The Texas Health and Human Services Commission (HHSC) provides or contracts for home and community-based services for people with physical or intellectual disabilities in what are often referred to as small residential settings. Most of these have six people or fewer living in them.
While it may be necessary for law enforcement to respond to a crisis at a small residential setting, HHSC contracted providers are expected to address routine, non-criminal behavioral issues.
Should your department responds to a call at an HHSC residential setting or other small residential setting that is not within the scope of law enforcement duties, please call 1-800-458-9858. The phone is answered from 7 a.m. to 7 p.m., Central Time, Monday through Friday. A message can be left after business hours or on weekends.
To help HHSC follow up with the reported concerns, please provide the following information:
- Name of the program, if known
- Address of the residence
- Name of individuals involved
- Name of the responding officer
- Name of the law enforcement agency
- Call back number for the officer or law enforcement agency
You also can report any concerns you have regarding the supervision or care of people in the facility using the same phone number or by email to CRSComplaints@dads.state.tx.us.
If you have any questions about reporting an incident, please email LocalAuthoritiesCAO@dads.state.tx.us.
Small Residential Settings
Small residential settings are houses where people with physical, medical or intellectual disabilities (IDD) live together with supervision. They can be found in neighborhoods all around the state; many people may not even be aware one is down the street from them.
Many of these providers (businesses) must contract with HHSC to operate; however, there are a few that do not have to do so. Often, the only way to identify the kind of residence and whether or not it is licensed or certified by the state is to ask to see the provider's license or certification.
While it may be necessary for law enforcement to respond to a crisis at a small residential setting, contracted HHSC providers are expected to address routine, non-criminal behavioral issues themselves. Understanding the types of residential settings and who they serve may help law enforcement when responding to a call.
The letter to law enforcement agencies, dated Feb. 18, 2015, provides guidance for when law enforcement responds to a call that is not within the scope of their duties.
Settings Licensed or Certified by DADS for People Who Have IDD
Deaf Blind with Multiple Disabilities (DBMD)
People who get services from the DBMD program have deaf blindness or a condition that will result in deaf blindness and an additional disability. Services may be provided in either 1- to 3-bed or 4- to 6-bed homes.
Providers who run a 4- to 6-bed home must have an assisted living facility license. Providers who run a 1- to 3-bed home are considered a home and community support services agency.
Home and Community-based Services (HCS)
People who get services from HCS have IDD, formerly called "mental retardation," or a similar type of deficit. People with IDD have significantly impaired intellectual functioning as well as difficulty managing daily activities.
Providers who operate HCS group homes must post the name, address and telephone number of the program provider in a conspicuous location. Law enforcement may request to view this information.
The Texas Department of Family and Protective Services (DFPS) investigates allegations of abuse, neglect and exploitation at these homes.
Intermediate Care Facilities
People who live in an intermediate care facility (ICF/IID) will have either a IDD or a related condition. A related condition is a severe and chronic disability, other than mental illness, that is closely related to IDD. Examples of a related condition include cerebral palsy and epilepsy. These homes may serve from 4 to more than 100 people, but most homes serve around 6.
ICF/IID providers should make all licenses, permits and approvals of the facility available to law enforcement upon request. Small ICF/IIDs looks similar to an HCS group home. However, the license and number of people served distinguish it from HCS.
DFPS investigates allegations of abuse, neglect, and exploitation at these facilities.
Licensed or Certified Residential Settings for People Who Are Elderly or Who Have a Physical Disability
Adult Foster Care (AFC)
Adults who get AFC services are unable to live on their own because of physical, mental or emotional limitations. Providers may contract with DADS to provide AFC services in a home they own or lease.
AFC homes commonly serve 1 to 3 people. However, they can serve 4 or more if they are licensed by DADS in addition to contracting with the agency.
Assisted Living Facility (ALF)
Assisted living facilities provide food, shelter and personal care services to 4 or more people unrelated to the owner. Many people who live in ALFs are older and need help with bathing, dressing and other personal care activities. ALFs range in size from 4 to more than100 beds.
ALFs must display their license. Because ALFs can be as small as 4-6 beds, it is possible to have one in a residential neighborhood. Some people who get services through the DBMD program may live in an ALF.
Residential Settings Not Licensed or Certified by DADS
Some living arrangements may resemble the individuals and services provided under the settings licensed or certified by DADS. It will be important to determine if there is a license or certification from DADS to distinguish the following settings from the ones listed above.
A boarding home operator may have 3 or more people who are unrelated to them by blood or marriage live with them in a home they own or lease. The people who board with the operator will have IDD or a physical or emotional disability.
A boarding home may provide basic meal preparation, laundry, transportation, grocery shopping, assistance with self-administration of medication and money management.
Municipalities or counties may require boarding homes to have a permit to operate ( Health and Safety Code Chapter 260, Boarding Home Facilities). DFPS investigates allegations of abuse, neglect, and exploitation at these facilities.
HHSC has no jurisdiction over boarding homes unless they are providing personal care services without a license. If local law enforcement believes a boarding home is operating illegally without a license, please call 1-800-458-9858.
Small Personal Care Home
A home owner/lessee may provide assistance with personal care ( feeding, bathing, assistance with toileting) to 3 people or fewer without a license. Law enforcement can ask if the homeowner or lessee contracts with DADS for adult foster care or if he or she is associated with an HCS provider certified by DADS.