Mental Retardation Services
Intake and Assessment
Services
Intake and Assessment
Step
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Description of this Step
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Action
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1.
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Begin the application process
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Call 1-800-643-0967 and ask for "MR Intake"
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2.
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Applicant information needed
Note: All information given to the Gulf Coast Center is protected for privacy by the national Health Insurance Portability and Accountability Act, see
www.cms.hhs.gov/hipaa
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Services received in the past from Gulf Coast Center
Name
Address where they live
Telephone number at this address
Male or Female
Age and Birth Date
Note: For children, birth to three years old with disabilities and developmental delays, Early Childhood Intervention ( ECI) is a statewide program available for families. See program details
Texas - www.dars.state.tx.us/ecis/index.shtml
Brazoria County - www.bacheci.org
Galveston County - call (409) 772-7717
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3.
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Caller information needed, if different from the Applicant
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Name , Address, Telephone number, Relationship to Applicant
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4.
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Diagnosis of the Applicant and who made the diagnosis.
A diagnosis may have been made by a school official, doctor or an MHMR center.
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The diagnosis may be one or more of the following:
- Mental Retardation
- Autism
- Asperger's Syndrome
- Pervasive Development Disorder
- Mental Retardation & Mental Illness
- None - reason you believe Applicant has one or more of the above conditions
- Not Known
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5.
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Who is the legal representative of the Applicant?
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The person who makes legal decisions may be the Applicant, a parent, a guardian or a spouse.
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6.
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What are the Applicant's or family's needs for services
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What do you need?
When do you need it?
What is the age of the primary caregiver?
Do you think there may be a family crisis or change that will require out-of home placement in the next year?
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7.
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Additional information the Intake Specialist will need
Note: You cannot be refused services due to an inability to pay. Non-Medicaid services are provided by Gulf Coast Center on a "sliding scale" basis, as determined by Center staff using prescribed guidelines. See
www.dads.state.tx.us/services/
dads_help/mental_retardation/payment.html
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Applicant's current source of income, if any
- SSI , SSDI, Employment, Trust fund, Other
Applicant's insurance, if any
- Medicaid , client number
- Medicare , client number
- Private insurance , policy number
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8.
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Make an appointment for the Applicant to come to the Gulf Coast Center for a Determination of Eligibility
Note: A packet with information on types of services will be mailed to the Applicant.
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The Applicant will meet with a Gulf Coast Center psychologist.
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9.
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Applicant information to bring to the appointment
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Primary physician's name and phone number
- Medical status
- Any physical limitations
- Any current medications
- Any hospitalizations
- Social Security number
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10.
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Intake and Assessment are finished
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You will receive the following:
- Results of evaluation
- Type of services available now or when services may be available
- Possible alternatives if services are not immediately available
You will be able to specify what services in which you are interested.
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Service Coordination
Admission Criteria
- Diagnosis of Mental Retardation
- Individual of any age who have been determined by assessment or endorsement, in accordance with Texas Health and Safety Code, to have a diagnosis of mental retardation or to be a member of the DADS mental retardation priority population and has been assessed as having multiple needs.
A Brief Description
Service Coordination provides assistance in accessing medical, social, educational and other appropriate services and supports that will help an individual achieve a quality of life and community participation acceptable to him or her as described in the plan of services and supports, which is based on a person-directed process. Service coordination includes assessment, service planning and coordination, monitoring and crisis prevention and management. The role of staff persons who provide service coordination is to support and assist the person in achieving personal goals.
Contact
Leigh Saunders
MRSC Supervisor
281-585-7456 or 1-888-839-3229
leighs@gcmhmr.com
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IHFS (In Home and Family Support)
Admission Criteria
Eligibility is based on diagnosis, residency, financial, and need factors.
- Diagnosis factor - The person must have a diagnosis of mental retardation; or pervasive developmental disorder; or have a developmental delay diagnosed within the previous 12 months and eligible for early childhood intervention.
