Revision 24-1; Effective March 1, 2024

24100 Definitions

Revision 24-2; Effective Aug. 15, 2024

In this section, the terms below have the following meanings.

Crisis intervention specialist (CIS) – Provides information about intellectual and developmental disability (IDD) programs and services. Collaborates with local intellectual and developmental disability authority (LIDDA) staff and transition support team (TST) members to identify people with IDD in the LIDDA’s local service area who are at risk of requiring crisis services.

Crisis respite – Short-term service providing therapeutic support for a person with a diagnosis of IDD who is experiencing a crisis that cannot be stabilized with existing natural or formal supports. Service includes:

  • Out-of-home crisis respite: provided in a safe environment with staff on-site who provide 24-hour supervision for up to 14 calendar days; and
  • In-home crisis respite: provided to a person when it is deemed clinically appropriate for the person to remain in their natural environment and it is anticipated the crisis can be stabilized within 72 hours.

LIDDA – The local intellectual developmental disability authority (LIDDA) identified in the Client Assignment and Registration (CARE) System is assigned based on the person’s county of residence.

Community ICF/IID programs – Community intermediate care facilities for individuals with intellectual disability (ICF/IID) are licensed residential facilities that provide 24-hour supervision, services and supports to people with an intellectual disability or related condition.

Professional staff and other service providers support each resident design an individualized, person-centered plan of services and supports based on the needs and choices of the resident and their legally authorized representative (LAR). Plans include comprehensive medical and therapy services, training and support to further develop independent living skills, and opportunities for participation in family and community activities. Staff help the resident with activities of daily living so their health and safety needs can be met while they work to gain skills to increase their independence. There is no waiting list or interest list for this program.

Note: Community ICF/IID programs:

  • are federally funded by the Centers for Medicare & Medicaid Services (CMS);
  • can be small or large facilities; and
  • focus on active treatment and must abide by federal and state regulations and rules.

Legally Authorized Representative (LAR) – A person authorized by law to act on behalf of a person about a matter described in this subchapter. May include a parent, guardian, managing conservator of a minor or the guardian of an adult.

24200 LIDDA Responsibilities Related to Admissions to Community ICF/IID Programs

Revision 24-1; Effective March 1, 2024

40 TAC, Section 2.307

LIDDAs help people access community-based intermediate care facilities for individuals with an intellectual disability or related conditions (ICF/IID) homes by:

  • providing eligibility assessments;
  • facilitating applications for Medicaid;
  • sharing lists of providers operating homes in the communities where the person would like to live; and
  • completing Form 8578, Intellectual Disability/Related Condition Assessment, in the Texas Medicaid and Healthcare Partnership (TMHP) Long-term Care (LTC) Online Portal.

24300 Continuity of Services for People Admitted to ICF/IID Community Homes

Revision 24-1; Effective March 1, 2024

40 TAC, Sections 2.305 and 2.307, Texas Health & Safety Code (THSC), Section 533.0355 (Access to services and safety net provisions)

Continuity of care services delivered by the local intellectual and developmental disability authority (LIDDA) may be necessary to support a resident in a community intermediate care facility for individuals with an intellectual disability or related conditions (ICF/IID) home to remain in their home when their needs are reported to exceed their ICF/IID provider’s present abilities to serve and support them. The LIDDA’s continuity of care staff can help by linking the person to a crisis intervention specialist (CIS), transition support team (TST) or crisis respite, as well as other resources in the community to help address needs.

If the provider issues a notice of intent to discharge a person from the ICF/IID facility within 30 days, the LIDDA may help the ICF/IID provider, the person and their legally authorized representative (LAR) locate a new provider or transition to another service. The new provider or service must meet the needs for services and supports identified by the person, their LAR and their interdisciplinary team (IDT).

The LIDDA continuity of care staff may need to advocate for the person to keep their community residence for an extended time if other services are not located in time for the provider’s notice of intent to terminate services. Should the provider be unwilling to extend the residential placement, the LIDDA continuity of care staff performs safety net functions, including developing a plan of services to support the person while alternate arrangements are made. This may involve a referral for services funded through General Revenue that could address their needs in the person’s family home, while living with a friend, or temporarily while being served in a crisis respite location. The LIDDA continuity of care staff may help by providing referrals to other ICF/IID providers, facilitating enrollment in another Medicaid program, or linking to other community programs. This may also involve requesting a Home and Community-based Services (HCS) crisis diversion or an HCS nursing facility diversion slot for the person.