I was talking with a parent recently and while we were talking about Supplemental Security Income and all of the hoops parents must jump through, they asked “how can I ask questions if I don’t know what to ask”? I thought about this and realized there are so many topics that parents need to know and either don’t know where to go to get this information, who to ask or what to ask. Solutions for Special Needs Families is here to help you navigate through the maze of government benefits and keep those benefits. This will be the first in a series of articles that I feel are vitally important for parents to in caring for you child with special needs. Call me (512-217-7468) or email me [email protected] if you have any question about the information below.
Medicaid Waivers in Texas
As soon as your child is diagnosed with a disability put your child’s name on the Texas Medicaid Waiver lists. If you become disabled and you have a disabled child, put your child’s name on the Texas Medicaid Waiver lists. The waiting time to receive services is currently 15 to 18 years. If you are wondering whether your child will need these services, put their name on the list and when their name comes to the top of the list, you will be able to make that decision then.
What is a Medicaid Waiver– There are 7 different Medicaid Waivers. They are:
Home and Community Based Services (HCS)
Community Living Assistance and Support Services (CLASS)
Texas Home Living (TxHmL)
Medically Dependent Children Program (MDCP)
Youth Empowerment Services (YES)
Star+Plus Home and Community Based Services (HCBS)
Deaf Blind with Multiple Disabilities (DBMD)
What services do the Medicaid waiver program offer in Texas? Adaptive aids; Day habilitation; Dental treatment; Minor home modifications; Nursing; Residential assistance; Respite; Specialized therapies; Supported employment. Each of these waivers offer various services to the individual and the family.
What am I waiving– Admission into a nursing facility or living in a Intermediate Care Facility for individuals with an intellectual disability or related condition (ICF/IDD).
Where do I call – There are two entities to contact. Call 877-438-5658 for MDCP, CLASS or DB/MD; go to https://apps.hhs.texas.gov/contact/search.cfm to locate your local authority for the county in which you live. Go to that website and find the phone number where you will call to place your child on the list for HCS, Texas Home Living, or the Star+Plus Waiver
Are their requirements or qualifications to receive benefits– Yes, the individual must have a certain level of need (LON), an Full IQ of 75 or below, and you must meet the income and asset limitations and be eligible to receive Medicaid. Medicaid income and asset limit for waivers is higher than the normal $2,000 and meet the financial qualification to receive Medicaid.
The local authority in your county will provide the individual with a determination of an intellectual disability (DID) and an ICAP assessment in accordance. The ICAP consists of two parts: the adaptive skills section and a behavior section. Generally, the higher the service level, the more adaptive skills the individual possesses. Exceptions exist for individuals who have more cognitive skills and limited physical abilities. The person acting as the respondent for the ICAP should be familiar with the individual’s abilities.
How do I know where my child is on the list – Call the phone number when you originally put your child’s name on the waiting list. Be sure to call these numbers if you move or your phone number changes. If Texas Health and Human Services cannot locate you, they will drop your child’s name on the list.
What happens if our family moves to Texas and my child was receiving Medicaid Waiver services– The parent should call SSA to provide them with the new address, phone number and email address. They will notify Medicaid and you will need to apply for Medicaid in Texas and then call 877-438-5658 and contact your local authority https://apps.hhs.texas.gov/contact/search.cfm for the county in which you live. Your disabled adult child will retain their SSI benefit but lose the other state’s Medicaid Waiver services and will have to start from the beginning in Texas.
Next months topic – Supplemental Security Income.