- Residency factor - The person must be currently living in his or her natural home, or must be leaving an institutional setting and moving into a home in the community. Applicants must reside in either Brazoria or Galveston County.
- Financial factor - A person or family meets the requirements if the current annual gross income is less than 150% of the current Texas median income level.
- Need factor - The person or family must have a need that can be met with an item that will promote the person’s self-sufficiency.
A Brief Description
The In-Home and Family Support program provides funding for services or items, including:
- Special equipment
- Home Health services
- Architectural modifications
- Respite care
- Counseling and training services
- Transportation
- Other items or services that meet criteria
Funding is limited to no more than $2,500 a year per recipient.
Contact
For more information about the IHFS program or to obtain an application, please call Stephanie Little or Becky Eve at 1-877-226-8780, (409) 935-6083 or (281) 585-7430
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HCS (Home and Community-based Services)
The HCS program is a Medicaid Waiver Program, which provides community-based services and supports to eligible persons as an alternative to the Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR) program. Services are available to persons living in their own home and living with their family or paid companion. Services may also be provided to persons living in small group homes where no more than four persons may live.
Services May Include:
- Case Management
- Residential Services and Supports
- Day Habilitation
- Nursing
- Supported Employment
- Dental Treatment
- Adaptive Aids
- Minor Home Modifications
- Respite
- Specialized Therapies
Eligibility Requirements are adults and children with mental retardation or a related condition who:
- meet the Intermediate Care Facility for Persons with Mental Retardation (ICF/MR) Level of Care (LOC) 1 criteria,
- are eligible for Supplemental Security Income (SSI) or eligible for Medicaid under one of the optional Medicaid groups covered by the MRLA program,
- require services that do not exceed the cost limits set by the state of Texas,
- are not enrolled in another Medicaid waiver program, and if they are enrolled in another Medicaid waiver program, they must choose which program is best for them,
- choose to participate in the HCS program instead of the ICF/MR Program.
Waiting (Interest) List
- There is currently a long statewide waiting (interest) list for persons interested in receiving HCS Services.
Comparisons between HCS and other Waiver Programs
HCS vs CBA (Community Based Alternatives)
HCS vs CLASS (Community Living & Support Services)
HCS vs CWP (Consolidated Waiver Program)
HCS vs MDCP (Medically Dependent Children Program)
How to Apply for Services
Contact Leigh Saunders
MRSC Supervisor
281-585-7456 or 1-888-839-3229
leighs@gcmhmr.com
After I've Applied and been placed on the waiting list, what next?
- What to do while I'm waiting?
- What other services are available while I'm waiting?
When I'm offered an opportunity to enroll, what do I need to do?
Center staff will take you through the following steps in the order they are listed:
- Determine eligibility.
- Who does this? This is done by Center staff with input and information from the family.
- Apply to Medicaid.
- Who does this? This is done by Center staff with input and information from the family.
- Perform an assessment called the Inventory for Client and Agency Planning (ICAP).
- Who does this? A planning team which includes the person, the Legally Authorized Representative (LAR), Case Manager, a nurse, and other persons chosen by the person or LAR develops a plan of services. The plan describes the goals, services, and supports the person needs to ensure his/her health and welfare in the placement.
Choose Services that may include:
- Case Management is provided for anyone enrolled in HCS and includes:
- Coordination of the development and implementation of the person's Individual Service Plan (ISP)
- Coordination of various aspects of services delivered under the HCS Program and through other sources
- keeping track of the person's progress or lack of progress toward their goals
- reviewing issues related to rights, safety, and health
- Residential Services and Supports
- Supported home living is provided to individuals living in their own or family home. Includes support in learning, retaining, or improving skills related to activities of daily living.
- Supervised living provides habilitation, supervision and availability of staff to assist individual if needed during normal sleeping hours in a group home setting.
- Residential support provides supervision and supports from awake staff during normal sleeping hours in a group home setting. Address needs such as special medical conditions, maladaptive behaviors and assistance with daily living activities.
