Frequently Asked Questions

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Getting Started

Are state inspections and audits available to family members?

Absolutely. We can provide written evidence, or we can direct anyone to the State’s websites that contain all such reports online, public record for anyone to view.

Are there other options beyond HCS and ICF services?

Yes. There are several other waiver programs, including Texas Home Living and CLASS (Community Living and Assistive Services) that are typically easier to access more quickly, but do not typically offer as full and intensive array of services as ICF and HCS.

Do you lease or own your residential homes? Do you have short term or long term leases?

We lease some homes and own others homes. There are advantages and disadvantages of both scenarios. Home ownership affords us the opportunity to make modifications, as necessary including wheelchair accessibility and fire safety modifications that are required for some individuals with more significant physical disabilities. However, some of the nicer and safer neighborhoods that are clearly more desirable to individuals and family members only have homes for sale that are cost prohibitive to the individuals we serve with their limited financial resources necessary to pay their own room and board. When desirable neighborhoods are cost prohibitive for home purchasing, renting a home in that neighborhood can be a perfect solution. In addition, we can usually secure long-term leases and develop long-term relationships with supportive landlords, who typically love to have us for tenants because we stay, we take good care of the property, and we pay our rent on time every month without delay.

Does your agency employ staff who speak other languages?

We absolutely do employ staff who speak multiple languages, as needed by the individuals we serve. In some of the regions in which we serve individuals an increased number of Spanish speaking individuals, including in the Rio Grande Valley, we employ many Spanish speaking staff. In addition to different spoken languages, we are able to hire staff proficient in sign language, as needed.

How and where will an individual be cared for when ill?

An individual who is ill will be kept home from day activities and monitored by an extra staff until well. The assigned nurse will monitor the status of the individual periodically, and will visit the individual in person, whenever necessary. In the event that in individual is not getting well within an expected timeframe, outside medical attention will be sought. In the event that the individual is exhibiting signs or symptoms of a serious nature, emergency services will be activated. No chances will ever be taken on your loved one’s health for the convenience of the agency or any of our staff.

How are complaints addressed?

We have a link on our agency’s website on every page of the site called “Satisfaction Survey.” We encourage family members, staff, and even neighbors or strangers who have knowledge of our services to voice concerns through this method. Doing so can be completely anonymous, or a name can be included. Either way, the information comes through our email system directly to the President, CFO and CEO. With this approach, there is no way for any caregiver or professional staff, regional manager, or Director to keep the concern from the attention of the executive leadership and ownership of our organization. Once the concern is known, all possible steps will be taken to rectify the concern. With teamwork, genuine concern and regard for doing the right things, along with some occasionally needed creativity, we can solve almost any problem. We will never take a defensive posture in response to the concerns that are brought to our attention; we know that any family can take their loved one to another program and any good staff can choose to work elsewhere. Our goal is to keep your loved ones in our program and to address the disgruntlements of everyone to minimize turnover of employees and a revolving door of individuals served. In order to do that, we must take concerns, comments, and disgruntlements very seriously and make every effort necessary to work through them successfully by implementing corrective solutions that are within our means.

How are individual finances managed? Can I manage the finances and money for my loved one?

You have a choice; you can continue to manage the finances of your loved one, or you can entrust the task to us. We are happy to take on that task; in fact, we prefer to do it in order to ensure continuity of eligibility for benefits. If you opt to manage the finances, you will be required to pay us the room and board amount monthly (HCS individuals). If you opt for us to manage the finances, we will ensure that those finances are managed according to very strict guidelines and oversight provided by the State. In addition, we will ensure that the funds are properly safeguarded and accounted for. We will provide you with ledgers and/or back statements, as you request. And most importantly, we will make sure that the funds are available you your loved one, as needed. We have a very solid track record in all of our related State inspections, known as trust fund audits. In the event that we do make a mistake in accounting or expenditure (or any other similar issue), we will reimburse your loved one’s account accordingly. However, we take great pride in our history of proper management of individual’s accounts, which we handle with precision, accuracy, and numerous checks and balances to prevent fraud and abuse of funds or cash money.

How are non-verbal individuals accommodated?

Non-verbal individuals require special attention and additional patience from caregiver staff. Many non-verbal can communicate in limited ways through gestures, signs, and communication devices. Unfortunately, most non-verbal individuals have no means of communication whatsoever, other than by exhibiting agitation when frustrated due to the inability to communicate when needed. Our staff are trained to detect such agitation quickly at the onset in order to prevent escalation, and respond to the best of their abilities to address primary issues, such as hunger, pain, discomfort, need use the bathroom, etc. However, sometimes such agitation can occur from less significant needs, including changes in schedule, new staff, or in some way neglecting to address the emotional needs of an individual…such as by forgetting to say hello or not paying attention to an individual. The most important aspect of serving those who are completely non-verbal and totally functionally limited in communication is to get to know each person as an individual, which takes time and special caring. Knowing the specific needs of such individuals, and knowing historically what is likely to create agitation can be the first and best step toward preventing it. Also, it is usually very helpful to obtain as much information as possible from family members and former caregivers who know the individual best and can help train new caregivers regarding the unique needs of each non-verbal individual. Finally, it can be very helpful for caregiver staff to speak to non-verbal individuals, even though those individuals cannot speak responsively; sometimes just explaining to such individuals what’s going to happen next and throughout the day (e.g., “now we’re going to make dinner”) can be stress relief because many non-verbal individuals can understand what’s being said. This ongoing explanation can be comforting for those who prefer a structured routine.

How are program suggestions, comments, and/or concerns addressed?

Of course, any issue that involves the safety, security, or happiness of your loved one will be addressed immediately, especially if you use the “Satisfaction Survey” tool on this website. In addition, our organization utilizes a Consumer Advisory Committee (CAC) to review all program complaints, concerns, comments, and suggestions. This committee is made up of key management staff, outside members who have experience in the services we provide (but who have no specific interest in any of our companies), family members, and even a few individuals served in our program. All issues presented to the committee are discussed at length, and solutions are developed by the committee and presented to the program’s management team for review and implementation. There is a regional CAC meeting held quarterly in each of the six areas in which we provide services in Texas. The minutes of these committee meetings are even reviewed by outside regulatory authorities to ensure that we are taking all feedback seriously and responding in an appropriate and timely manner.

How do I get on the HCS interest list?

Contact your local authority and let them know you would like to be placed on the HCS interest list ( HCS Waiting List ). We can help guide you to the right person within that entity.

How do I lose an HCS slot – can we be removed from the interest list?

You can request to come off the HCS interest list at any time ( HCS waiting list ). Typical circumstances that would led to this significant decision might include moving out of state, choosing a different waiver service or an ICF facility, or perhaps a significant medical condition that is not likely to resolve that requires care beyond the scope of the services provided in a HCS program.

How do staff train individuals to be more independent in their daily living?

Training regarding daily living skills is a tricky business that varies greatly from individual to individual. It is a process that involves multiple steps that must occur one at a time, and in the proper order. First, a thorough skills assessment must be completed that identifies strengths, areas for improvement, and is also yields realistic information about pre-requisite skills (or the lack thereof) that are necessary for training in any one area. For example, we would not identify a training goal of learning to cross the street safely and independently for an individual who is blind and in a wheelchair. Once needs accurate training needs are determined, a service planning or interdisciplinary team will make decisions, with overriding input from the family, about what training areas are priority. Sometimes if a particular privilege is restricted due to lack of necessary skills (e.g., making a purchase independently), we may suggest related skill training toward the eventual lifting of that restriction. Once realistic areas are identified for skill development, we develop a plan for training that involves breaking the skill down into logical steps (e.g., taking the cap off of the toothpaste tube), and training toward independence on that step…gradually fading the staff’s assistance until that step is mastered. Then, we move on to the next step in the task. It’s important to provide lots of verbal praise for all efforts, regardless of whether the attempt was successful…the process must be made to be fun and enjoyable in order for individuals to be motivated to participate in skill development. It may take a long time, but eventually a skill can be mastered by anyone with this step-by-step approach, as long as the individual has the pre-requisite abilities necessary.

