pursue educational and/or occupational goals. The Transition to Independence (TIP) model is an integral part of the approach within the program. TIP concentrates on helping young adults with engagement strategies, guiding self-discovery, and building a team of supports that the young adult can utilize while working towards their personal goals. These young adults are supported in their journey into adulthood by the utilization of the Individual Placement and Supports (IPS) model of supported employment. TAY encourages any young adult with a desire to pursue education or vocational goals and work towards mental health recovery to participate in the program. TAY also provides mental health services in conjunction with the IPS and TIP model. Young adults can participate in skills training, medication services, counseling, and group opportunities.
Youth Crisis Respite House
The Youth Crisis Respite House (YCRH) is a 6 bed facility that provides short term, enhanced, and readily accessible services for youth ages 13 to 17, who are experiencing a behavioral health crisis. YCRH is designed to decrease the need for more intensive interventions such as; psychiatric hospitalization, the use of the emergency room for non-medical emergency care, and the use of juvenile detention when inappropriate. Activities and services can include, but are not limited to: academics, development of life skills, social skills, and coping skills, art and group activities, individual counseling, family counseling, case management, medication training and support, peer services, and family partner services.
TCOOMMI
(Texas Corrections Office on Offenders with Medical and Mental Impairments, Special Needs):
A collaborative program between KCF and the local juvenile probation department also known as SNDP (Special Needs Diversionary Program) through the juvenile probation department that is designed for youth who have juvenile justice involvement within the department, have a mental health diagnosis, in need of mental health services and are at high-risk of re-offending. The idea was that it would be difficult for youth to successfully complete their probation without taking in to account the role their mental health disorders played in their behavior and day to day interactions. This program was developed to provide appropriate mental health treatment and mental health supervision along with probation supervision in order to increase the chances of success. The communication and organization between the QMHP and JPO are crucial for this program to be successful, as the main roles of the QMHP is to be the advocate for the youth, provide skills training and case management while collaborating with the Juvenile Probation Department. The designated KCF TCOOMMI QMHP provides skills training and intensive case management services to a required caseload of 15 clients and their families. Clients also have access to all other KCF services. Clients who are currently in KCF services may be referred to TCOOMMI if the client possesses the qualifying criteria and appears to require the intensive services and supervision that are provided in this program. This type of referral must be submitted directly to the KCF Juvenile Justice/Case Management Supervisor and later staffed by the TCOOMMI team for appropriateness. As the majority of the referrals come directly from the juvenile probation officers to the TCOOMMI team, which include youth that may not be currently in services with KCF but are involved within the juvenile probation department and appear to be in need of the TCOOMMI program. If accepted into the TCOOMMI program, these youth will then be admitted into KCF services. TCOOMMI is voluntary and clients typically remain in the program for at least six months, though some clients may be served longer if determined and approved to be justified by the team.Committment Reduction Program (CRP)
A collaborative program involving KCF and the local juvenile probation department to reduce the commitment to TJJD and out of home placement, in which the goal is to reduce delinquency, increase offender accountability and rehabilitate juvenile offenders through a comprehensive, coordinated community-based juvenile probation system. The purpose of CRP is reduction of TJJD Commitment and for youth to stay within their local community, as the focus is the youth’s Social Network and Complex Needs. The mission is to develop and maintain social supports for youth & family in order to promote sustainability of treatment gains. CRP has two designated KCF QMHPs, where one is providing skills training and the other case management services to approximately 20-25 clients and their families who are mandated by the court to participate in this program. CRP includes more intensive probation supervision and intensive mental health services. Clients also have access to all other KCF services. These clients typically have some type of behavioral issue and often have a diagnosis of ODD or Conduct Disorder. They also have one or more convictions and are considered to be at high risk for admission into TJJD or for placement in a residential treatment center. The typical length of the program is a period of 6 months but can be extended if needed. Clients who are currently in KCF services may be referred to CRP if the client possesses the qualifying criteria and appears to require the intensive services and supervision that are provided in this program. The referral must be made to the KCF Juvenile Justice/Case Management Supervisor and later staffed by the CRP team for appropriateness. As the majority of the referrals come directly from the juvenile probation officers to the CRP team, which include youth that may not be currently in services with KCF but are on probation within the juvenile probation department and appear to be in need of CRP. If accepted into CRP, these youth will then be admitted into KCF services.Encircle