- Foster/companion care services provides habilitation, supervision and supports in a home-like environment as an alternative to living in a group home.
- Day Habilitation
- Assist individual in learning, retaining and improving self-help, socialization and adaptive skills necessary to successfully and safely reside in the community.
- Nursing
- Licensed nurse monitors health conditions, medication administration, referrals for medical services and training for families and staff.
- Supported Employment
- Assistance to sustain paid employment for individuals who require intensive on-going supports to perform in a work setting.
- Dental Treatment
- $1000 per plan year to address emergency, preventive, and therapeutic dental treatment, including regular and routine examinations.
- Adaptive Aids
- Devices, controls or appliances that enable a person to retain or to increase their abilities to perform activities of daily living or control their environment. Annual allocation of $10,000 per service plan year.
- Minor Home Modifications
- Assess the need for, arrange for and provide modifications and/or improvements to an individual's living quarters allowing for community living and to ensure safety, security, and accessibility. Lifetime maximum amount available-$10,000.
- Respite
- Provided to individuals unable to care for themselves, on an in home or out-of-home basis because of the absence or need for relief of the unpaid primary care giver. Short term relief limited to 30 days per plan year.
- Specialized Therapies
- Audiology: for assessment, intervention, training and consultation with individual, family, provider.
- Dietary: assessment, consultation and staff training related to basic or special nutritional needs.
- Occupational therapy: assists with achievement of independent functioning skills including assessment, development of treatment plans, intervention, training, consultation, and assistance with adaptive aids
- Physical therapy: assist individual with range of motion, improve physical functioning, retain physical conditioning through assessment, development of treatment plans, intervention, training, consultation, and assistance with adaptive aids.
- Speech therapy: assist with corrective or rehabilitative treatment for individuals with speech or language disability through assessment, development of treatment plans, intervention, training, consultation, and assistance with adaptive aids.
Choose a Provider
- Obtain the Provider List for the county you live in (Galveston or Brazoria). There are 2 ways to obtain the list:
- View it on the internet. The list of certified HCS providers for your county can be viewed on the website for the Department of Aging and Disability Services (DADS) at: http://facilityquality.dads.state.tx.us/ . Then click on "Home and Community Based Programs (Waivers)". Then click on "Home and Community Based Services (HCS)". Then select your county.
- Call the Gulf Coast Center and request a Provider List. The Gulf Coast Center does maintain current copies of the Provider List for Galveston/Brazoria Counties. Individuals, families or interested parties can call toll free 1-888-839-3229 and request a copy of the Provider List for Galveston/Brazoria Counties.
- Questions to Ask Providers
- Additional Resources
After I'm enrolled can I make changes?
- Can I change providers? Yes. How? Contact Leigh Saunders at The Gulf Coast Center.
According to "Your Rights....In a Home and Community Based Services (HCS) Program" published by the Texas Department of Aging and Disability Services
"Requesting a new provider:
- You have the right to choose another HCS program provider.
- Your case manager will inform you, or your Legally Authorized Representative if you have one, about your choices and will provide you with a list of providers who have been approved to serve the area(s) in which you want to live.
- Your HCS Program provider must assist and cooperate with your request to move to another HCS Program provider, including any changes to your plan that are needed."
If an individual or family member wants to report a complaint regarding the assistance or cooperation given by their provider during the transfer process, they should contact the Consumer Rights and Services at the Texas Department of Aging and Disability Services 1-800-252-8154.
After the initial HCS enrollment, the local Mental Retardation Authority does not have an official role to play when individuals/families decide to transfer from one HCS provider to another.
- Can I change services? Yes. How? Contact Leigh Saunders at The Gulf Coast Center.
Contact
Leigh Saunders
MRSC Supervisor
281-585-7456 or 1-888-839-3229
leighs@gcmhmr.com
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ICF/MR (Intermediate Care Facilities for Persons with Mental Retardation)
Admission Criteria
- Individual must be Medicaid eligible
- Individual must have mental retardation or a related condition.