How does our agency incorporate the family’s wishes, when those wishes are different from what the agency believes is best?

Family members are in the “driver’s seat” at all times. We do not impose our will in the key decisions that affect your loved one, unless you truly choose for us to do so. Of course, there are limitations in what we can provide with the resources that we have. But mostly, all of the key decisions affecting the care and services of your loved one are made by family members whenever they choose to be involved, or to whatever extent they choose to be involved. Family members make decisions about medications, choice or residence, choice of day program, choice of activities, diets, and many other key decisions. Our role is to support individuals, but also to support families…never to supplant them.

How does our agency involve the individual/guardian/family into the development of the individual’s program plan?

The family is in the driver’s seat regarding all services we provide. We develop all individual plans based on formal assessments that we complete with the family’s input, to whatever extent the family chooses to be involved. These assessments are helpful in determining individual’s needs, including training needs. We develop training ideas for developing skills based A) on the needs determined through these assessments (that already have family input) and B) based on what family members determine to be priority training needs. Together, our agency and family members develop training goals and objectives for individuals, based mostly on the family’s well established knowledge of the individual.

How does your agency build community awareness about persons with disabilities moving into their neighborhood? How does your agency resolve concerns?

We encourage positive interactions between our individuals and their neighbors. We are courteous, friendly, and helpful in any possible situation. We don’t advertise our presence, but we also don’t hide it. Many of our neighbors are very friendly and embracing of what we do, and express their positive regard through friendly interactions without individuals and staff in passing. We also try to keep low profile in situations that could potentially seem intrusive by training our staff regarding good neighbor practices. Such practices include parking responsibly in a manner that doesn’t take up sidewalk space or block mailboxes. We also train our staff to inform their own loved ones who may be picking them up or dropping them off to work at the group home to be quiet with car stereos turned off and not to linger or loiter. We keep our lawns mowed, and our landscaping at a nice level of aesthetic. We pick up unintended trash on our properties and take empty trash cans back in to our garages expeditiously. We train staff to engage in only calm, quiet, and unobtrusive interactions at all times outside the house, and to be friendly to neighbors, even if neighbors come over to our premises to voice concerns. If necessary, a member of our management team will be available to address a neighborhood association meeting to help allay irrational fears held by some about people with intellectual disabilities living in their neighborhoods. Most importantly, we know and are willing to explain to anyone, as a last resort, the protections our individuals have in living in the community under the Americans with Disabilities Act, as well as the Fair Housing Act. In extreme cases, we have fought legal battles and have won. Courtesy and kindness is the name of the game, but we will passionately protect the rights of our individuals to reside in the community like all non-disabled people, if necessary.

How does your company pair housemates…is it based on age, gender, level of functioning, or some combination of these factors?

We definitely try to keep homes single-sexed, with very few exceptions. We generally prefer to pair housemates with peers who are on a similar level of communication and participation. However, our many years of experience in trying to anticipate who will get along best with whom has taught us that ”obvious” matches might not be as intuitive as they may seem; sometimes our intuition regarding how we anticipate individuals will get along is not correct, and we have to try alternate arrangements (with everyone’s consent) until we are truly successful in matching up peers who get along in ways we never would have predicted. There’s usually some trial and error until we get it right…but eventually, we will achieve success. Also, having more homes within a geographical region from which we might try out different combinations, when needed, expands the opportunities for re-matching and thus helps to facilitate better group cohesion in the long run. In a nutshell, we don’t force friendships, we try out different combinations until the right combinations become clear.

How does your organization tailor services to someone with autism spectrum disorder, apart from someone with an intellectual disability?

We serve many individuals on the spectrum … possibly as many as half of the individuals we serve. We fully understand the concerns of family members of a loved one on the spectrum regarding the simple fact that their loved one may not have an intellectual disability, but rather more of a challenge in communication, etc. We appreciate the challenge of a service delivery system that tends to lump everyone together. However, we are not opposed to people living and working together; we believe it is more important to understand each individual’s hopes, dreams, wants, and needs…and develop individualized programs for caregiving, behavior support, and social interaction opportunities that address that person’s individualized needs, regardless of the housemates. Ultimately, the key to success is in A) knowing an individual and B) providing thorough training and supervision to caregiver staff to ensure that everyone knows what works for each individual, regardless of diagnosis. Knowing what people like to do, and not do. Knowing what types of environmental variables might contribute to a problem (e.g., triggers). Knowing the nuances of an individual’s communication (receptive and expressive) in order to promote satisfaction and minimize frustration. Volumes of information can be written about the details of how we make it all work; in an effort to summarize our approach to a successful outcome, we know we must capture as much information as possible (from people who know your loved one best), develop plans that work, train staff thoroughly, supervise staff constantly, and ultimately accept and respect what makes people different, not the same.

How is a day program chosen?

We encourage all individuals served to attend the day-hab of their own choosing, with significant input from family members and guardians. Of course, we hope that the individuals we serve will choose our own day programs. But we appreciate that there are many competing day programs that might specialize in serving a particular type of individual or might provide a program with a unique theme that might be better suited to the interests of a particular individual. We are happy to transport individuals to other day programs, as long as those programs are within a reasonable distance and have fees and charges that are within the scope of what individuals can afford through their care plans. In addition, we require that “outside” day programs maintain their own separate liability insurance, as any proper organization providing caregiving services of any kind should.

How will your company include me in important decisions?

We maintain on-going communication with key family members identified for every individual we serve. The services we provide to your loved one are driven by the identified key family members. We see or role as providing the care that you decide your loved one needs, and making suggestions along the way, when out input is solicited. If we were a restaurant, you would get the menu and place your order, and we would do the rest.

I am interested in your program, but not yet ready to make a decision. Can I talk to other family members of individuals already receiving your company services to learn more about their experiences with your company?

We will furnish any interested family with contact information of key family members of individuals presently receiving our services so that investigating family members can call to check a reference. We only give such information from family members who don’t mind receiving the call, but we encourage all of those the facility members giving the reference to be honest and not hold back any negative information. We understand how scary it is to choose a program for a loved one and we believe that honesty is the most important factor. We also know that the local authority is restricted from making recommendations about provider agencies…and so many families feel completely on their own in making such an important decision. We want interested families to have a true and accurate picture of who we are and how we operate based on honest testimony from existing family members.

I do not have Medicaid. Can you help me obtain Medicaid?

The local authority service coordinator will usually start the application. The application process could take 45 to 60 days to complete. When the local authority sends us a copy of the application, we can follow up with HHSC once you have signed a form for Appointment of an Authorized Representative to Allow Another Person to act for You (H1003).

I have been out of work for a while and don’t have a lot of extra funds to help my loved one with special purchases, including clothing, etc. Will your company help to ensure my loved one’s most important needs are met?

If the family of an individual cannot assist with such additional expenses such as clothing, we will pool our resources to help ensure that each individual has adequate clothing. We will also help with a holiday gift, and occasional outings if the individual cannot afford them with their own finances.

I’m interested in HCS services, but I don’t know a whole lot about the program or where to begin. How should I proceed, and how can your agency help me in this early stage?

The best advice we give to any family member searching for services for the first time, or looking to transfer from another program, is simply to call us. If you call any of our regional offices or our corporate office, listen to the outgoing message for the option to receive more information about services for your loved one. You will either be directed to a live person, or asked to leave a detailed message…in which case you will get a call back within 24 hours. During that initial call, you will have an opportunity to tell us all about your loved one, what specifically you are looking for or hoping to improve upon, and ask us any question about our services. We’ll give you as much time as you need. And if you have a good feeling from your initial contact with us, we may encourage you to come visit us. We would love to introduce you to our professional team, give you a tour of our facilities, and introduce you to our staff and individuals during a time when you can see the group home in action. We can answer any question about HCS services, and how we approach providing those services. We are very proud of the services we provide, and giving tours and helping families learn more about us and the system in general is truly one of our favorite endeavors.

