Texas Department of Aging and Disability Services
Resources for DADS service providers

LON documentation — Behavior increase

The following indicates the essential documentation to be submitted to the Texas Department of Aging and Disability Services (DADS), Access and Intake, IDD Waivers Program Enrollment/Utilization Review to support the Inventory for Client and Agency Planning (ICAP) ratings and the increased services and supports being provided to an individual in either the Intermediate Care Facilities for Persons with an Intellectual Disability (ICF/ID) or Home and Community-based Services (HCS) waiver programs that would warrant an increased Level of Need (LON) due to dangerous behavior.

Initial request

  1. Form 8603, Level of Need (LON) Review/Increase Cover Sheet
  2. A cover letter addressing the following:
    • What is the behavior that necessitates additional staff coverage?
    • What is the work schedule of the added staff resources for this individual?
  3. What is the general staffing pattern in the residence?
  4. A complete copy of the current ICAP response booklet and computer scoring sheet.
  5. Behavior support plan (BSP) that meets DADS criteria and addresses the dangerous behavior including:
    • a definition of the behavior;
    • a functional assessment (completed before or during the development of the program);
    • a history of previous interventions;
    • preventive measures;
    • detailed procedures to address the behavior; and
    • appropriate approvals. Click here to review BSP requirements and expectations.
  6. Any pertinent and current (within past year):
    • Progress notes or quarterly monitoring reports/progress notes reflecting monitoring of the BSP by appropriate staff including data regarding the effectiveness of the program and plans for addressing problems in implementation or effectiveness.
    • Incident, injury and restraint reports documenting serious occurrences or attempts to exhibit targeted behavior(s) that support the frequency and severity ratings of the identified problem behavior(s) and reflect staff interventions.
    • Observation/progress notes/data sheets — home/residential and/or day program staff notes.
    • Psychological and psychiatric evaluations/updates.
    • Any team/interim meetings along with any professional assessments that discuss the dangerous behavior, interventions and/or changes in treatment due to the targeted behavior(s).
    • Other documents that would validate the LON increase.
  7. The latest annual staffing and Individual Program Plan (IPP) for the ICF/ID or the Person Directed Plan and Implementation Plan for waiver programs.

Per Information Letter No. 11-74 (PDF format), as of June 20, 2011, DADS will not require program providers to submit a packet of documentation to accompany a request to renew a previously authorized initial LON increase. The provider will still be required to submit the request to renew a LON increase through the electronic submission of the Intellectual Disability/Related Condition (ID/RC) Assessment. The provider will also continue to be required to maintain the complete documentation and justification for the LON increase in the individual's record. These records are subject to review during any on-site review conducted by PE/UR staff or if requested by DADS.

Documentation should be mailed to:

Mailing Address:
Texas Department of Aging and Disability Services
Access & Intake
IDD Waivers Program Enrollment/Utilization Review
Mail Code: W355
P.O. Box 149030
Austin, TX 78714-9030

Physical Address:
Texas Department of Aging and Disability Services
Access & Intake
IDD Waivers Program Enrollment/Utilization Review
MC: W355
701 W. 51st St.
Austin, TX 78751

Fax: 512-438-4249
(Note: Do not fax more than 20 pages without prior approval.)

If you have questions, please call 512-438-5055 and indicate that you have a LON question.

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Updated: September 5, 2012