A collaborative program involving KCF and the local juvenile probation department that is designed for youth who have juvenile justice involvement within the department who are having difficulties in school and are placed or transitioning from McLennan County Challenge Academy. Services are focused on the academics, social, emotional and family needs of each youth. The designated KCF ENCIRLCE QMHP provides skills training and intensive case management services to a caseload of approximately 35 clients and their families, as this QMHP will also be available to provide clients in KCF services on other assigned caseloads while attending the McLennan County Challenge Academy skills training and/or crisis intervention services. Clients also have access to all other KCF services. Clients who are currently in KCF services may be referred to ENCIRLCE if the client possesses the qualifying criteria and appears to require the intensive services and supervision that are provided in this program. This type of referral must be submitted directly to the KCF Juvenile Justice/Case Management Supervisor and later staffed by the ENCIRCLE team for appropriateness. As the majority of the referrals come directly from the McLennan County Challenge Academy and juvenile probation officers to the ENCIRCLE team, which include youth that may not be currently in services with KCF but are involved within the juvenile probation department and appear to be in need of the ENCIRCLE program. If accepted into the ENCIRCLE program, these youth will then be admitted into KCF services. ENCIRCLE is voluntary and clients typically remain in the program until completion of enrollment at the McLennan Challenge Academy, though some clients may be served longer if determined and approved to be justified by the team.
Juvenile Justice Transition Team (JJTT)
A KCF juvenile justice program designed to provide intensive mental health services to high-risk youth transitioning from TCOOMMI , CRP, Encircle and TJJD into less intensive on-going services. The designated KCF JJTT QMHPs provide skills training and intensive/routine case management services per caseload of 25 clients and their families. Clients also have access to all other KCF services. Referrals to JJTT will come from one of the three specialized juvenile justice programs and youth releasing back into their communities from TJJD along with those youth from substance abuse or residential treatment centers and relocating into our service areas. Youth upon completion within one of these three specialized programs will be referred internally as a matter of course to JJTT. The services for JJTT youth will be somewhat less intensive than those provided in one of the 3 intense JJ programs from which they have been transitioned but significantly more intense than services delivered to core KCF clients. The aim here, being to provide a step-down in intensity and frequency of services that is not as drastic as a pure transition from one of these JJ programs to core services thereby reducing recidivism and regression. Upon completion of the approximate 6 month episode of care JJTT youth with a continued need for mental health services will be transitioned to the appropriate KCF and/or community services, though some clients may be served longer if determined and approved to be justified by the team.School Based Services
Klaras Center for Families School Based Mental Health (SBMH) Program literally brings KCF’s services directly into the educational milieu allowing children to receive services on-site at their designated school campus. This typically places a tandem of two staff including a case manager and a counselor who are integrated into the school setting. School districts identify their most intense students in need of mental health services and provide KCF with direct access and designated space to provide these much needed services. Services provided include the full array of mental health and behavioral, health services comprising trauma-informed psychotherapy, case management, crisis services, psychiatric assessment family partner support, and skills training (including prosocial behavior skills, anger control, etc.).
The ultimate goal of SBMH services is to engender both personal and academic success.
Since 2017, the SBMH program has provided services to 1,238 students and their families in over 8 school districts and 45 different campuses. The number of students served has increased per year starting at 173 to 409 this past year. The program has enlisted financial support directly from these school districts in the amount of $235,000 for the current school year. Currently, SBMH is primarily serving McLennan County school districts with one district in Hill County. However, KCF continues to look for financial support and investment from existing and additional school districts in our six-county area to expand the reach of SBMH programming.
