Case Manager Community Care for Aged and Disabled Handbook

Appendix XXXIV-D
Waiver Program Descriptions
Deaf Blind with Multiple Disabilities Program

Revision 12-1; Effective January 2, 2012

The Deaf Blind with Multiple Disabilities (DBMD) waiver program provides home and community-based services to people who are deaf and blind with multiple disabilities. The program helps meets the individual's specific needs by providing an opportunity to increase independence and communication.

DBMD is offered as a cost-effective alternative to Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition (ICF/IID) institutional placement.

Residential Support

Individuals, with help from families and program providers, choose from three options for residential support:

  • apartments or homes with support,
  • residing with a parent/guardian with support, or
  • group homes with support.

Medicaid recipients residing in a nursing facility who are determined eligible for community care before discharge are evaluated for eligibility without being placed on the DBMD interest list.

Residential Services Provided

  • Habilitation — Assistance with skills of daily living throughout the day and evening.
  • Intervenor — A bridge between the individual and the community.
  • Chore provider — Assistance with home maintenance.
  • Assisted living (licensed to facilities with up to six beds) — All services listed above provided as a bundle in a group home.
  • Case management — Eligibility determination, plan of care development and service monitoring.
  • Specialist consultations — Consultations for physical and occupational therapy, orientation and mobility assistance, dietary services, skilled nursing and behavior/communication assistance.
  • Speech therapy.
  • Respite care — Support to individuals who live with their families.
  • Medical equipment — Equipment used to increase interaction with the environment.
  • Environmental accessibility — Modifications to the home or apartment.
  • Prescription medications — Those allowable in excess of Medicaid card purchases.
  • Adaptive aids and medical supplies.
  • Transition assistance services — Assistance to individuals moving from an institutional setting to the community.

DBMD also offers family training and a summer camping experience to individuals with these disabilities.


  • Age — Individuals must be age 18 or older.
  • Financial Eligibility — The individual must be a Medicaid recipient to be determined eligible for this program. The determination is based on the income and resource requirements for Medicaid benefits in nursing facilities. The case manager applies exclusions to income and resources. Spousal impoverishment provisions apply.
  • Deaf — The individual cannot understand speech, even with amplification.
  • Blind — Less than 20/200 vision in the better eye with correction, or a severe visual field defect.
  • Multiple disabilities — The individual has one other disability, such as an intellectual disability or autism, that results in impairment to independent functioning and requires 24-hour support.
  • Medical necessity — The individual must meet the same medical necessity determination requirements as individuals for ICF/IID Level VIII.
  • Individual plan of care (POC) — The individual's POC cannot exceed 200% of the cost of ICF/IID institutional care.
  • Informed choice — The individual must choose waiver services instead of institutional care based on an informed choice.
  • Level of care (LOC) — The individual must meet the institution LOC criteria for ICF/IID facilities.


Individuals may call 1-877-438-5658 and ask for the DBMD Waiver or contact:

DBMD Waiver Program Manager
Department of Aging and Disability Services
Mail Code W-521
P.O Box 149030
Austin, TX 78714-9030
Telephone: 512-438-3530
Fax: 512-438-5135

To Apply

individuals request a DBMD referral form. When openings become available, individuals are sent a list of providers in their area. The individual contacts the provider of his choice and arranges an interview. After eligibility is established, the individual and the provider develop a plan of care and, once approved, services begin.

Additional Information

Consult the Deaf Blind with Multiple Disabilities Handbook for complete information on the DBMD program at: