Revision 14-2, Effective November 7, 2014
3100 Service Criteria
Revision 14-2; Effective November 7, 2014
Only providers that have Title XX contracts may accept applicants/individuals who meet social services block grant income eligibility guidelines and resource limits. Each region makes this decision based on funding available.
The provider must serve individuals determined eligible by the Texas Department of Aging and Disability Services (DADS). See Section 5140, Freedom of Choice. However, licensing standards for adult day care facilities define an adult as a person 18 years of age or older and therefore prohibit facilities from serving persons under age 18.
3200 Medical Criteria
Mental illness, substance abuse, and intellectual developmental disabilities are not considered medical diagnoses.
3300 Duplication in Service
3310 Adult Foster Care
An adult foster care individual may receive up to 10 units of Day Activity and Health Services (DAHS) per week. Because foster care providers are reimbursed for providing personal care services and supervision only, a person receiving foster care or special services to persons with disabilities 24-hour attendant care may receive up to 10 units of DAHS per week to benefit from the services provided by the DAHS program.
A person receiving adult foster care services can attend a DAHS center operated by the adult foster care provider in whose home the individual lives if the:
- individual is eligible for DAHS and the case manager authorizes the service;
- individual has freedom of choice in the facility he attends; and
- adult foster care provider is in compliance with adult foster care minimum standards.
3320 Residential Care
An individual living in residential care (RC) may receive a maximum of one unit per day of DAHS only if the services provided by the DAHS facility are medical services which cannot be provided by the RC facility. RC providers are reimbursed for providing personal care service, 24-hour supervision, social and recreational activities, room and board, etc. Because RC facilities do not provide medical services, the number of units authorized to an RC individual should be limited to the time needed by the DAHS facility to provide the medical services. One unit (three-six hours) per day should be sufficient to meet the individual's medical needs. However, if the individual resides in a personal care facility that does not have a contract with DADS, the individual may receive up to two units of DAHS per day. A licensed personal care facility that does not have a DADS contract is not required to provide social and recreational activities.
3330 Client-Managed Attendant Services
An individual enrolled with the Client-Managed Attendant Services (CMAS) program may receive up to 10 units of DAHS per week.
3340 Waiver Programs
Individuals in the following waiver programs can access DAHS if they meet the DAHS eligibility criteria:
- Home and Community-Based Services (HCS);
- Home and Community-Based Services — Omnibus Budget Reconciliation Act (OBRA) (HCS-O); and
- Medically Dependent Children Program (MDCP).
3350 Community Living Assistance and Support Services
An individual in the Community Living Assistance and Support Services (CLASS) program may receive both CLASS waiver services and other community care services at the same time.
3360 Intermediate Care Facility for Individuals with an Intellectual or Developmental Disability
DADS policy prohibits providing community care services to individuals who live in an institution. An institution is defined as, among other places, an intermediate care facility for individuals with an intellectual or developmental disability (ICF-IDD).