Local Intellectual & Developmental Disabilities Authority (LIDDA) Services
LIDDA services include determining a person’s eligibility for services, enrolling an individual into programs, and coordinating on-going services for an individual to improve quality of life. Other important responsibilities include placing individuals on statewide and local interest lists, providing crisis respite services in a least restrictive setting, helping students transitioning from school services, state facilities, SSLC or Nursing Facilities into community-based services, and aiding families who request residential services for children and adults.
Intake and Screening
This is the central point of entry for all Intellectual & Developmental Disabilities Services. This is where the initial screening for eligibility begins and where information is provided about all service options available in the Center, community, and state. Please Contact the Helen Farabee Centers Centralized Intake line at 1-800-669-4166 to schedule an intake with an Intake corrdinator. Local Intake number for IDD services can be reached at 940-397-3335 or 940-397-3383.
This assessment determines whether a person has an intellectual or developmental disability, and whether a person is a member of the priority population for developmental disabilities services. The term IDD includes many severe, chronic conditions that are due to mental and/or physical impairments. IDD can begin at any time, up to 18 years of age for an intellectual disability and up to 22 years of age for developmental disabilities. It usually lasts throughout a person's lifetime. Studies show that somewhere between 1% and 3% of Americans have intellectual disabilities. People who have IDD have significant limitations in adaptive behaviors with major life activities such as: language, mobility, learning, reasoning, problem solving, self-help, and independent living. IDD can be caused from genetic conditions (Down Syndrome, Fragile X Syndrome), problems during pregnancy or Fetal Alcohol Syndrome, problems at time of birth, health problems such as whooping cough, measles, and exposure to environmental toxins. Additional common diagnoses include Epilepsy, Cerebral Palsy, Spina Bifida, Developmental Delay, and Autism Spectrum Disorder.
Statewide & Local Interest Lists
The state of Texas has federal authority to limit the number of persons served in the Home & Community Based Services (HCS) and Texas Home Living (TxHmL) Medicaid Waiver programs. The number of requests is greater than the number of available program “slots,” creating an Interest List of persons requesting the HCS or TxHmL Waiver when funds become available. For persons residing in one of Helen Farabee Center’s service counties, the LIDDA is responsible for the addition of a person to the Interest List and also for contacting each individual on the statewide HCS and TxHmL Interest List on a biennial basis to ascertain his or her continued interest in HCS or TxHmL services. This LIDDA, Helen Farabee Centers, has a local General Revenue (GR) interest list for services maintained and monitored by the IDD Intake staff.
Transition from Schools
Transition Services assist individuals approaching 22 years of age as they move from receiving services through a school district to receiving services from the Helen Farabee Centers or other community-based programs. The Service Coordinator or Intake Coordinator with the LIDDA works with school districts to participate in the student’s annual Transition – Admission, Review and Dismissal (ARD) Meetings held at the school. Information about all service options is shared annually with all school districts, and when requested at the Transition ARD Meetings.
Community Resource Coordination Group (CRCG)
LIDDA staff attend CRCG meetings with various community agencies to staff important cases to link children and their families to services needed within the local service area.
IDD Crisis Intervention Services (CIS)
Therapeutic supports are provided by the certified authorized provider, such as but not limited to, a psychologist or licensed psychological associate, to address stressors that result from challenging behaviors. The CIS provides training and information on IDD programs and services for collaboration with families, agencies in the community, and staff to attempt to prevent and reduce crisis situations.
“Therapeutic Support” means a flexible array of services, including behavioral support provided for individuals with IDD who require varying therapeutic and habilitative levels of intervention to holistically address the stressors that result in challenging behaviors.
Support may include training in:
• Activities to strengthen appropriate developmental functioning in areas of socialization, self-advocacy and rights;
• Developing coping skills; and
• Reducing or avoiding stressors to prevent crisis events.
After hours on-call for crisis is 1-800-621-8504. Contact the IDD Crisis Intervention Specialist at 940-397-3350 for questions regarding IDD crisis respite and therapeutic supports.