I’m not sure if a group home is the best residential option for my loved one. Can I try it out for a period of time, and switch to another residential option (e.g., Host or in-home support) provided or contracted through your company if the group home doesn’t work out? If so, is there a specific amount of time required by your company before such a switch is made?

Your loved one can switch between residential models (e.g., group home vs Host) at any time, which is your right in the HCS program. We do not intervene to promote or restrict your choice of residential model; we fully support your decision, no matter what it is. We will provide you with a full explanation at any time regarding the different choices, and keep you informed about openings in our group homes if you find that switching group homes might be helpful in solving a problem. In the ICF program, we will also keep you informed of such openings, and strive to accommodate your choices.

If I am interested in exploring services for my loved one through your company, but I am not entirely sure if your company is the best fit, how can I explore your services without actually making a firm commitment?

We suggest coming for a tour of a few of our group homes in the search area. We strongly suggest visiting them when individuals and staff are home, not during the day during the week when our individuals are out receiving day services. It’s important to see the facility in full operation…meet the other residents and the staff, and witness the interactions between them. If, after an initial visit, there is interest, then we encourage families to allow their loved ones to have trial visits…maybe a dinner at the home with the potential new peers, or even an overnight weekend visit to getter a fuller impression of how a loved one fells in the home. We are happy to facilitate as many visits as desired in order for individuals and family members to feel really good about their choice. Although sometimes family circumstances may dictate the speed at which a loved one may need to be placed, we will certainly never rush that process or make any decision make feel “pushed.” We do not engage in aggressive sales tactics. At most, we may call interested parties from time to time to see if there are any additional questions that can be answered by us.

If I choose to participate in an ICF/IID program will it keep me from receiving an HCS slot?

If you choose for your loved one to participate in ICF/IID now because of the immediate availability of ICF program services in your area, your loved one will still remain at the same place on the HCS interest list. ICF can be a great option while waiting for HCS services; the ICF experience can help promote more effective adjustment to the HCS environment and also provide immediate relief to a family who has unexpected circumstances that require increased focus on other family members. And, of course, some individuals are just ready to move to “their own place” because they have observed their brothers or sisters go off to college, etc…and feel more normal trying out living away from home. It is, however, necessary to call the local authority annually to inform of your ongoing interest in ultimately receiving HCS services.

If I choose your company for my loved one, what paperwork do I need to provide?

Guardianship papers, if that applies. Your loved one’s photo ID, if available. Birth Certificate, if available. Social Security Card, if available. Medicaid Card or Managed Care Organization Card. Medicare card, if applicable. Private Insurance card, if applicable. Determination of Intellectual Disability, which is usually made available by the local authority. Document indicating choice of our program, which is also typically provided by the local authority.

If we choose the group home option, can I have input in selecting the housemates of my loved one?

At the time that you choose a group home with our agency, you are certainly encouraged to choose among our homes with vacancies that have individuals residing in them that seem like a great fit for your loved one. Once placed in a home, if the peer match-up doesn’t quite work out as expected, you are welcome to consider moving to your loved one to any of our other homes that have a vacancy (within single sex parameters, of course). However, we are not likely to move other individuals out of their existing homes to accommodate your wish for a new vacancy that didn’t otherwise exist at your new “requested” home unless the needs of others might coincidentally be well met by such a “reshuffle.” In other words, you are always free to choose from what’s available, and in some less frequent circumstances, a multi-individual move could possibly and coincidentally be in the best interests of all parties involved. However, we certainly cannot promise such a “reshuffle”, although they do occur from time to time. In that case, each family has to agree.

Is my loved one eligible for food stamps?

Yes, if you are in the HCS program and your income does not exceed the SSI minimum which is approximately $735. If you are in the HCS program, your loved one is eligible for food stamps. It depends on their income and their financial responsibilities such as rent and utilities. Typically, in our program, if their income does not exceed $733, then they qualify for food stamps. ICF/IDD clients do not qualify for food stamps because their food is covered by this program.

Is there an ICF interest list?

No, ICF Services do not have an interest list ( waiting list ). ICF services are available within our agency on a first come, first serve basis. If our treatment team determines that your loved one’s needs can be successfully met by our team of professionals and caregiver staff, we will schedule visits and tours of our homes without delay and hopefully be able to place your loved one in any of our existing vacancies of your choosing. We usually have a vacancy, although we strive to have all of our openings full. If, in the event that we are completely full in our ICF program for a significant period of time, we will keep you loved ones information on record and notify you as soon as there is an opening. However, rather than maintain a strictly followed waiting list, we prefer to place individuals where they are best suited to live and co-habitat with individuals already residing where the vacancy exists in order to create the best match-ups. The social “chemistry” among all of the residents in any particular residence is of the utmost importance to us.

What activities are offered to enhance the lives of individuals?

In addition to nice homes in nice neighborhoods, as well as friendly and well-trained caregiver staff, our professional teams strive to know the interests, likes, and dislikes of each individual in order to provide an overall experience that takes into consideration individual differences in hobbies and interests in recreational activities. Once such information is established, we strive to provide as many recreational opportunities as possible so that individuals can get out into the community and enjoy fully all of what life in the community has to offer. Getting out and engaging in activities also promotes social interaction between peers and with other non-disabled people to promote a sense of normalcy and belonging in the community. There is much more to be said on this subject, but in summary, facilitating as many opportunities as possible for recreation, social interaction, and skill development is at the heart of any dynamically enriching program.

What are the requirements to get on the HCS interest list?

To be placed on the HCS interest list ( HCS waiting list ), the person receiving services must have a diagnosis of an intellectual disability ( or a related condition ), or a diagnosis of autism spectrum disorder. Contact your local authority IDD services liaison, and keep the communication ongoing during the process. The local authority can assist you in getting IQ testing.

What choices will my family member have concerning day programming, vocational training, supported employment, etc.?

Family members are invited and encouraged to participate in all aspects of choosing and planning all services. We are willing to contract with any day hab facility that charges a reasonable daily rate, and are also willing to transport individuals residing in group homes to any such program. The choice of day programming is driven by individuals and their families.

What fees do I have to pay?

None. Medicare and Medicaid cover your loved ones basic needs. There are no fees involved with using our programs.

What geographic locations do you serve?

We serve individuals in six primary geographic areas centered in and around the following cities in Texas: Abilene, Beaumont, Harlingen, Houston (predominantly northwest area), McAllen, and San Antonio.

What is an IQ? How do I arrange get my loved one evaluated?

The IQ (Intelligence Quotient) assessment tool is used in determining eligibility for services. Typically, the Local Authority (county government entity), can assist a family in getting a loved one assessed with an IQ test, but sometimes there can be a wait time for that assistance. A family member can obtain additional information forms our agency in how to expedite IQ testing, and how to explore other options for getting this test completed more quickly if the wait time is an obstacle to receiving needed services (e.g., private testing).

What is the ratio of staff to individuals?

We generally provide a ratio of 1 staff to 3 individual during waking hours. Depending on the needs of specific individuals, we may provide additional staff support during high activity periods, including mealtimes, grooming and hygiene, medication pass, bathing, etc. In the highest need situations (e.g., where there may be 3 or more individuals in a wheelchair, we may require 2 overnight awake staff to assist with potential evacuations if such individuals are completely staff-dependent. In summary, we will provide the staff necessary to ensure our individuals are safe and receive proper care.

What is the Texas Home Living Program?

A Medicaid waiver program in Texas that provides a variety of services to an eligible individual, but does not include the same level of residential assistance as is offered in the HCS program.

What is your company’s complaint process?