Current School Districts:
Waco ISD
Midway ISD
LaVega ISD
Lorena ISD
Robinson ISD
Connally ISD
Whitney ISD
Youth Homelessness Demonstration Program
In August of 2019, the U.S. Department of Housing and Urban Development (HUD) selected twenty-three communities to receive the transformational demonstration grant called the Youth Homelessness Demonstration Program (YHDP). The Heart of Texas Region, one of eight rural communities selected to be part of this demonstration program, was awarded $2.23 Million by HUD, to develop and implement comprehensive approaches, projects, and strategies to ensure all youth have a safe place to call home.
The Klaras Center for Families, a program of the Heart of Texas Behavioral Health Network (HOTBHN), designed and developed 5 YHDP programs which are to be launched on October 1, 2020. These 5 programs include:
- The Heart of Texas Transitional Crisis Housing for Youth (HOTTCHY) Program: HOTTCHY is designed to be safe, inclusive, and affirming for youth ages 16-18, offering them temporary Transitional Housing with a full panoply of supportive services, to include skills training, counseling, nursing, mentoring and peer support, with the overall goal of transitioning youth into permanent housing. Access to HOTTCHY is available 24-hours, 7 days a week.
- Drop-in Opportunities Bolstering Engagement for Young adults in the Heart of Texas Region (DOBEY): DOBEY offers the Heart of Texas Region a much-needed Drop-in Center for young adults between the ages of 18-24. DOBEY Drop-in services prioritize a quick transition out of homelessness into permanent housing, as well as access to social skills support services, mental health skills training support, employment support, with education support services, and more.
- Supports to Aid Rapid Rehousing and Skills for Keeping Young adults Engaged (STARRSKYE): A fundamental goal of STARRSKYE is to reduce the amount of time a young adult, aged 18-24, is homeless by offering Rapid Rehousing services. STARRSKYE will offer scattered-site housing where a young adult is able to be a leaseholder of a housing unit located within the community. Case Management services will also be provided to connect young adults to additional supportive services to assist in obtaining permanent housing and achieving self-sufficiency.
- Homeless Young adults Gaining Entrance into Housing & Bolstering Engagement and Access throughout the Region (HYGEH BEAR): HYGEH BEAR is a mobile, multi-disciplinary Navigation Team with the focus of assisting youth as they move from homelessness to stable housing. HYGEH BEAR will serve youth between the ages of 16-24. HYGEH BEAR prioritizes the support of a quick transition out of homelessness into permanent housing, as well as providing other essential life-domain supports.This Navigation team will also provide triage to those youth finding themselves entering homelessness and connect them to diversion and emergency shelter as needed. The team will provide basic needs, linkages to mainstream services, coordinated entry assessment, and navigation of systems via progressive engagement centered around youth choice.
- YHDP Planning Grant: The Heart of Texas Behavioral Health Network (formerly Heart of Texas Region MHMR Center) has been selected by the Heart of Texas Homeless Coalition to serve as the YHDP Lead Agency and is thus charged with the administration of the YHDP initiative in the Heart of Texas Region. This grant includes supporting funding of the YHDP Project Director, coordinating YHDP and Youth Advisory Board (YAB) meetings (The YAB is comprised of youth with lived homelessness experience that provides leadership and consultation apropos of all YHDP Programs), and ongoing evaluation and monitoring of YHDP projects, as well as implementation of the Coordinated Community Plan.
Rural Expansion of Services
The Heart of Texas Behavioral Health Network (HOTBHN), through KCF, is expanding services in the effort to radically support behavioral health access and equity in the Heart of Texas’ rural regions. The To Infinity and Beyond Initiative is our vision for filling identified service gaps in its rural sectors. This Initiative will vitally expand and support rural behavioral health services by instituting the following programs: 1) reducing barriers to access by creating a rural transport system; 2) increasing rural case management services for all ages; 3) expanding Substance Use Disorder services for all ages; 4) strengthening rural peer services, and youth crisis services; and 5) augmenting salary for rural personnel to recruit and retain rural staff.
