What is Home & Community-based Services (HCS)?
The Home and Community-based Services is a waiver program that provides individualized services and supports to children and adults with intellectual disabilities who are living with their family, in their own home or in other community settings, such as small group homes with no more than 4 people.
What Are Waivers and How Do They Work?
A waiver is a provision in the Medicaid program that allow states the flexibility to use Medicaid funds to provide service in community settings as an alternative to institutional settings for people with disabilities or special needs.
They are named waivers because certain Medicaid eligibility requirements are waived and doesn’t apply to the program. All is based on just the child’s income alone not the whole family’s income.
The benefits of home and community-based services
Prior to the creation of waiver programs, individuals with intellectual or developmental disabilities had to live in hospitals, nursing homes, or other institutional setting. Home and community-based services allow Medicaid beneficiaries to receive assistance and services in their own homes or communities.
Some of the services a beneficiary can get with a waiver are: assistance with daily living, Nursing care, Minor home modifications, Respite care, Certain therapies. These services allow the them to live independently in their communities and play active roles in societies.
Some of the qualifying diagnoses for the home and community-based program include intellectual disability, cerebral palsy, seizure disorder, autism, or a similar condition.
The application process to enroll in the waiver program
To apply for the waiver care program, expect a bit of a lengthy and time-consuming process. Many individuals apply, and the number selected and cared for is limited. That doesn’t mean, however, that you should simply give up and not apply.
Here’s the beginning-to-end process to apply for the waiver care program:
- Call 1-877-438-5658 for information about putting your child on an interest list for long-term services or
- Call your Local Intellectual and Developmental Disability Authority (LIDDA) to get your name on the interest list for the HCS and Texas Home Living Waiver programs. You can search for your LIDDA’s telephone number.
- Once your child moves to the top of an interest list, a service coordinator, case manager, or nurse will schedule a home visit. This will start the process of determining if your child is able to enroll in the waiver programs.
- If your child is in a crisis or has high medical needs, call your LIDDA to ask about diversion slots. You can search for your LIDDA’s telephone number on the Texas Health and Human Services (HHSC) website. These slots are for extreme cases only, such as a critical health crisis that puts the family at risk of placing the child in a state-supported living center. If approved, your child moves to the top of the HCS interest list.
- If approved, HHSC will offer you the choice of a direct service provider agency and a case management agency you will be assigned a care coordinator/service coordinator with a managed care entity who will assist in developing, implementing, and monitoring your care plan to live as independently and healthily as possible.
- Your service Coordinator will work with you to choose the provider of your choice
- If disapproved, you will be given an opportunity to appeal right away to have your application reconsidered.
- If, after a second attempt, the individual is still disapproved, the HHSC will provide some different options for your consideration.
Important Tips to consider.
- Consider adding your child to the waiver interests lists as possible when your child is first diagnosed with a disability or special health-care needs. You should also think about adding your child to the lists even if they aren’t diagnosed but have reason to believe that your child will have a long-term disability or special health-care needs.
- Ask for an email confirmation or a mailed letter when you add your child to the Medicaid waiver interest lists. Keep this in a safe place.
- It is very important to keep your address and contact phone numbers updated. If your child moves to the top of the interest list and they can’t reach you, your child will be dropped from the list. They might also call you or send you a letter to see if your child still needs services. If they can’t reach you, they might take your child off the list.
- At least once a year, call to update your contact information. Most parents remember by calling around their child’s birthday.
Texas Health and Human Services
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