Contact our local Program Manager, the company President or CEO, or use the anonymous satisfaction survey function on our company website at any time, day or night, weekday or weekend. No concern is too small to report. We take every concern seriously, and investigate quickly and with sensitivity and confidentiality to determine the root cause of any identified problem. The, we work quickly to correct the problem to the satisfaction of the concerned party, to the fullest extent possible. Sometimes that means making a purchase. Sometimes an employee needs to be re-trained. In the worst case, an employee may need to be terminated due to serious misconduct. Most importantly, we never take a defensive position in responding to complaints; rather, we are grateful for all of the information that others are willing to share with us in order to help us have all of the information necessary to provide the safest and most rewarding possible services we can to the individuals we serve. If we are unable or seemingly unwilling to solve a problem in the exact way desired, we encourage the use of the HHSC complaint hotline.

What is your Host (foster) program?

“Host” is a residential option in the HCS program in which an individual can live in a home other than a group home, and receive caregiver services from an agency-contracted adult. In this option, the adult caregiver can actually be the individual’s parent, sibling, or other family member or friend. This caregiver must pass a background check and have other related credentials. In this “Host” option, this caregiver is called the Host provider, and is responsible for all of the daily assistance needs of the individual; the agency does not provide any additional staff to the home. Also, in this model, the agency does not provide transportation and the Host provider is responsible for assuring that all of the individual’s needs are met, including medications, medical appointments, cooking, housework, shopping, daily documentation, and many other responsibilities. However, the Host provider is well compensated by the agency, per the individual’s Level of Need (determined in advance by assessment), and that money is non-, per taxable income per IRS rules for foster care compensation.

What kind of meetings do I have to attend, how often, and where are meetings held?

Each individual served has at least an annual team meeting to review service outcomes from the previous year and plan services for the upcoming year. Typically, those meetings occur at our program office. However, we can make special arrangements for people who have transportation restrictions or related issues on occasion. Most importantly, we want to facilitate the participation of family members in the planning of all services received by loved ones. In addition to annual meetings, we sometimes have situational meetings to address unanticipated problems…and we can usually conduct those over conference call, but always invite family members to attend in person, if preferred.

Why did your organization decide to serve individuals with intellectual/developmental disabilities?

We’ve been in operation for over a quarter of a century. Most of the original members of our team, as well as many of our newer employees have some personal connection to the work we do. Some of us have family members with needs similar to the individuals we serve, and others have become exposed to such individuals through happenstance, and felt an immediate connection. We all consider our chosen career to be of the greatest blessings in our lives, as most people go to work simply to earn a paycheck. We get so much more…the satisfaction and pride in knowing that we are contributing to positive outcomes for a vulnerable and often de-prioritized population. And if that wasn’t reason enough, we also get back a lot of love every single day from individuals, co-workers, and families.

Will the group home be located in close proximity to the school / day program / place of employment?

We encourage individuals to choose day programs and related activities that are within a reasonable proximity to the home. However, these distances may vary. We do not consider proximity to be the primary determining factor in placing individuals in day programs. Instead, we encourage family members and individuals to choose day programs and related activities that are best suited to their interests and overall functioning levels, as many day programs specialize in meeting different types of needs. Day program is a choice, and sometimes it’s not the most convenient choice…but should always be the best choice.

Will you complete the Medicaid paperwork for my loved one?

If you choose for us to be the representative payee, we will complete all monthly, quarterly, and annual paperwork required to continue Medicaid, food stamps, Medicare, social security and other government entities.

Will your company provide me with information and guidance even if I don’t think you company is the best program for my loved one or doesn’t currently have a vacancy in a group home?

Absolutely. We are happy to provide any assistance necessary to ensure that you are satisfied with the services we provide, or to assist you in finding another provider that you believe, for any reason, may be better equipped or otherwise better suited to meet the needs of your loved one. We know we can’t be a “one size fits all” program, and sometimes we must be realistic about what we can do and what we cannot do as well as some of our competitors. We strive to build bridges with all families, and sometimes that means earnestly helping families seek alternate placement in a completely non-begrudging manner. And perhaps one day, we may be able to serve your loved one again if circumstances favor such a decision.

Residential Services

Am I responsible for any expenses if my loved one is in your group home?

The HCS program combined with the individual’s social security income covers all of the basic needs of an individual. Typically, the only expenses incurred by a family member might include clothing, occasional gifts, etc.

Are sufficient staff available to support my family member in additional activities in the community? (i.e. Girl Scouts, religious activities, sports teams, etc.)?

Absolutely, we strive to ensure that everyone can participate in whatever chosen activity he or she desires, as long as such activities are within a reasonable geographic proximity to the home. We have individuals who attend bowling activities, martial arts classes, swimming lessons, bible studies, volunteer activities, and even work in real jobs during unique times. In each of the regions in which we operate, we have multiple homes and multiple staff…which affords us the opportunity to reassign staff and individuals for short periods in order to accommodate everyone’s interests.

Are there any restrictions on visitation?

None, unless there is a court order with a specific (e.g., a particular family member, etc.) restriction.

Can any of my relatives provide in-home care to my loved one? If so, are there any restrictions?

Yes, with some restrictions. Relatives can definitely be the caregiver staff for a loved one in the natural home setting of that loved one, as long as that staff does not reside at the same location as the individual (as determined by documentary evidence, such as a driver’s license of the staff showing a different address than that of the individual).

Can I choose which bedroom my loved one will have in the group home?

Typically, bedrooms are chosen on a first-come basis. However, some bedrooms are specially adapted to the unique physical needs of some of the individuals we serve and will be made available to those individuals, first.

Can I decorate my loved one’s room?

We encourage families to assist loved ones in decorating rooms. We only ask that wall damage is avoided, other than small holes for pictures. We also encourage families to get ideas from looking at some other rooms that are already decorated.

Can I visit my loved one at the group home at any time, unannounced?

Absolutely any time, and unannounced, if you wish. We only ask that if you come during sleep hours, you are careful not to wake the other residents.

Can my loved one have cable TV and/or Internet service in the home?

Typically, each of our residential homes has basic cable service in the common living area ( living room ). Where appropriate, each individual we serve may choose to have cable or Internet service installed in their bedroom at their own expense.

Can my loved one receive in-home support during sleep hours?

Community First Choice – CFC (formerly Supported Home Living) services through the HCS program can only be provided during awake hours because the billable services that these supports include generally involve service activities that would require the individual to be awake. However, there are a few acceptable activities within this type of service that can be provided away from the individual, including shopping for the individual or doing laundry for the individual. Is such cases, it is conceivable that the individual might be temporally asleep (e.g., for a nap). However, these services are generally not billable during sleep time hours.

Can my loved one stay back from an outing? If my loved one stays back from an outing, how will your company provide supervision in that situation?

We operate a network of homes in each of our regions, and they are mostly located relatively close to each other. Our staff are cross-trained to work in any of our houses, and we typically match up houses to go on activities together. It is very common that one or more individuals may choose not to attend a particular outing, for any number of reasons. Regardless of the reason, we can accommodate everyone’s wishes by having a staff stay back. which will not jeopardize the supervision on the outing because we still have multiple staff attending

Can your company transport my loved one to a relative’s home for a visit when I am unable to provide that transportation?

We may be able to provide transportation of a loved one to a family member if the distance is not too far, and the timeframe doesn’t disrupt important activities of the remaining individuals, such as med pass time, meals, or other planned activities.

Do neighbors ever provide resistance, and if so, how does your company respond so that my loved one feels accepted in the neighborhood?

Our individuals’ choice of residence in the community is protected by the Americans with Disabilities Act (ADA), as well as the Fair Housing Act. Any effort to prevent people with disabilities from living in any public neighborhood is discriminatory and illegal, and we will engage in any legal efforts necessary to ensure that the individuals we serve are free of such discrimination. However, we understand the importance of being good neighbors ourselves…and we engage in many efforts to ensure that we do not create any trouble in our neighborhoods, including monitoring parking of company vehicles and training staff on friendly non-confrontational interactions with neighbors. Truly, most of our neighbors are very supportive of our presence and view the support or individuals receive as a wonderful blessing.

