Revision 05-1; Effective December 2, 2005    

 

 

Individuals who receive hospice care and reside in the community may be eligible to use community services. Contracted providers in the community, such as home health and community support services agencies, furnish services not related to the terminal illness. The following items describe the types of community services available in most areas. Contact local Department of Aging and Disability Services (DADS) offices for more information.

 

9100 Non-Medicaid Community Care Services

Revision 05-1; Effective December 2, 2005  

 

 

9110 Adult Foster Care (AFC)

Revision 05-1; Effective December 2, 2005  

 

Adult foster care (AFC) provides a 24-hour living arrangement with supervision in an adult foster home for consumers who, because of physical, mental, or emotional limitations, are unable to function independently in their own homes.

Providers of AFC must live in the household and share a common living area with consumers. With the exception of family members, no more than three adults may live in the foster home unless it is licensed by DADS.

Services may include minimal help with personal care, help with activities of daily living, and provision of, or arrangement for, transportation. The consumer pays the provider for room and board.

 

9120 Client Managed Personal Attendant Services (CMPAS)

Revision 05-1; Effective December 2, 2005

 

Personal assistant services are provided to consumers with physical disabilities who are mentally competent and willing to supervise their attendant or who have someone who can provide the personal assistant’s supervision. Consumers interview, select, train and supervise their personal assistants. Licensed personal assistance services agencies determine client eligibility; the care needed; develop a pool of potential personal assistants; and provide emergency back-up personal assistants. Services include: personal assistance services and additional services may include health-related tasks prescribed by a physician.

 

9130 Day Activity and Health Services (DAHS) Title XX

Revision 05-1; Effective December 2, 2005

 

Day Activity and Health Services (DAHS) facilities provide daytime services Monday through Friday to consumers residing in the community to provide an alternative to placement in NFs and other institutions. Services are designed to address the physical, mental, medical, and social needs of consumers. Services include:

  • noon meal and snacks,
  • nursing and personal care,
  • physical rehabilitation,
  • social, educational and recreational activities, and
  • transportation.

 

9140 Emergency Response Services (ERS)

Revision 05-1; Effective December 2, 2005

 

Emergency Response Services (ERS) provides an electronic monitoring system to functionally impaired adults who live alone or are socially isolated in the community. In an emergency, the consumer can press a call button to signal for help. The electronic monitoring system, which has a 24-hour, seven-day-a-week monitoring capability, helps ensure that the appropriate person or service agency responds to an alarm call from a consumer.

 

9150 Home Delivered Meals

Revision 05-1; Effective December 2, 2005

 

The Home Delivered Meals Program provides a nutritious meal that is taken to the consumer's home, which helps ensure a consumer receives at least one healthy meal per day.

 

9160 In-Home and Family Support (IHFSP)

Revision 05-1; Effective December 2, 2005

 

The In-Home and Family Support Program (IHFSP) provides direct grant benefits to consumers with physical disabilities and/or the consumer's family to purchase services that enable them to live in the community. Eligible consumers are empowered to choose and purchase services from the following:

  • assistance with purchase or lease of special equipment or architectural modifications to a home;
  • counseling and training programs;
  • home health aide and homemaker services;
  • household assistance;
  • medical services and other health services related to a consumer’s disability;
  • other disability related services prior-approved by DADS;
  • personal attendant care for assistance with activities of daily living;
  • pre-approved transportation and room and board cost incurred by a person with a physical disability or the family during evaluation or treatment;
  • respite care;
  • transportation services.

 

9170 Residential Care Program (RC)

Revision 05-1; Effective December 2, 2005

 

The Residential Care (RC) Program provides services to eligible adults who require access to care on a 24-hour basis but do not require daily nursing intervention. Services include personal care, home management, escort, 24-hour supervision, social and recreational activities, and transportation.

Supervised living is a state-funded 24-hour living arrangement in which the consumer is expected, if able, to contribute to the total cost of his care. The consumer keeps a monthly allowance for personal and medical expenses, and the remainder of his income is contributed to the total cost of his care.

Services provided under the RC program are delivered through either residential care or emergency care.

