In January 2000, Texas embarked on a Promoting Independence Initiative in response to the U.S. Supreme Court ruling in Olmstead v. Zimring. The Court ruled in June 1999 that states must provide community-based services for people with disabilities who would otherwise be entitled to institutional services, when:
- the state's treatment professionals determine that such placement is appropriate;
- the affected people do not oppose such treatment; and
- the placement can be reasonably accommodated, taking into account the resources available to the state and the needs of others who are receiving state supported disability services.
Texas' Promoting Independence initiative supports allowing people with disabilities to live in the most appropriate care setting available. The statewide initiative began in 1999 when Gov. George W. Bush affirmed, in an executive order, the value of community-based alternatives for people with disabilities.
Gov. Rick Perry signed Executive Order RP 13 on April 18, 2002, also relating to community-based alternatives for people with disabilities. In response to Gov. Bush's order and the Supreme Court's decision in Olmstead v. Zimring, the Texas Health and Human Services Commission developed the Texas Promoting Independence Plan.
People living in nursing homes
People living in nursing homes who receive Medicaid can request services in the community under the Money Follows the Person program without being placed on a waiver interest list.
To access Money Follows the Person, you must:
- Live in a Medicaid nursing home
- Be eligible for Medicaid community services
- Be approved for waiver services
If you don't meet these criteria, your name can be placed on an interest list to receive community services.
Statewide relocation assistance is available to people living in nursing homes who qualify for Money Follows the Person. Information and assistance is available from the local Aging and Disability Resource Centers or the local area agency on aging (AAA) regarding housing, health care, transportation, daily living and social activities to help people make decisions from the planning phase to actual relocation in the community.
People living in ICF/IIDs or state supported living centers
As resources allow, Home and Community-based Services (HCS) are offered to people who live in state supported living centers or in a large (14 beds or more) community intermediate care facilities for individuals with an intellectual disability or related conditions (ICF/IID) whose names are on the state's HCS interest list.
The state's goals in response to the Texas Promoting Independence Plan include:
- providing opportunities for people living in state supported living centers to move to a community alternative within 180 days of their request and recommendation for movement to an alternative living arrangement; and
- providing opportunities for people living in community ICF/IIDs serving 14 or more individuals to move to a community alternative within 12 months of the date they are determined to be ready for an alternative living arrangement.
Money Follows the Person Demonstration
The demonstration is a multiyear federal demonstration to help the state provide additional community-based options, and promote a person's choice in where they want to receive their long-term services and supports. The demonstration is worth more than $175 million in enhanced federal funding through 2016.
Money Follows the Person Demonstration Behavioral Health Pilot
The pilot, part of a federal demonstration grant awarded to DADS, is administered by the Texas Department of State Health Services. Nursing facility residents in certain areas of San Antonio and Austin can receive substance abuse and cognitive adaptation services through the pilot.
Transition Assistance Services (TAS)
One-time grants of up to $2,500 in TAS funds are available to nursing facility residents who are moving from the facility to certain types of living arrangements. They are designed to be used to purchase certain items necessary to set up a household, including:
- Essential furnishings
- Moving expenses
- Rental security deposits
- Services to ensure health and safety
- Utility service deposits
Transition to Life in the Community (TLC) grants
These grants provide a one-time assistance of up to $2,500 to help nursing facility residents move to community settings; however, TAS funds must be used before TLC funds.
Housing Voucher Program
The Project Access Voucher (PAV) provides rental assistance for people relocating from an institutional setting. The Texas Department of Housing and Community Affairs and DADS are working in partnership to distribute the vouchers.
Community Transition Teams
Community Transition Teams are public-private regional community resource coordinating groups who work with individual and systemic barriers to community relocation. One team in each of the DADS regions meets monthly to address specific barriers that prevent a nursing facility resident from relocating into the community.
Updated: November 6, 2012