Do you lease or own your residential homes? Do you have short term or long term leases?

Does your agency employ staff who speak other languages?

Does your company do all of the shopping for my loved one’s needs and wishes (e.g., clothing, music, etc.), or may I participate in in shopping for my loved one’s needs and wishes, as I see necessary?

Family members are strongly encouraged to shop for loved ones. We facilitate the process by connecting family members to key management staff and our account managers to ensure funds are safeguarded, receipts are obtained, and all proper accounting mechanisms remain in place to maintain accountability of funds. If family members would prefer that we do the shopping, we are happy to do so.

Does your company encourage/help my loved one with developing social skills?

Yes. Our company encourages and organizes a wide variety of group activities, ranging in scope from a simple visit to another of our group homes for a shared meal with other peers to a major sporting or theatrical event. Some individuals participate in Special Olympics. Most attend a church of their choosing. Some even attend events in other cities for very special outings requiring more significant organization and funding. Most importantly, individuals have the ability to choose activities and the peers with whom they wish to socialize. We strive to nurture individual friendships among peers and create opportunities to cultivate those relationships in a supervised but non-intrusive manner.

Does your company ever employ family members of loved ones served?

We generally do not employ family members of loved ones served, and in some cases, our billing guidelines prohibit it.

Does your company furnish the house? If so, how often does your company replace furniture as it gets older and worn?

We do furnish our homes in the common areas, and encourage families to participate in the furnishings of loved ones’ bedrooms. However, if that is not possible, we will fully furnish bedrooms, also…it’s per the preference of the family. We replace furniture and other decor as often as necessary to ensure it is all clean, functional, and in good repair.

Does your company have any policy on switching between residential models (e.g., between Host, in-home supports, or group home)?

Family members who serve as principle decision-makers are informed that their loved one can switch between any available residential models at any time, as is their right in the HCS Program. Switching between group homes is based on availability. But changing between residential models (e.g., from group home to Host) can be accommodated at any time and as often as requested. We want to work with families, and their changing needs…and we want to ensure families and loved ones are satisfied and stay with us for the long haul.

Does your company provide respite in my loved one’s home? Does your company ever provide respite in its own group homes?

We do provide respite in your home, and generally we find that respite works best in an environment that is most well-known to your loved one. However, if your home is not available when respite is needed and if we have an available spot in one of our group homes that is suited to meet the needs of your loved one, we are open to offering that home as an alternative.

Does your organization provide a reference list of families to talk to regarding the services you provide to their loved one?

Absolutely. We have a deep appreciation for the level of stress and anxiety associated with choosing a provider, and fully understand how helpful and comforting it might be to talk to someone with direct experience with our agency. Contact the Program Director in the region in which you are searching, and we will provide you with a list of family members of individuals we are currently serving. We have encouraged all such family members to be honest and straightforward…the good, the bad, and the ugly.

How and where will an individual be cared for when ill?

How are non-verbal individuals accommodated?

How are physicians chosen? Does your agency offer options for using alternate physicians?

There are several physicians who see our individuals for a variety of specialized needs within each of our geographic regions. We utilize the services of physicians and specialists who we know well and have been working with for years. However, we do not require that your loved one see any of these physicians if you have established relationships with other physicians and specialists by whom you would prefer your loved one be seen. We are flexible about medical services, and are only bound by the distance and insurance coverage (i.e., that your desired physician is on the managed care plan of your loved one).

How do staff train individuals to be more independent in their daily living?

How do you accommodate non-ambulatory individuals?

We can accommodate non-ambulatory individuals in a variety of ways, all based on what any specific individual may need. First, we can coordinate with funds available on an individual’s care plan to complete minor home modifications to assist with mobility around the house and safe bathing. Such modifications may include, but are not limits to, widened doorways, roll in showers, raised toilets, roll-under sinks, doorway ramps, and many other potential home modifications. Then, we can coordinate with funds available on an individual’s care plan to obtain adaptive equipment, as needed, including but not limited to wheelchairs, portable ramps, specialized eating and bathing equipment, and many other portable devices that can assist a non-ambulatory individual. Finally, we can purchase a van that is modified with a hydraulic wheelchair lift, safety tie downs, etc., in order to ensure that non-ambulatory individuals can be transported safely throughout the community and participate in all of the same activities as their ambulatory peers.

How do your more experienced and professional staff mentor new staff?

We pair all new staff with an experienced veteran staff for a training experience that we call “shadowing.” Shadowing involves working side by side with the veteran staff, who will explain everything that’s being done as it is happening. Through shadowing, additional questions can be answered that new staff might not think to ask in the “classroom” setting, such as who, what, where, when, and why. For example, it’s much easier to understand and remember where certain supplies are stored if those supplies are being shown by the veteran staff in person. More importantly, veteran staff know our individuals…their likes and dislikes, their behavioral triggers, and the special nuances that must be known and understood in order to make the experience enjoyable and stress-free for the individual and the staff. It’s more practical to pass that information in person at the site of service working with the individuals, instead of talking about them in another location. “Shadowing” is not just for new caregiver staff, it’s also helpful for new professional staff…such as for nurses and case workers, who can sit down at computers, charts, medical records, etc. with veteran nurses and case workers to be shown how processes work and documents are written. Of course, “shadowing” will never fully take the place of traditional classroom-style training…but is absolutely necessary to provide the hands-on training that is essential for turning out well trained new employees. And, of course, we welcome family members to be part of the training process to whatever extent they wish; we know that in some more medically complex cases, for example, an involved family member can provide input from a unique perspective that is so helpful.

How does your agency build community awareness about persons with disabilities moving into their neighborhood? How does your agency resolve concerns?

How does your agency get adaptive equipment for my loved one?

The process of obtaining adaptive equipment can sometimes be complex and arduous, but is a wonderful service through the HCS program and our staff are knowledgeable in this process. Specifically the process involves getting a professional recommendation for the item(s), getting proof of Medicaid denial, getting bids for the best price, our agency purchasing the item, and then getting reimbursed for the item. More expensive items can take longer to obtain, usually because of the time it sometimes takes to get the Medicaid denial.

How does your company ensure that my loved-one’s home environment is clean and free of maintenance problems?

We provide initial and ongoing training regarding the cleanliness and maintenance of our homes. In addition, we clearly spell out all of the related expectations in fine detail in staff’s job descriptions, which serve as an employment agreement between our agency and our home staff. But most importantly, our management team does rounds on homes constantly and at varied times to ensure that homes are clean, well-organized, stocked properly with food and supplies, and free of maintained issues. We utilize several home inspection checklists, and take swift action if we are not satisfied with our findings. In addition, we employee maintenance specialists in each of our regions to be available to address related needs, either by fixing problems immediately OR Coordinating an outside specialist (e.g., plumber, electrician, HVAC, etc.). In the worst case scenario, we will make hotel arrangements at our own expense if any of our homes is not livable due to a significant maintenance problem until the problem is fixed.

How does your company maintain good relations with group home neighbors?

We understand the importance of being good neighbors, and we engage in many efforts to ensure that we do not create any trouble in our neighborhoods, including monitoring parking of company and employee vehicles and training staff on friendly non-confrontational interactions with neighbors. Truly, most of our neighbors are very supportive of our presence and view the support or individuals receive as a wonderful blessing. Also, we maintain the grounds of our homes and take all steps necessary to ensure that our homes look their best at all times.

How does your company maintain the group home’s grounds so that my loved one lives at a location that is admired, not shunned?

Yes. We maintain contracts with expert groundskeepers to ensure lawns are mowed regularly never to exceed a reasonable length, as well as keep hedges trimmed, beds weeded, leaves removed, and whatever grounds keeping work is necessary to ensure that our group homes don’t stand out in a negative from the rest of the homes in a neighborhood. In addition, we employ local maintenance staff in each of our regions to address related issues in a timely manner, such as changing lightbulbs, mending fences and garage doors, addressing pest issues, and a variety of other maintenance efforts to ensure our homes are safe and well-maintained residences.