Is defined as assistance for an individual residing in a Nursing Facility to access appropriate specialized services necessary to achieve a quality of life and level of community participation acceptable to the individual and LAR on the individual’s behalf. A Habilitation Coordinator (HC) meets face-to-face with an individual monthly, or more frequently if needed, unless the only specialized service the individual is receiving is Habilitation Coordination, in which case the HC meets face-to-face with the individual at least quarterly. Based on these requirements, the SPT determines the frequency of face-to-face visits. Habilitation Coordination activities include:
• assessing and reassessing habilitative service needs by gathering information from the individual through observation and/or other appropriate sources to determine habilitative needs and the specialized services that will address those needs;
• facilitating an SPT meeting;
• monitoring and providing follow-up activities through observation of:
• the initiation and delivery of all specialized services agreed upon in an IDT or SPT meeting and following up when delays occur;
• the individual’s satisfaction with all specialized services;
• the individual’s progress or lack of progress toward achieving goals and outcomes identified in the HSP; and
• offering educational opportunities and information activities about community living options and addressing concerns about community living.
Enhanced Community Coordination (ECC)
Designed for all individuals diverting or transitioning or diverting from a Nursing Facility or State Supported Living Center (SSLC) for up to one year to provide enhanced coordination for the following activities to ensure essential supports are identified and received:
• Transition or Diversion Planning;
• Coordination with the Relocation Specialist and Managed Care Organization (MCO);
• Pre-Move Site Reviews; and
• Post-Move Monitoring
Continuity of Care: Enrollment
Enrollments into General Revenue (GR) Community First Choice (CFC), Home and Community Services (HCS), Texas Home Living (TxHmL), and PASRR programs are completed by LIDDA staff. Additionally, staff are responsible for facilitating enrollments into State Supported Living Centers (SSLC) and for providing information about Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) programs, when individuals indicate a preference for these services. When individuals are recommended for enrollment in a Medicaid HCS or ICF/IID program upon discharge from a state hospital, SSLC or Nursing Facility, LIDDA staff facilitate the transfer and completes the enrollment into the HCS or referral to ICF/IID program chosen by the individual or family. LIDDA staff enroll individuals into a HCS Medicaid Waiver program who are transitioning from a Nursing Facility at their preference.
This is defined as assistance in accessing medical, social, educational, and other appropriate services and supports that will help an individual achieve a quality of life and community participation acceptable to the individual and LAR on the individual’s behalf: Crisis Prevention & Management; Monitoring; Assessment; Service Planning and Coordination. This service is further defined by the program that the individual participates in and the individual’s place of residence. To be eligible for Service Coordination, an individual must be a member of the priority population and meet at least one of the following criteria and have a Service Coordination Assessment completed by the LIDDA:
• have two or more documented needs that require services and supports other than Service Coordination and not reside in an institution;
• in the process of enrolling in the Intermediate Care Facility (ICF/IID) program;
• in the process of enrolling in the Home & Community Based Services (HCS) or Texas Home Living programs;
• in the process of enrolling in CFC services provided through a Managed Care Organization (MCO);
• be 21 years of age or older with an ICF/IID level of care and receiving CFC services through a MCO;
• be seeking admission to a State Supported Living Center (SSLC);
• transitioning from an ICF/IID or from a Nursing Facility to community-based services;
• transitioning from a state Mental Health facility to community-based services; or
• be a Nursing Facility resident who is eligible for specialized services for an Intellectual Disability or a Related Condition.
Pre-Admission Screening & Resident Review (PASRR)
PASRR is a federal requirement as documented in the Code of Federal Regulations, Title 42, Part 483, Subpart C. PASRR is a process to identify people with a mental illness (MI), intellectual disability (ID), or developmental disability (DD), which is also known as a related condition (RC), who apply to, or reside in, a Medicaid-certified nursing facility (NF) to ensure the appropriateness of Nursing Facility admission. PASRR is also intended to ensure that people with MI, ID or DD are receiving all the necessary specialized services.