SAFETY NET PROGRAM
Safety Net is a community-based program that meets the immediate needs of runaway and homeless youth and their families. Safety Net seeks to reunite youth with their families, whenever possible, or to locate appropriate alternative placements. The program also provides youth (13 up to age 18) with emergency shelter, food, clothing, counseling and referrals for health care.
Services Provided:
- Utilize Positive Youth Development throughout program
- Emergency shelter up to 21 days, food, clothing, and medical care
- Trauma-informed individual, group, or family counseling
- Outreach to youth who may need assistance
- Recreation programs
- Aftercare services for youth after they leave Youth Crisis Respite House
Klaras Children’s Center ECI
324 South 4th St
Waco 76701
Mailing address: PO Box 890
Waco, TX 76703
Phone: (254) 297-7089
Toll-Free: (866) 752-3451
Fax: (254) 296-2932
Click here to visit the Klaras Children’s Center Website
This unit, staffed with early childhood specialists and licensed therapists, serves children, ages birth through three years, who are developmentally delayed or have medical conditions likely to result in delay, including hearing and vision concerns. Services are primarily delivered in “natural environments” such as the child’s home or child care setting. Over 800 children receive services throughout the year.
Working with a Young Child
Click the link below to go to Klaras Children’s Center (a subsidiary of the Heart of Texas Behavioral Health Network) website.
Center for Developmental Services
Center for Developmental Services |
Mexia Office |
Hours of Operation: Monday through Friday; 8 a.m. to 5 p.m.
The Center for Developmental Services (CDS) is the front door to eligibility for, information about, and access to services and resources in the community for people with Intellectual and Developmental Disabilities. The office in Waco is the primary location for access, but all services provided through that location are also available through the office in Mexia.
The people working at the CDS approach the individuals in services through the concept of Person Centered Thinking and Person Centered Planning. What this means is that they are interested in helping the individual develop their own goals and establish what services they need and want, instead of telling individuals what their goals should be and what services they should want. Our employees are in a constant mode of discovery, always trying to get more information from and about the individuals served to best help them to be healthy and safe, and socially active and productive members of the community.
CDS works closely with Private Providers of ICF, HCS and TxHmL services, as well as with Nursing Facilities, State Supported Living Centers and State Hospitals to assure that individuals with IDD who interact with these various resources are getting the supports they need, and are getting them in the least restrictive environment. While we help people to access the more restrictive living environments, we also work diligently to transition people from those settings to less restrictive residential settings in the wider community.
Feel free to explore through this website the resources within IDD services. We are a Local Intellectual and Developmental Disability Authority (LIDDA), meaning that we engage with all individuals receiving IDD services in the 6-county region, monitoring services to ensure people are getting what they want. We are also a Provider of IDD services through several distinct programs that are explained within these pages.
Local IDD Authority
(LIDDA)
Eligibility Determination
The front door of the Center for Developmental Services handles eligibility determinations, community information and referral, service coordination referral, hospital and state school liaison, HCS, TxHmL, ICF/MR enrollment, Permanency Planning, State School Community Living Options Information Process, and emergency and crisis services.
Continuity of Service (COS)
Continuity of Services is the continuation of or transition to services from one setting to another, with the least amount of service interruption as possible. The services a person receives in one program are important enough that we want to ensure they carry over to another program when possible, and that there is no gap between or delay of services because of the transition. Moving from one place and one program to another brings with it change, and change is stressful. Continuing those services that we know the individual likes and expects through the change helps to reduce the stress of the change. Click on the link to learn more about the HOTRMHMR COS program.
Independent Service Coordination
Based on the requirements of the Texas Administrative Code, Service Coordinators assist individuals in planning, developing and coordinating a Person-Directed Plan, and in monitoring services to ensure their effectiveness. Our Service Coordinators develop strong working relationships with individuals and their families, and have significant knowledge of community resources.
