Introduction

With this grant, Texas proposes to build on its current practice of assisting individuals to transition out of institutions into community-based programs and to focus new efforts on persons with complex support needs, particularly those with behavioral health conditions. The mechanisms Texas uses to assist persons with intellectual and developmental disabilities and who are aging and/or have physical disabilities are different for each population and have evolved over time. This grant will provide Texas with the opportunity to conduct rebalancing efforts that would have been difficult without the additional federal funding. Texas will not need to change its current home and community-based services array and will not need to design new processes to assist individuals who are aging and/or have physical disabilities with transitioning out of nursing facilities. Texas is proposing, however, a new strategy for transitioning individuals with intellectual and developmental disabilities out of community-operated nine-plus bed ICFs/MR and new demonstration services for persons with behavioral health conditions.

With this grant, for individuals in nursing facilities, Texas:  1) will build upon its current MFP Initiative and use the enhanced match to finance community-based services and improve outreach efforts; and 2) will better target for transition individuals with complex support needs in general and through a new pilot focused on individuals with co-occurring behavioral health conditions.

For individuals in institutions serving persons with intellectual and developmental disabilities, Texas:  1) will continue its current Promoting Independence Priority Populations Initiative and use the enhanced match to transition individuals out of 14-plus bed community-operated intermediate care facilities and State Mental Retardation Facilities; and 2) will implement a new initiative to close nine-plus bed community-operated intermediate care facilities and transition residents to other settings of their choice, including home and community-based waiver programs.

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Updated: May 1, 2015