16000, Guidelines for Determining Less Restrictive Setting

Revision 20-1; Effective June 18, 2020

These guidelines describe the procedures used by the local intellectual and developmental disability authority’s (LIDDA’s) service coordinator by providing a preliminary summary to aid in the discussion of determining the less restrictive setting for persons requesting admission, or on whose behalf admission is considered or requested, to a state supported living center. Form 8515, Guidelines for Determining Less Restrictive Setting, is only one part of the admission criteria that must be considered by the service planning team (SPT).

16100 Instructions

Revision 20-1; Effective June 18, 2020

The local intellectual and developmental disability authority (LIDDA) must ensure to:

  • Use Form 8515, Guidelines for Determining Less Restrictive Setting, to assist the service planning team (SPT) discussion regarding whether a person can be adequately and appropriately supported in an available, less restrictive setting;
  • Use Form 8515 when admission to a state supported living center (SSLC) is considered or requested; and
  • Use a person-centered approach when determining eligibility for an available, less restrictive setting.

To ensure the “key items” from these guidelines are documented in interdisciplinary team (IDT) reports, the LIDDA must:

  • Incorporate the “key items” as essential elements of the LIDDA’s policy and procedure for IDTs;
  • Develop an internal monitoring system to ensure that Form 8515 is used by IDTs; and
  • Ensure that a completed Form 8515 accompanies any SSLC application.

16200 Discussion of Key Issues Using Probing Questions

Revision 20-1; Effective June 18, 2020

The service coordinator will use Form 8515, Guidelines for Determining Less Restrictive Setting, to discuss the following key items with, and in a manner understood by, the person, legally authorized representative (LAR), supported decision maker or someone else actively involved with the person.

Item: Preferences of the Person, LAR and/or Someone Else Actively Involved with the Person

Section 1 of Form 8515 ensures the local intellectual and developmental disability authority (LIDDA) provides to the person, current LAR and/or someone else actively involved with the person, the explanation of possible services and supports and an explanation of, and copy of, the “Rights in Local Authority Handbook,” as administered by the Texas Health and Human Services Commission (HHSC).

Section 2 of Form 8515 ensures the person, their current LAR, supported decision maker or someone else actively involved with the person has expressed to the LIDDA preferences for the possible types of services available to them. In the event the person cannot communicate or is not responsive, choose “Not Applicable” in the drop-down boxes.

Section 3 of Form 8515 ensures the LIDDA requests the history of services and supports provided for a person. This section also describes the person’s involvement in local resources and/or those administered under HHSC. In this section, a diversion slot refers to a nursing facility (NF) slot, or a Home and Community-based Services (HCS) crisis diversion slot.

Item: Medical

Section 4 of Form 8515 describes the types of medical and nursing needs the person requires. This section also describes behavior support requirements and/or any mental/behavioral health needs.

Item: Quality of Life

Section 5 of Form 8515 identifies factors important to the person, LAR, supported decision maker or actively involved person in choosing a place to live, including but not limited to family, friends, employment, leisure activities, living arrangements, daily routine, privacy, community integration, faith or religion, self-determination, safety, freedom of movement and dignity of risk.

This section should:

  • Support the development of meaningful relationships and the continuity of current relationships;
  • Promote the development of skills that foster independence, to the extent possible;
  • Maximize opportunities for integration, relationships and involvement of people with and without disabilities;
  • Balance safety, freedom of movement, with or without supports and assistance, and dignity of risk, as determined by the person’s preferences/needs;
  • Provide opportunities for expression of faith or religion in a way or to the extent desired; and
  • Provide opportunities to make personal decisions to the extent possible.

Item: Persons Under 22 Years of Age

Section 6 of Form 8515 outlines the needs and requirements for persons under the age of 22 concerning permanency planning (focuses on the outcome of family support for persons under 22 years of age by facilitating a permanent living arrangement in which the primary feature is an enduring and nurturing parental relationship).

Additional Information:

The final section of Form 8515 is to be used to provide additional information for any of the aforementioned sections.

16300 Documentation

Revision 20-1; Effective June 18, 2020

Documentation in the interdisciplinary team (IDT) staffing summary will include:

  • Source of the information discussed;
  • Relevant deliberation; and
  • Outcome of the discussion of key items.