Emergency care is a state- or Title XIX-funded living arrangement that provides services to eligible consumers while caseworkers seek a permanent care arrangement. Emergency care consumers do not contribute toward the cost of their care.

 

9180 Respite Care

Revision 05-1; Effective December 2, 2005

 

The Respite Care Program provides short-term services for elderly and disabled adults who require care and/or supervision while their care givers receive temporary relief. Services may be provided inside or outside of the home. Services may be provided in:

  • an NF or hospital and include personal care, nursing intervention, supervision, meal preparation, and a room;
  • an adult foster care home or an assisted living facility and include personal care, housekeeping, supervision, meal preparation, transportation, and a room;
  • an adult day health care facility and include personal care, nursing services, supervision, meal preparation, and transportation;
  • the consumer's own home by a home care attendant and include personal care, housekeeping, meal preparation, supervision, and transportation;
  • the consumer's own home by a sitter and include housekeeping, meal preparation, and supervision.

 

9190 Special Services

Revision 05-1; Effective December 2, 2005

 

 

9191 Special Services to Persons with Disabilities

Revision 05-1; Effective December 2, 2005

 

Special Services to Persons With Disabilities provides special services to community care clients in a variety of settings. These services are designed to assist consumers in developing the skills needed to remain in the community as independently as possible. Services include counseling, homemaking and housekeeping assistance and personal assistance services.

 

9192 Special Services to Persons with Disabilities 24-Hour Attendant Care

Revision 05-1; Effective December 2, 2005

 

Special Services to Persons With Disabilities 24-Hour Attendant Care makes attendant care available to consumers on a 24-hour basis. Consumers live independently in clustered living arrangements and use this service to achieve habilitate or rehabilitative goals.

 

9200 Non-waiver Medicaid Community Care Services

Revision 05-1; Effective December 2, 2005

 

 

9210 Day Activity and Health Services (DAHS) Title XIX

Revision 05-1; Effective December 2, 2005

 

Day Activity and Health Services (DAHS) facilities provide daytime services Monday through Friday to clients who reside in the community as an alternative to placement in NFs and other institutions. Services are designed to address the physical, mental, medical, and social needs of clients. Services include:

  • noon meal and snacks,
  • nursing and personal care,
  • physical rehabilitation,
  • social, educational, and recreational activities, and
  • transportation.

 

9220 Primary Home Care (PHC)

Revision 05-1; Effective December 2, 2005

 

Primary Home Care (PHC) is a non-technical, personal care service available to eligible adults and children whose health problems cause them to be functionally limited completing activities of daily living. A practitioner must provide a statement that the consumer has a current medical need or assistance.

PHC provider agencies also provide family care services. Family care also is a non-skilled, non-technical service provided to eligible consumers who are functionally limited in performing daily activities.

PHC services are provided by an attendant through a licensed home and community support services agency under the personal assistance services (PAS) category of licensure.

 

9300 Medicaid Waiver Programs

Revision 05-1; Effective December 2, 2005

 

 

9310 Community Based Alternatives (CBA)

Revision 05-1; Effective December 2, 2005

 

The Community Based Alternatives (CBA) program provides home and community-based services to aged and disabled adults as cost-effective alternatives to institutional care in nursing facilities (NFs).

DADS staff provides case management. Waiver services include:

  • adaptive aids and medical supplies,
  • adult foster care,
  • assisted living/residential care services,
  • consumer directed services,
  • emergency response services,
  • home delivered meals,
  • minor home modifications,
  • nursing services,
  • occupational therapy,
  • personal assistance services,
  • physical therapy,
  • respite care,
  • speech pathology services, and
  • transition assistance services.

 

9320 Community Living Assistance and Support Services (CLASS)

Revision 05-1; Effective December 2, 2005

 

The Community Living Assistance and Support Services (CLASS) program provides home and community-based services to persons with related conditions as a cost-effective alternative to Intermediate Care Facility for Persons with Mental Retardation or Related Conditions (ICF/MR-RC) institutional placement. A related condition is a qualifying disability, other than mental retardation, which originated before age 22 and effects their ability to function in daily life.

