People confirmed to have mental illness or intellectual and developmental disability (also known as a related condition) are also evaluated to determine the need for specialized services through the PASRR process.
In Texas, there are three types of specialized services based upon who administers the service: nursing facility, local intellectual and developmental disability authority, and local mental or behavioral health authority. Nursing facility and LIDDA specialized services are provided in the nursing facility for PASRR-eligible people with IDD (including related conditions). Service descriptions for these services are on this page. To learn more on LMHA/LBHA specialized services, visit the LMHA/LBHA PASRR page.
Nursing Facility Specialized Services for People with IDD
Nursing facility specialized services are identified through the PASRR Evaluation and can be provided to a designated resident with IDD. Nursing facility specialized services are: therapy services (also known as habilitative therapy services), customized manual wheelchair, and durable medical equipment.
Nursing facility specialized services definitions:
- Therapy services (also known as habilitative therapy services): These services include assessment and treatment to help a designated resident learn, keep or improve skills and functioning of daily living affected by a disabling condition. Therapy services are limited to: physical therapy, occupational therapy and speech therapy.
- Customized manual wheelchair: A wheelchair that consists of a manual mobility base and customized seating system; and is adapted and fabricated to meet the individualized needs of a designated resident.
- Durable medical equipment: These items along with any accessories and adaptations needed to operate or access the item are all considered durable medical equipment. These types of items include but are not limited to gait trainers, positioning wedges, and specialized or treated pressure-reducing support surface mattresses.
To learn more, see Texas Administrative Code 40, Part 1, Chapter 19, Subchapter BB, Division 1, Rule §19.2703.
LIDDA Specialized Services for People with IDD
LIDDA specialized services are identified through the PASRR Evaluation and can be provided to a designated resident with IDD at a nursing facility. Nursing facility and LIDDA specialized services are provided at the nursing facility. LIDDA specialized services are support services, other than nursing facility services. LIDDA specialized services are: service coordination (which includes alternate placement assistance), employment assistance, supported employment, day habilitation, independent living skills training, and behavioral support.
LIDDA specialized services are identified through an evaluation process for a designated resident with IDD living at a nursing facility. LIDDA specialized services are support services, other than nursing facility services, that include service coordination (which includes alternate placement assistance), employment assistance, supported employment, day habilitation, independent living skills training, and behavioral support.
LIDDA specialized services definitions:
- Service coordination: Assistance in accessing medical, social, educational, and other appropriate services and supports that will help a person achieve a quality of life and community participation acceptable to them and the legally authorized representative on their behalf. Service coordination includes alternate placement assistance.
- Employment assistance: Assistance provided to a person to help them find competitive employment in the community, consisting of a service provider performing the following activities:
- Identifying a person's employment preferences, job skills, and requirements for a work setting and work conditions.
- Locating prospective employers offering employment compatible with a person's identified preferences, skills and requirements.
- Contacting a prospective employer on behalf of a person and negotiating the their employment.
- Transporting the person to help them locate competitive employment in the community.
- Participating in service planning team meetings.
- Supported employment: Assistance to a person who, because of a disability, requires intensive, ongoing support to be self-employed, work from the person's residence, or perform in a work setting at which persons without disabilities are employed, for the person to sustain competitive employment. Assistance consists of the following activities:
- Making employment adaptations, supervising and providing training related to the person's assessed needs.
- Transporting the person to support them to be self-employed, work from the person's residence, or perform in a work setting.
- Participating in service planning team meetings.
- Day habilitation: Assistance to a person to acquire, retain or improve self-help, socialization and adaptive skills necessary to live successfully in the community and participate in home and community life. Day habilitation provides:
- Individualized activities consistent with achieving the outcomes identified in the person's service plan.
- Activities necessary to reinforce therapeutic outcomes targeted by other support providers and other specialized services.
- Services in a group setting, other than the person's residence for typically up to five days a week, six hours per day on a regularly scheduled basis.
- Personal assistance for a person who cannot manage personal care needs during the day habilitation activities.
- Transportation during the day habilitation activity necessary for a person's participation in the day habilitation activities.
- Independent living skills training: Individualized activities consistent with the individual service plan and provided in a person's residence and at community locations (for example, libraries and stores). Supports include:
- Habilitation and support activities that foster improvement of, or facilitate, the person's ability to perform functional living skills and other daily living activities.
- Activities for the person's family that help preserve the family unit and prevent or limit out-of-home placement of the person.
- Transportation to facilitate the person's employment opportunities and participation in community activities, between their residence and day habilitation site.
- Behavioral support: Specialized interventions by a qualified service provider to assist a person to increase adaptive behaviors and to replace or modify maladaptive behaviors that prevent or interfere with the person's inclusion in home and family life or community life.
- Behavioral support includes:
- Assessing and analyzing assessment findings so an appropriate behavior support plan can be designed.
- Developing an individualized behavior support plan consistent with the outcomes identified in the individual service plan.
- Training and consulting with family members or other providers and, as appropriate, the person.
- Monitoring and evaluating the success of the behavior support plan and modifying the plan as necessary.
- A qualified service provider of behavioral supports:
- Is licensed as a psychologist in accordance with Texas Occupations Code, Chapter 501.Is licensed as a psychological associate in accordance with TOC, Chapter 501.
- Has been issued a provisional license to practice psychology in accordance with TOC, Chapter 501.
- Is certified by HHS as described in the Texas Administrative Code, Title 40, Part 1, Chapter 45, §5.161 of this title.
- Is licensed as a licensed clinical social worker in accordance with TOC, Chapter 505.
- Is licensed as a licensed professional counselor in accordance with TOC, Chapter 503.
- Is certified as a behavior analyst by the Behavior Analyst Certification Board.
- Behavioral support includes:
LMHA/LBHA Specialized Services
Mental Health Specialized Services are provided to those with mental illness or with mental illness and IDD. Texas Resilience and Recovery is the provider for all services. Visit the LMHA/LBHA webpage for details.
- PASRR Handbooks
- Data Verification Manual
- Local IDD Authority