- Specific eligibility criteria are described in 40 TAC Chapter 9, Subchapter E governing ICF/MR Programs
A Brief Description
An ICF/MR, which may be operated by a private or public entity, provides residential and habilitative services, medical services, skills training, and adjunctive therapies with 24 hour supervision and coordination of the individual program plan. These residential facilities range from six beds to several hundred beds for persons who have mental retardation or a condition related to mental retardation. The Gulf Coast Center assists individuals through the application and admission process to either Community-Based ICF/MR or to the State Mental Retardation Facilities (also known as State Schools). This is not a Medicaid Waiver Program.
State Mental Retardation Facilities – focus on intensive and specialized residential services for individuals with severe or profound metal retardation and those individuals with mental retardation who are medically fragile or who have behavioral problems. State law limits admissions to individuals with mental retardation.
Contact
Donna Dean
Continuity of Services Liaison
281-585-7433 or 1-888-839-3229
donnad@gcmhmr.com
For information on state schools:
http://www.dads.state.tx.us/services/dads_help/mental_retardation/services.html#schools
http://www.dads.state.tx.us/services/stateschools/index.html
To locate vacancies in ICF/MR:
http://www.dads.state.tx.us/business/mental_retardation/icfmr/search/index.cfm
Note regarding ICF/MR placements for individuals under the age of 22: Permanency Planning
In Texas, a family-based setting in the preferred living arrangement for an individual under 22 years of age because that individual is more likely to reach his or her potential with the support of a sustained, long-term relationship. The process by which state agencies promote this type of living arrangement is called “permanency planning.” Texas law requires permanency planning for all individual under 22 who are placed in an institution such as an ICF/MR or HSC program residence.
Additional information about Permanency Planning can be found at:
http://www.dads.state.tx.us/handbooks/instr/2000/F2261/res/2260-2261-attachment.pdf
http://www.hhsc.state.tx.us/CRCG/RelatedLegislation/Permanency_Planning.html
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Voucher Respite and Out of Home Respite
Admission Criteria for Voucher Respite
- Must be determined eligible for Mental Retardation Service
- Families of children under 18 may be assessed a fee based on income
- Must receive Service Coordination and have individualized service budget
- Individual must live at home with their family
A Brief Description of Voucher Respite
Voucher funding is available for families to select and hire their own providers rather than utilizing the Gulf coast Center’s Respite facility. This offers more choice to the families as to when and by whom the services will be provided. Individual providers must be at least 18 years of age and not living in the same home as the individual receiving services.
Admission Criteria for Out of Home Respite
- Must be determined eligible for Mental Retardation Service
- Individual must live at home with their family.
- Families of children under 18 may be assessed a fee based on income.
- Must receive Service Coordination and have individualized service budget
A Brief Description of Out of Home Respite
This service is intended to relieve family members of their responsibilities for providing care on a temporary basis for short periods of time. Respite may be provided during crises resulting from specific events or on a regularly scheduled basis. Respite might be provided while a parent is recovering from an illness, on a Saturday to allow other family members to shop, rest, or participate in events the respite participant does not enjoy, or at a time when the respite participant indicates a need for a break in the usual routine. Duration of this service may be for part of one day or for several consecutive days. Depending on the weather, outside activities will be scheduled for every weekend. Activities may include, but are not limited to, Horseback Riding, Fishing, Recreational sports and feeding of small animals. There are also a variety of indoor activities available including bingo, games, arts and crafts, videos, video games and computer activities. This service is provided at the Lone Oak Ranch facility in Santa Fe, Texas.
Weekend Respite services - are available to families on weekends beginning Friday at 6:00 pm through Sunday at 5:00 pm at the Lone Oak Ranch facility in Santa Fe, Texas.
Day Respite services - are available to families Monday thru Friday 9:00 am to 5:00 pm at the Lone Oak Ranch facility in Santa Fe, Texas.