The CLASS service model focuses on consumer independence and integrating consumers into everyday community life. The CLASS program has two service providers: one provides independent case management, and one provides all other services, which include:

  • adaptive aids and medical supplies,
  • case management,
  • consumer directed services,
  • habilitation,
  • minor home modifications,
  • nursing services,
  • occupational therapy,
  • physical therapy,
  • psychological services,
  • respite care,
  • speech pathology,
  • specialized therapies,
  • support family services, and
  • transition assistance services.

 

9330 Program of All Inclusive Care for the Elderly (PACE)

Revision 05-1; Effective December 2, 2005

 

PACE provides community-based services to frail elderly people who qualify for NF placement. The program uses a comprehensive care approach to provide an array of services for a capitated monthly fee that is below the cost of comparable institutional care.

Covered services include any and all needed health-related services needed. These services include in-patient and out-patient medical care, specialty services such as dentistry and podiatry, social services, in-home care, meals, transportation, day activity, and housing assistance.

 

9340 Consolidated Waiver Program (CWP)

Revision 05-1; Effective December 2, 2005

 

The Consolidated Waiver Program (CWP) provides home and community-based service to consumers who are eligible for nursing facility care or intermediate care facility for persons with mental retardation or a related condition (ICF/MR-RC) as a cost-effective alternative to institutional placement. Services include:

  • case management,
  • adaptive aides and medical supplies,
  • adult foster care,
  • assisted living/residential care,
  • audiology,
  • behavior communication specialist,
  • child support services,
  • consumer directed services,
  • dental treatment,
  • dietary services,
  • emergency response services,
  • family surrogate services,
  • habilitation (residential, day, supported employment and prevocational),
  • home delivered meals,
  • independent advocacy,
  • intervention services,
  • minor home modifications,
  • nursing services,
  • orientation and mobility services,
  • personal assistance services,
  • prescribed drugs,
  • psychological,
  • respite (in and out of home),
  • social work,
  • therapies (physical, occupational, speech),
  • transportation, and
  • 24-hour residential habilitation.

 

9350 Deaf Blind with Multiple Disability (DBMD) Program

Revision 05-1; Effective December 2, 2005

 

The Deaf Blind with Multiple Disability (DBMD) Program provides home and community-based services to consumers who are deaf-blind with multiple disabilities as a cost-effective alternative to ICF-MR/RC institutional placement. The DBMD Program focuses on increasing opportunities for consumers to communicate and interact with their environment. Services include:

  • adaptive aides and medical supplies,
  • assisted living/residential care,
  • case management,
  • chore provider,
  • consumer directed services,
  • dietary services,
  • habilitation,
  • intervention,
  • minor home modifications,
  • nursing services,
  • occupational therapy,
  • orientation and mobility,
  • physical therapy,
  • respite care,
  • speech, hearing and language therapy.

 

9360 Home and Community Based Services (HCS) Program

Revision 05-1; Effective December 2, 2005

 

The HCS Program for consumers with mental retardation provides individualized services and supports to consumers living in their family home, their own homes, or other community settings such as small group homes where no more than four people live. Services include:

  • case management,
  • adaptive aids,
  • minor home modifications,
  • counseling and therapies,
  • dental treatment,
  • nursing,
  • residential assistance,
  • respite,
  • day habilitation,
  • supported employment.

 

9370 Texas Home Living (TxHmL) Program

Revision 05-1; Effective December 2, 2005

 

The TxHmL Program provides selected essential services and supports to consumers with mental retardation who live in their family homes or their own homes. The cost of covered services has a cap and may include:

  • adaptive aids,
  • minor home modifications,
  • specialized therapies,
  • behavioral support,
  • dental treatment,
  • nursing,
  • community support,
  • respite,
  • day habilitation,
  • employment assistance,
  • supported employment.

 

9380 Medically Dependent Children Program (MDCP)

Revision 05-1; Effective December 2, 2005

 

The Medically Dependent Children Program (MDCP) provides a variety of services, which are cost-neutral, to support families caring for children who are medically dependent and to encourage de-institutionalization of children in nursing facilities. Services include case management by regional DADS staff, adaptive aids, adjunct support services, minor home modifications, respite and transition assistance services.