Revision 19-4; Effective September 9, 2019

 

The guidelines set forth in this section describe the procedures to be used by the local intellectual and developmental disability authority’s (LIDDA’s) interdisciplinary team (IDT) for determining the less restrictive setting for persons who are requesting admission, or on whose behalf admission is requested, to a state supported living center. The determination of a less restrictive setting is only one part of the admission criteria that must be considered by the IDT.

 

16100 Instructions

Revision 19-4; Effective September 9, 2019

 

The local intellectual and developmental disability authority (LIDDA) must ensure interdisciplinary team (IDT) members:

  • use these guidelines to determine whether a person can be adequately and appropriately habilitated in an available, less restrictive setting when admission to a state supported living center (SSLC) is requested;
  • have received appropriate training on the use of these guidelines and in an approach that is person-centered; and
  • use a person-centered approach when determining eligibility for an available, less restrictive setting.

To ensure the “key issues” from these guidelines are documented in IDT reports, the LIDDA will:

  • incorporate the “key issues” as essential elements of the LIDDA’s policy and procedure for IDTs; and
  • develop an internal monitoring system to ensure that these guidelines are used by IDTs.

 

16200 Discussion of Key Issues Using Probing Questions

Revision 19-4; Effective September 9, 2019

 

The interdisciplinary team (IDT) will discuss the following key issues using the provided probing questions in a manner understood by the person and legally authorized representative (LAR) or someone else actively involved with the person.

Issue: Preferences of the Person, LAR and/or Someone Else Actively Involved with the Person

  • Question: Has the local intellectual and developmental disability authority (LIDDA) provided the person/LAR and/or someone else actively involved with the person with an explanation of the array of services and supports administered by Texas Health and Human Services Commission (HHSC) and other state agencies for which the person may be eligible?
  • Question: Has the LIDDA explained to the person/LAR and/or someone else actively involved with the person his or her rights in accordance with HHSC rules?
  • Question: Has the person/LAR and/or actively involved party expressed a preference for types of services?

Issue: Medical

  • Question: Does the person have medical/nursing needs? If so, describe the scope of those needs and the types of services needed. The IDT should consider the need of the person for immediate access to emergency medical assistance.
  • Question: Can these needs be met through either generic or specialist services that are generally available in the community?
  • Question: What can be done to support or facilitate these needs being met in both the person’s current setting and other settings under consideration?

Issue: Behavioral or Psychiatric

  • Question: Does the person have behavioral or psychiatric treatment needs? If so, describe the scope of those needs and the type of services needed.
  • Question: Can these needs be met through either generic or specialist services that are generally available in the community?
  • Question: What can be done to support or facilitate these needs being met in both the person’s current setting and other settings under consideration?

Issue: Quality of Life

  • Question: Determine factors that are important to the person/LAR and/or someone else actively involved with the person in choosing a place to live, including but not limited to: family, friends, employment, leisure activities, living arrangements, daily routine, privacy, community integration, faith or religion, self-determination, safety, freedom of movement and dignity of risk. See Section 16300, Additional Guidelines for Quality of Life.
  • Question: What can be done to support or facilitate these factors being met in both the person’s current setting and others under consideration?

Issue: Persons Under 22 Years of Age

  • Question: For persons under 22 years of age, has there been a discussion with the family of the importance for the minor to live in a long-term, nurturing relationship with a family and of options to living in an institutional setting?
  • Question: Has permanency planning been incorporated into the service plan and reviewed as required?
  • Question: What efforts have been made to ensure LAR or family participation in services or permanency planning activities?
  • Question: Have educational issues been addressed, including contact with the local school district?

Issue: History of Services and Supports

  • Question: Has the person received services and supports previously? If yes, describe these and how they benefited the person.
  • Question: Are there other services and supports that have not been tried but should be considered? If so, explain.

Issue: Other

  • Question: Were other issues discussed? If so, explain.

Issue: LIDDA Recommendations

  • Question: Based on discussion of the issues described above, the IDT must determine if there is a less restrictive setting other than the state supported living center. If so, whether the less restrictive setting is available.

 

16300 Additional Guidelines for Quality of Life

Revision 19-4; Effective September 9, 2019

 

The environment should:

  • afford the development of meaningful relationships or the continuity of current relationships;
  • allow the development of skills that foster independence, to the extent possible;
  • be as inclusive as possible, maximizing opportunities for integration, relationships, and involvement of people with and without disabilities;
  • balance safety, freedom of movement, with or without supports and assistance, and dignity of risk, as determined by the person’s preferences/needs;
  • provide opportunities for expression of faith or religion in a way or to the extent desired; and
  • provide opportunities to make decisions, as appropriate.

 

16400 Documentation

Revision 19-4; Effective September 9, 2019

 

Documentation in the interdisciplinary team (IDT) staffing summary will include:    

  • source of the information discussed;
  • relevant deliberation; and
  • outcome of the discussion of key issues.