How does your company monitor the content of entertainment for my loved one? Can I have input in minimizing my loved one’s exposure to entertainment that I don’t think is appropriate?

At the request of and with overriding input from the family, the professional team can meet to determine what, if any, restrictions need to be placed on entertainment content for your loved one. We fully appreciate the individual differences that the people we serve have in understanding and safely processing violent, sexually explicit content, or otherwise graphic content in entertainment. Cable TV can be set up with a variety of controls, user-specific or for the entire house. Outings and other activity choices are also chosen with respect to these concerns. And we would like to emphasize that there are many age-appropriate entertainment options that are not graphic in nature, and thus caution in such choices never has to restrict the number of outings or the amount of fun our individuals have.

How does your company pair housemates…is it based on age, gender, level of functioning, or some combination of these factors?

How does your company prevent theft of my loved one’s property?

We complete inventories of all new items and maintain all personal belongings to the best of our ability. Occasionally, an item may come up missing for any number of reasons beside theft, in which case we will investigate the problem and make restitution whenever we failed to protect the property of your loved one…typically by replacing the item. We encourage a variety of traditional safeguards related to items of higher value, and limit the cash on hand with any one individual to what we determine can be safely maintained by that individual without assistance (typically between $5-$20). We strongly discourage families from sending cash through the mail and from giving loved ones cash directly; instead, we encourage family members to send funds to one of our account managers, who can deposit the funds for future availability and thus safely account for those funds.

How does your company screen visitors? Can staff have visitors?, and if so, how does your company screen those people?

We use the same screening tools for visitors as we do for employees, including criminal background check and Employee Misconduct Registry check (for possible listing of confirmation of perpetration of abuse, neglect, and/or exploitation not otherwise prosecuted as a crime). Shift staff may not have visitors at any time. However, Live-In staff may have pre-screened visitors (other than children) at low-activity times during which caregiving (as proposed to general availability/monitoring) is not being provided (i.e., after bedtime)…and on a limited basis. Most importantly, our Live-In staffs’ number one responsibility is to be available to meet the needs of the individuals we serve, and if we find at any time that a visitor’s presence is a distraction to the Live-In resulting in diminished supervision and/or availability to the individuals served at that house, we will eliminate that visitation immediately. Furthermore, if we are informed or are otherwise aware on any inappropriate conduct stemming from the presence of that visitor, either between the Love-In and the visitor of between an individual and the visitor, we will eliminate the visitation immediately.

How does your organization tailor services to someone with autism spectrum disorder, apart from someone with an intellectual disability?

How easily can my loved one switch homes if there is a problem in the current home that cannot be resolved any other way?

We can offer any home that has an available spot to any family of any individual presently being served. We prefer to keep our homes single-sexed, as most families prefer that environment for their loved one, as well. We understand that group home placement is a trial and error experience, and placing individuals with like peers (i.e., similar in functioning level, interests, etc.) does not always work out as well as we expect…and sometimes we have to try alternative housemate parings to create the perfect fit, as determine by outcomes, not expectations. We know flexibility is required by all, and we surely all have everything to gain from great peer relationships in cohabitation. This process requires some patience and understanding, but will result in a long term overall positive experience for everyone involved once the right fit comes together.

How many individuals does your program serve at the present time, and what is your capacity to serve more individuals in the future?

We serve approximately 300 individuals throughout Texas, clustered in six areas: Abilene, Beaumont, Harlingen, North Houston, McAllen, and San Antonio. We have not limited our capacity, but have mostly opted to grow at a steady pace in order to keep quality in check and to ensure we know all of the individuals we serve and their family members well.

How many staff will be working at any given time in my loved one’s home?

Depending on the combination of needs of all of the individuals residing together, we will have between one and two staff working in any group home at any given time that the residents are present. In rare higher-need situations, there may be a 3rd staff in a 6-bed ICF facility.

How often can I take my loved one from the group home to my home for a weekend or holiday, and for how many days in a row?

Home visits are strongly encouraged. In the ICF program, a loved one can visit home for an unlimited number of 3-day visits, as well as one 10-day visit per year, which can be split into two 5-day visits, or a 4 day/6 day split…with another 3-day tagged n to the end of one of those. In the HCS program, a loved one can go for a number of 14-day visits, as long as the individual spends the 14th night overnight in the group home before resuming the time home.

How often do your supervisory staff monitor group homes on site?

Almost daily, and at random times, on weekdays and weekends, and by all supervisory staff, including but not limited to Case Managers, Nurses, Program Directors, maintenance specialists, and even executive staff…including the company President, CEO, and owner. Someone is in each of our homes constantly and unexpectedly. This supervision is truly key to ensuring a higher level of quality in the services we provide. Although we place a lot of trust in the people we employ, additional monitoring and supervision not only promotes accountability…it also increases the opportunity for ongoing training and “on-the-spot correction,” as well as encouraging the relationships between individuals residing in the homes and the supervisory staff that work out of our offices. This additional benefit of cross level relationships keeps everyone on the same page about our expectations, and helps us better understand what the individuals we serve want and need.

How often is your company inspected by regulatory authorities?

At least annually, and more often if significant complaints are reported. Also, local authority service coordinators visit the individuals we serve regularly, and in a variety of environments in which they receive services. Most importantly, we have an open door policy to all family members

How will your company ensure that my loved one gets around safely?

Our agency performs driving history checks on all employees and screens out drivers with verified evidence of history of reckless driving. In addition, we ensure all of our company vehicles are in good working order, well maintained, current on all inspections and registrations, and are outfitted with tires with proper tread life. We train all of our staff on safe driving, and take serious corrective action with staff who violate rules related to avoiding distracted driving (e.g., using cell phones, etc.). For our professional staff who have company cell phones, we utilize a program that works with GPS to disable those phones while in motion, and those phones will remain disabled until the driver is safely still for at least two minutes (i.e., longer than at a stop light). We plan all driving routes in advance, and ensure staff know where they are going before they go. We have a strict policy regarding limiting employment of who are involved in “at fault” accidents. And in the worst case scenario, we have clear guidelines for how to respond to vehicle accidents, which involve immediate medical assessment and notification of family members.

I have been out of work for a while and don’t have a lot of extra funds to help my loved one with special purchases, including clothing, etc. Will your company help to ensure my loved one’s most important needs are met?

I’m interested in HCS services, but I don’t know a whole lot about the program or where to begin. How should I proceed, and how can your agency help me in this early stage?

I’m not sure if a group home is the best residential option for my loved one. Can I try it out for a period of time, and switch to another residential option (e.g., Host or in-home support) provided or contracted through your company if the group home doesn’t work out? If so, is there a specific amount of time required by your company before such a switch is made?

If I am interested in exploring services for my loved one through your company, but I am not entirely sure if your company is the best fit, how can I explore your services without actually making a firm commitment?

If I am unable to decorate my loved one’s room, will your company provide furniture and décor for my loved one’s room?

If a family is unable to provide furniture, we will provide a twin mattress set with frame and headboard, a chest of drawers, a nightstand with lamp, wall decorations, and hangers for the closet. Sometimes we may have a spare television, but that is not always the case. We are happy to help, but that furniture purchased by us will remain our company property.

If I choose to participate in an ICF/IID program will it keep me from receiving an HCS slot?

If sick, how will my loved one me monitored?

We will provide supervision and support in the group home during the day to ensure that no individual who is not well is required to attend day services. In addition, we will ensure that all individuals who need to be seen by a physician are seen expeditiously. Our nursing staff will check in periodically, or as often as needed to monitor the signs and symptoms of the illness in order to ensure that your loved one is getting better, or will seek additional outside treatment from a physician to address longer-term illnesses. Of course, in significant situations, we will not hesitate to call 911, and our staff are all trained so they do not need our permission to do so…we trust in our staff’s judgement.