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Day Habilitation
Admission Criteria
- Must be determined eligible for Mental Retardation Service
- Must be assigned a service coordinator and have individualized budget
- Must receive Service Coordination and have individualized service budget
A Brief Description
Day Habilitation, or site based classroom activities, are available to individuals who do not currently have a desire for supported employment or for whom supported employment is not considered a current option. Day habilitation offers activities that will enhance the individual’s participation in their community. Providers will utilize the individual’s person directed plan to focus on individuals desires to increase their. Examples of these might include assistance in self help skills, socialization, money management, safety training etc…
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Texas Home Living (TxHmL)
Medicaid Waiver Program
Admission Criteria
- Individual must be Medicaid eligible
- Individual must have a diagnosis of mental retardation or an IQ of 75 or below with a related condition
- Specific eligibility criteria are described in 40 TAC Chapter 9, Subchapter N governing TxHmL
- Total annual cost for services may not exceed $10,000
NOTE: If an individual’s name is on the Interest list for the HCS Program, he or she may be offered an opportunity to enroll in the TxHmL program – no additional application is needed.
A Brief Description
The Texas Home Living (TxHmL) Program provides essential services and supports so that individuals with mental retardation can continue to live with their families or in their own homes in the community. TxHmL services are intended to supplement instead of replace the services and supports an individual may receive from other programs. Services consist of community support, nursing, adaptive aids, minor home modifications, specialized therapies, behavioral support, dental treatment, respite, day habilitation, employment assistance, and supported employment. Service coordination is provided to the individual by The Gulf Coast Center. TxHmL Program services are limited to a yearly cost of $10,000 per participant.
Contact
Leigh Saunders
MRSC Supervisor
281-585-7456 or 1-888-839-3229
leighs@gcmhmr.com
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Employment Assistance/Supported Employment
Admission Criteria
- Must be determined eligible for Mental Retardation Service
- Individuals must be at least 18 years of age and must have completed their public school eligibility.
- Must receive Service Coordination and have individualized service budget
- Individuals must be drug free or actively involved in a treatment program.
- Individuals must first apply for services with Department of Assistive and Rehabilitative Services prior to receiving Gulf Coast Center funding
A Brief Description
Supported Employment offers funding support for individuals interested in individualized, integrated job opportunities in the community. Employment services, through the Center’s provider network, offers consumer assessment, job development, placement assistance, job coaching and on-going support and assists individuals with mental retardation to work in real jobs for real pay.
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Community Support
Admission Criteria for Gulf Coast Center Provider Services
- Must be determined eligible for Mental Retardation Service
- Must receive Service Coordination and have individualized service budget
A Brief Description
This service supports people in maintaining or establishing a home, supports individuals in achieving their educational/or employment goals, supports individuals in pursuing leisure activities at their home or in the community. Staff provide support in the following areas: Personal care, health maintenance, independent living skills, community activities, transportation, crisis intervention, continuing education, and site-based habilitation.
Admission Criteria for External Provider Services
- Must be determined eligible for Mental Retardation Service
- Must receive Service Coordination and have individualized service budget
A Brief Description
External services providers are available through the Gulf Coast Center Provider network for individuals to have more choices in the selection of their service provider. This service supports people in maintaining or establishing a home, supports individuals in achieving their educational/or employment goals, supports individuals in pursuing leisure activities at their home or in the community. Staff provide support in the following areas: Personal care, health maintenance, independent living skills, community activities, transportation, crises intervention, continuing education, and site-based habilitation.
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Additional Resources
DADS Reference Guide
DADS Explanation of MR Services and Supports - English (pdf file)
DADS Explanation of MR Services and Supports - Spanish (pdf file)
HCS Enrollment Information (PowerPoint file)
Documents in PDF format require the use of the free Adobe Reader, which can be downloaded from Adobe Systems, Inc. You can also download the free Acrobat Accessibility Reader for PDF's.
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