Pre-Admission Screening and Resident Review (PASRR)
PASRR was started to assure that people eligible for IDD services who live in nursing facilities had access to the same services someone who lived in the community, including training needed to one day be able to move from the nursing facility back into the community. PASRR services include information and education about supports in the community that assures that people are well informed about their options in order to make an informed decision about transition to a community setting. A service Coordinator from the LIDDA facilitates program planning and planning team meeting in order to get a person started and maintaining a heading down the path toward community and greater independence. Click on the link to learn more about the HOTRMHMR PASRR program.
Eligibility & Intake
The CDS is the sole entity in the six-county Heart of Texas Behavioral Health (formerly HOTRMHMR) region to determine that someone is eligible for the myriad services overseen by the Health and Human Services Commission to people with IDD, Autism and Related Conditions. The Determination of Intellectual Disability, or DID, is governed by the DID Best Practices Guidelines, published by the Department of Aging and Disability Services, April 1, 2016. The Best Practices Guidelines are available at:
The eligibility process takes time, but there are a number of things you can do to speed up the process when you decide to seek eligibility. Your first call to the Intake Social Worker will result in an understanding of the intake process, with specific focus on the types of reports that may be requested that will help facilitate the process, and setting up an initial appointment. At the first appointment, with the Intake Social Worker, the eligibility process is again reviewed, state-required documentation is completed, and consents to gather information not already provided are signed. Since the process involves gathering information including school and medical records, previous psychological testing, and social and familial history, providing as much documentation and information as possible at the initial appointment will speed the DID process. Keeping your appointments and communicating regularly with the intake SW prior to the appointment are also very important.
After we receive requested documentation, the diagnostician reviews it all to get an initial impression as to eligibility status. If the determination is that the individual is likely to be eligible, testing will be scheduled. On the day of testing, it is expected that the individual/family block as much as 4 hours of time for the entire process, because a number of different tasks are accomplished.
- The individual/family will meet with a benefits eligibility specialist who not only conducts a state-mandated Financial Assessment to determine the presence of a Maximum Monthly Fee for services, but also makes the determination that the individual may be eligible for additional benefits, such as social security and Medicaid. The eligibility specialist can help you get some of these benefits once you are in services.
- The individual meets with the intake social worker and the diagnostician to discuss social and medical history, and also for completion of an assessment for deficits in adaptive skills.
- The individual meets with the diagnostician for Intelligence Testing.
All testing information and other information collected is included in a report that is titled the Determination of Intellectual Disability (DID). The determination is yes or no, eligible or not eligible. Most people who go through intake are determined eligible for services. If not, there is a process for appeal of the results.
Four Ways to be Eligible
There are four ways that an individual can be determined eligible for IDD services. These are important because how a person is determined eligible may also determine what types of services the individual will be eligible for.
- An IQ of 69 or below: Eligible for the full range of IDD Services and Supports
- An IQ of 69 or below with a Related Condition: Eligible for the full range of IDD Services and Supports
- An IQ of 70 to 75, with a Related Condition and deficits in adaptive skills: Eligible for the full range of IDD Service and Supports in General Revenue Services*, and eligible for ICF services, but not currently eligible for IDD waiver services like HCS, TxHmL or DBMD.
- A diagnosis of Autism with an IQ above 75: Eligible for the full range of IDD Service and Supports in General Revenue Services, but not currently eligible for IDD waiver services like HCS, TxHmL or DBMD.
After the determination is made and the report is written, a copy of the report is given to the individual and the results are discussed. When people are determined eligible, and if they are seeking actual services from CDS, they will be referred to the Service Coordination Unit.
The Eligibility and Intake Unit can be reached by calling 254-757-3933 and expressing your desire to speak with someone in this unit.
LIDDA Service Coordination
Service Coordination, by definition in the Texas Administrative Code, Title 40, Chapter 2, Sub-chapter L (402-L), is:
“assisting an individual in accessing medical, social, educational, and other appropriate services and supports that will help the individual achieve a quality of life and community participation acceptable to the individual”.