If sick, will my loved one be required to go to the day program sick, or be allowed to remain home with a staff person?

If we choose the group home option, can I have input in selecting the housemates of my loved one?

In the group home, is my loved one expected to do the cooking and the cleaning?

Our staff are expected to perform all of the tasks necessary to ensure clean and safe homes, as well as meal preparation and mealtime monitoring. Individuals are encouraged to help to whatever extent possible by sharing in reasonable parts of these tasks. But ultimately, our Direct Care Staff assume the final responsibility for these tasks. The group home is a great learning environment for practicing these tasks, varying on ability. But ultimately, our staff and our management must make sure our homes are clean and our meals are healthy and well-balanced.

Is my loved one eligible for food stamps?

My loved one can participate in cooking and cleaning, but ultimately needs help with these tasks. Please explain how your company deals with the individual differences of people’s skills.

We understand that the individuals we serve have limitations in their ability to perform various tasks, including cooking and cleaning. Our approach is to be encouraging and sensitive in requesting as much help from individuals in performing such tasks, but ultimately going behind individuals respectfully to make sure these tasks are completed thoroughly and to everyone’s satisfaction. Even though individuals are encouraged to share in the chores of the home, our Direct care Staff are ultimately responsible for keeping common areas, bedrooms, bathrooms, and kitchens, etc. up to par at all times, regardless of the varying abilities of the individuals for share them.

My loved one doesn’t like loud noise and crowds, but loves classical music and Disney movies. How will your company address the likes and dislikes of my loved one?

We provide a wide variety of activities and outings, ranging all the way from simple get-togethers with other homes (within our program) for dinner all the way to semi-formal dances, professional sporting events, theatrical events, symphony, etc. We appreciate that the people we serve have varying interest, just like all of us. Everyone is encouraged to participate in any event that we plan, but any individual may opt out…in which care we will switch our staff and individuals to facilitate anyone who wants to stay back. This switch out occurs regularly, and out staff are cross trained to work with individuals other than those to who they are primarily assigned.

My loved one has frequent constipation, and I am worried about bowel impactions. How will your company monitor my loved one’s bathroom usage to prevent from dangerous impactions?

We will implement a bowel movement record for any individual who has a history or diagnosis of chronic constipation. The use of this system requires the staff to supervise toileting, and at a minimum, visually note the toileting outcome in order to document that outcome on the record. For each such individual, all assigned staff are further trained in bowel movement expectations of that individual and the strict rules regarding communication of any deviation from what is expected (e.g., not having a successful outcome in more than a day). Our staff are well trained to call our nursing staff in such event, and out nursing staff will proceed accordingly…usually taking the individual for a physical examination or even to a minor emergency clinic, if necessary.

My loved one has high blood pressure and high cholesterol. How will your company ensure my loved one maintains an appropriate diet and gets regular exercise?

We provide a modified menu system for individuals with unique dietary needs, and train assigned caregiver staff in easily understood terms how to ensure adherence to such diets, including diets for high blood pressure and/or high cholesterol…typically in the form of a low fat, low sodium diet. We make special food item purchases for such individuals to ensure that they still enjoy what they are eating because we know that all people are more likely to me motivated to adhere to a special diet if that diet still includes enjoyable foods. We encourage such individuals to engage in exercise activities of their choosing, but also try to build in exercise in ways that are not always obvious, such as parking the vehicle a little further away from the entrance to an activity in the community and walking a few extra yards. Also, we have noticed that some of the individuals we serve love to participate in video game based exercise activities, which are especially helpful to promote exercise indoors during the hot Texas summer months.

My loved one is a participant in a variety of community activities, probably independent from other activities provided by your company. Can my loved one still participate?

Absolutely. All individuals living on our group homes will be transported by our staff to all activities in which they participate. We know that individuals have varying interests, and may choose to participate in unique activities aside from the group. We will accommodate those interests. We also check the driving history of all of our staff to ensure that we only employ safe drivers.

My loved one is diabetic and needs to have blood sugar monitored regularly. Who will monitor my loved one’s blood sugar and how will that person be trained?

An assigned Registered Nurse will thoroughly train all necessary staff regarding the procedures for using a blood sugar monitoring machine, as well as other signs and symptoms of out of range blood sugar specific to an individual. Also, the assigned RN will obtain an acceptable and individual-specific blood sugar range from that individual’s physician, rather than presume that all individuals with blood sugar problems be within the same range; each individual may vary in desired blood sugar range, as determine by a physician, and in the outer limits of what’s acceptable or expected in different situations (i.e., after meals, etc.).

My loved one is fairly high functioning, and many people cannot even tell there is any disability. How can your staff tailor their interactions with my loved one to avoid being accidentally insulting, stereotyping, or otherwise treat my loved one the same as all other loved ones at your company?

We provide significant orientation and ongoing training to ensure that all of our staff are familiar with the special needs of the individuals we serve. Typically those needs involve increased intervention by the staff due to an advanced need. However, the same attention will be paid to individuals who have less or minimal such needs in order to promote the individuality of higher functioning individuals. If possible, we may place higher functioning individuals together with similar peers. We also train our staff to adapt their communication to functioning level of individuals, and to request more participation form higher functioning individuals in the chores of the home. Most importantly, we encourage higher functioning individuals to participate in every opportunity to make choices in all possible areas of daily living, recreational activities, etc.

My loved one is mostly independent in grooming and hygiene, but needs some assistance that is consistent, but not intrusive or offensive to my loved one. How will your company provide this delicate balance between ensuring my loved one’s grooming and hygiene needs are met without seeming too controlling or “parental”?

Assisting with bathing, hygiene, grooming, meal preparation, and even toileting is always handled with the utmost privacy, dignity, and respect…regardless of functioning level. We serve individuals at all levels of functioning, and we understand fully that even higher functioning individuals may need some assistance in these areas, even of that assistance is in the form of verbal reminders. As an agency, we understand that we are ultimately responsible to ensure that these needs are fully met, regardless of functioning level…and that we cannot ignore the need for assistance with a higher functioning individual just because that individual may “seem” fully capable. However, we fully understand and appreciate the variation of feelings among higher functioning individuals related to receiving help, and the overall degree of acceptance of help for higher functioning individuals who may not fully embrace at least some minimal assistance from our staff. To ensure that such needs are adequately met, we provide individualized training to our staff to foster additional sensitivity, as needed.

My loved one is particularly vulnerable and probably not capable of self-defense if challenged by a peer. How does your company protect my loved one from potential aggression from peers?

We intervene, when necessary, with the placement of individuals with peers that are altogether a good fit in any particular home. We attempt to avoid predictable conflicts by discouraging placement of individuals who are likely to compete for dominance or otherwise engage in conflict that is likely to escalate. We strive to serve individuals who are not significantly aggressive, although we understand that many people with intellectual disabilities experience much higher levels of frustration and communication impairment, and understandably are more likely to act out. Most importantly, we train staff to detect triggers and intervene to prevent dangerous conflicts, as we fully accept our responsibility to ensure the safety of all of the individuals we serve at all times.

What are adaptive aids?

Adaptive Aids includes common items like diapers, wipes, ensure, multi-vitamins, thick-it, hearing aid batteries, glasses, walkers, van lifts, etc. and is limited to $10,000 per year.

What are you doing about COVID ( corona virus ) in your homes?

COVID-19: What we are doing to protect your loved ones and our communities, see http://icltx.net/covid19

What are your emergency back-up procedures when there is crisis or the home is short staffed?