In Texas, local intellectual and developmental disability authorities (LIDDAs), local mental health authorities (LMHAs) and local behavioral health authorities (LBHAs) play key roles in the PASRR process. All individuals seeking entry into a Nursing Facility must have PASRR Level 1 (PL1) screening before admission. PASRR is a federally mandated program that is applied to all individuals seeking admission to a Medicaid-certified Nursing Facility, regardless of funding source.
PASRR must be administered to identify:
• individuals who have a mental illness, an intellectual disability or a developmental disability (also known as related conditions),
• the appropriateness of placement in the nursing facility, and
• the eligibility for specialized services.
The PL1 is completed for every individual seeking admission to a Medicaid certified nursing facility regardless of their funding source or diagnosis.
• If the screening is positive — meaning the individual is suspected of having a mental illness, an intellectual disability or a developmental disability — the Local Authority will complete and submit a PE within 7 to 14 days, depending on the type of admission and length of stay.
• If the screening is negative — meaning the individual is not suspected of having a mental illness, an intellectual disability or a developmental disability — the Nursing Facility enters the PL1 into the Texas Medicaid Healthcare Partnership Long-term Care (LTC) Online portal, and the PASRR process ends for that individual.
More information on the PASRR program found at the HHSC link: https://hhs.texas.gov/doing-business-hhs/provider-portals/resources/preadmission-screening-resident-review-pasrr
Community First Choice
• Community First Choice (CFC) provides certain services and supports to individuals living in the community who are enrolled in the Medicaid program and meet CFC eligibility requirements. Services and supports may include: Activities of daily living (eating, toileting, and grooming), activities related to living independently in the community, and health-related tasks (personal assistance services); acquisition, maintenance, and enhancement of skills necessary for the individuals to care for themselves and to live independently in the community (habilitation); providing a backup system or ways to ensure continuity of services and supports (emergency response services); and training people how to select, manage and dismiss their own attendants (support management). In Texas, CFC may be available to people enrolled in Medicaid, including those served by: 1915 (c) waiver programs, Medicaid managed care; and personal care services for children. Individuals may use the Consumer Directed Services (CDS) option for certain CFC services. CFC is also available through managed care organizations for individuals who meet eligibility criteria.
• Information about eligibility for this program found at the HHSC link: https://hhs.texas.gov/services/health/medicaid-chip/programs/community-first-choice
Continuity of Care
Individuals who live in a State Supported Living Center (SSLC) are provided information and educational opportunities to learn about their options for moving to a community setting. Individuals who leave a SSLC to reside in the community receive enhanced community coordination to facilitate a successful transition to their new living environment. LIDDA staff complete court commitment requests for individuals that require voluntary or involuntary admissions to a SSLC. LIDDA staff assist in making referrals for alternate placement of an Intermediate Care Facility (ICF/IID) residential group home within the state based on the individual or LAR’s desire. LIDDA staff complete transfers to and from the local service area once enrolled into the Home & Community Based Services (HCS) Waiver and Texas Home Living Waiver programs.
More information and a directory for ICF/IID facilities found at the HHSC link: https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/intermediate-care-facilities-icfiid
More information on SSLC facilities found at the HHSC link: https://hhs.texas.gov/services/disability/intellectual-or-developmental-disabilities-idd-long-term-care/state-supported-living-centers-sslcs
HCS group home vacancy search at the HHSC link: https://apps.hhs.texas.gov/providers/HCS/search/
Permanency Planning is a philosophy and planning process that focuses on obtaining family support for children and young people with intellectual and developmental disabilities and facilitating permanent living arrangements for them in natural home environments. The LIDDA manages the completion of the planning process, documentation and reporting for all individuals under age 22 residing in institutional settings.
More information on Permanency Planning found at the HHSC link: https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/local-intellectual-developmental-disability-authority-lidda/permanency-planning-children
For more information about services, please contact the Helen Farabee Centers intake line at 1-800-669-4166. Local intake number for IDD services can be reached at 940-397-3335 or 940-397-3383.