Service Coordination is about helping an individual put words to their dreams and then helping the individual find, access, and maintain services and supports necessary to work toward those dreams. An individual’s Service Coordinator (SC) should be considered a primary advocate, someone who will look out for the individual’s best interests and whose focus is to help the individual fulfill their goals. Our service coordinators are trained in Person Centered Thinking and Person Centered Plan Facilitation – -which means they ask you what you want and try to mold the plan of supports around your goals and dreams. We do not prescribe services and supports based on what we think is best for you – we seek and coordinate services that help you be the person you want to be.
The SC will spend time with the individual to get to know him/her. The SC will ask questions about things the individual likes and is able to do. The individual’s SC will help the individual develop a planning team as well as help schedule and facilitate planning team meetings. The individual’s SC will develop a written plan, called a Person-Directed Plan (PDP), that includes those goals or outcomes the individual most desires to work toward. The individual’s SC will communicate frequently with the provider of services to assure that the individual is getting and benefitting from the services and supports that are being provided. And should you have complaints about your service providers, your SC will help you get resolution to those complaints.
Service Coordination through the CDS has always been dedicated to working with HHSC, the Private Provider Association of Texas (PPAT), the Provider Alliance for Community Services of Texas (PACSTX), the Texas Council of Community Centers, local HCS, Texas home Living and Nursing Facility providers, individuals receiving services and their families in whatever way necessary to assure openness in activities and communication. We have built productive working relationships with providers, and trusting relationships with consumers. And most of this work and trust is built through our strong team of Service Coordinators.
HHSC requires the LIDDA to provide Service Coordination in the General Revenue, TxHmL, HCS, Nursing Facility PASRR, and Community First Choice programs. Service Coordination is governed by a number of rules and guidelines. Each program within which SC is provided includes a section in their rule book or manual about LIDDA responsibilities around service coordination. Any questions about these responsibilities, or Service Coordination in general, should be directed to the Program Director of Service Coordination, who can be reached at 254-757-3933.
Pre-Admission Screening and Resident Review (PASRR) – Individuals with IDD in Nursing Facilities
An individual with IDD typically does not fit the mold of someone admitted to a nursing facility, unless they are elderly, yet there are a number of these folks who live in the more than 30 Nursing Facilities in the Heart of Texas Region. For many of these individuals, a nursing facility is a more restrictive living environment than they need, but they got there because at some point in time a doctor or caregiver didn’t know where else to put them. To compound the problem, once there the staff do not know how to best serve them.
Beginning in 2013, the Department of Aging and Disabilities Services (now HHSC), as a result of a Federal Mandate and under the scrutiny of advocacy groups and a lawsuit settlement, developed a program of services and supports to people with IDD residing in nursing facilities. The support beam in these services is Service Coordination, provided through the LIDDA.
Before an individual is admitted to a nursing facility, a PASRR Level 1 evaluation is completed that may identify the individual as someone who has IDD. For these individuals, the LIDDA receives an alert to complete a PASRR Evaluation (Level 2) which, once completed, confirms either eligibility for IDD PASRR services or not. If eligibility is determined, the case is referred to the LIDDA Nursing Facility Service Coordination Unit. A Service Planning Team meeting is held, a service plan is developed, and PASRR services the individual is entitled to and wants or needs are coordinated and monitored.
It is the intent of HHSC and the LIDDA to divert people with IDD from nursing facility placement as much as possible. Should that not be possible, attempts are made to coordinate services such as Independent Living Skills training, Day Habilitation, Behavior Support, and others in an effort to strengthen the skills a person needs to eventually transition from the nursing facility to a less restrictive residential setting in the community. At the same time, the Service Coordinator serves as the primary advocate for these individuals, helping to assure that they receive the medical and professional services from the nursing facility that they are entitled to.
For complete information about the PASRR program, click on this link: https://hhs.texas.gov/doing-business-hhs/provider-portals/resources/preadmission-screening-resident-review-pasrr