There are several types of emergencies that could arise, and we are prepared for all of them. The most common situation is a staff shortage, in which case we have a long list of trained staff on call and available to step in to work. This issue should never be of concern to any family member. Less common, but still possible is a significant maintenance problem, such as the AC going out. If there is a significant maintenance problem that renders the home temporarily unlivable, we will put up the individuals and the staff in existing homes that have vacancies or in adjoining hotel rooms until the problem is solved. In the event of a hurricane or other natural disaster that requires an evacuation due to mandate or lack of electrical power, we will relocate all individuals in that geographic area, along with staff and even staff’s family members, if necessary, to another of our geographic regions (frequently San Antonio, where we have a large day program that can accommodate all of our individuals in any region for day services) to ensure everyone is safe and comfortable. We have well designed and tested (e.g., Hurricane Ike and the Houston area evacuation, Hurricane Harvey and the Beaumont region evacuation) systems for ensuring continuity of services and management relocated to a different region.

What are your policies regarding privacy?

The individuals we serve have the same privacy rights as everyone else. We honor their right to privacy in every way possible. We never enter a private location, such as bedroom or bathroom, without knocking and requesting permission to enter. We don’t open an individual’s mail without permission and in that individual’s presence. We include individuals and their legally authorized representatives in all service planning meetings and related discussions. We don’t discuss anything about an individual to anyone who is not authorized by proper official consent to have access to such information, as part of our overall confidentiality policy. We provide detailed training to all employees, regardless of position, regarding privacy, confidentially, and all of the rights of the individuals we serve. Privacy may only be compromised in any way if there is a specific medical or clinical need (e.g., assistance in the bathroom or shower), and only with the official consent of the individual or the legally authorized representative.

What does your company do during holidays?

First, we have a blowout Christmas party in every region with music, dancing, awards, and great food. In addition, we coordinate with facility members to facilitate as many home visits as possible so that loved ones can spend time with their families during holidays. For those who do not have a place to go, sometimes our staff may take one or two home with them to enjoy a family outing. And finally, for the rest, we have wonderful activities at the homes…frequently multiple homes get together for holiday parties. We bring in appropriate meals, depending on the holiday. Sometimes, we have barbeque events where several houses get together. We go to see local fireworks, when available. And when day programs close, we schedule activities at home or in the community.

What geographic locations do you serve?

What happens if I move out of state?

HCS services are available to individuals residing in Texas. If you move out of state, but chose for your loved one to remain with us, we will make every effort possible to include you in every important decision, albeit remotely. ICF services are available in every state, and you should have no problem finding an ICF program anywhere you go. There are similar waiver programs in other states (i.e., similar to HCS), but the waiting period may vary from state to state. Of course, if you do choose to move out of state and bring your loved one with you, we will coordinate vigorously with any new provider agency to share information and documentation, at your request, without delay. If you and your loved one need to leave the state temporarily due to an emergency (e.g., hurricane evacuation), we will contact the appropriate regulatory personnel to assist you and your loved one to maintain services.

What if I move to a different town in Texas?

HCS is a statewide program in Texas. There are literally thousands of HCS providers throughout the state. We provide HCS services in six primary areas in Texas, and encourage any family that is receiving services with us in any of our geographic locations to choose our program in any of the other five areas if moving to one of those areas. If you are moving from another provider agency in another area to one of our areas, and that provider agency doesn’t have an HCS program in one of our areas, we are happy to show you our program and offer information to help you make decisions. We do not encourage families to leave their current providers, but we welcome everyone when there is no other option.

What if my loved one needs a higher quality adaptive aid item than what Medicaid will pay for?

In this case, the item can be funded through the HCS program, as long as the total cost for the year is less than $10,000 and the higher quality item is well justified by assessment and related clinical explanation.

What is respite and under what circumstances am I eligible to receive respite services?

Respite is a billable HCS service that is intended to provide temporary for a primary caregiver in the CFC (formerly Supported Home Living) model. If your loved one is receiving CFC in your home and you are the primary caregiver, then you may utilize up to 30 hours per year of this service. Specifically, respite typically involves the use of a caregiver staff who is familiar with your loved one providing supervision and assistance toy your loved one in your home while you may be away for a relatively brief period of time (e.g., a few days). Respite is particularly helpful because it can be provided to your loved one even during sleep hours, as long as the respite staff is on site and available to your loved one while you are away. Also, respite doesn’t have to be for an extended period of time…it can be for a few hours or maybe half of a day. Just keep in mind that the maximum of 300 hours equates to approximately 12.5 days (per year).

What is the availability of a nurse if my loved one becomes sick or injured?

One of our agency nurses will assess your loved one in person as soon as humanly possible. In the meantime, the nurse will communicate and coordinate with the on-site caregiver staff to get information about your loved ones current status (i.e., vital signs) and give clinical instructions over the phone. If the symptoms described to the nurse by the staff on-site sound even remotely dangerous or threatening in any way, the nurse will instruct the on-site staff to hang up and call 911 immediately. In less extreme situations, but still seemingly quite serious, if the nurse believes the individual should not wait until the nurse can arrive, the nurse may instruct the staff to take the individual to the nearest minor emergency clinic. In most situations, the nurse can arrive and make the necessary decisions on-site. There are other options available if the presenting symptoms indicate in any way that the situation cannot wait for the nurse’s travel.

What is the average length of employment of a caregiver staff at your company? How does your company minimize employee turn-over?

Our actual staff retention rate has remained fairly constant at around 65%, which means that in a given year, at least 65% of those who were employed with us at the beginning of that year are still employed with us by the end of that year. It is our goal to have every employee stay with us for at least four years. Of course, we want to keep our best staff forever, but we know that’s not realistic. We encourage all employees to pursue their dreams, and understand if we are not included in those plans. However, we do offer several opportunities for advancement within our organization, as evidenced by the number of employees in higher positions who started as direct care staff or first line supervisors.

What is the level of education, training, experience, and credentialing for staff?

Caregiver staff may come to us with a variety of training and/or experience. We strive to hire people with related experience working directly with individuals with intellectual disabilities. However, we are willing to take a chance on an applicant with less experience, if we sense that this applicant has a great attitude, warm personality, and is seemingly eager and trainable. We provide extensive on-the-job-training. For professional and management positions, we generally require more significant related experience and educational background. More professional positions in our regional offices require additional education, including but not limited to 4 year college degrees, nursing licenses, and other professional certifications related to the specific job. Required experience comes from working in other similar programs serving individuals with intellectual disabilities or others with similar needs (e.g., in nursing facilities, psychiatric programs, state supported living centers, or even private duty care). For positions that require specific credentials, such as a nurse or specialized therapist, of course we obtain and maintain documentary evidence of specific credentials (e.g., copy of a RN license).

What is the ratio of staff to individuals?

What is the role of the Group Home Caregiver Position?

Personal care of individuals with developmental disabilities in a group home setting. The ideal candidate should have caregiver experience, and be fun, clean, mature, dependable, organized, respectful, and patient in challenging situations. On-the-job training is provided. Duties include Assistance with grooming and toileting, Assistance with meal preparation and mealtime monitoring, Assistance with medications and supplies, Supervision during recreational activities, House cleaning, Driving company vehicles, Communication with outside family members and office staff, and Specialized documentation completion.

What is the role of the Live-In position?

Personal care of individuals with developmental disabilities in a group home setting. The ideal candidate should have caregiver experience, and be fun, clean, mature, dependable, organized, respectful, and patient in challenging situations. On-the-job training is provided. Each Live-in Staff resides at an assigned group home to provide care to three other residents during waking hours. Each Live-In is provided with a master bedroom and bathroom, free rent and utilities, plus significant overtime pay for any (or all) weekends that the Live-In chooses to work. Duties include:- Assistance with grooming and toileting- Assistance with meal preparation and mealtime monitoring- Assistance with medications- Supervision during recreational activities- House cleaning- Driving company vehicles- Communication with outside family members and office staff- Specialized documentation

What is your company’s complaint process?

What is your plan in the event of a hurricane?

During Hurricane Ike, all of our Houston area individuals evacuated for 12 days to San Antonio, where we covered the cost of all accommodations and activities, including hotel, food, and SeaWorld! In addition, we extended an offer to all of our regional staff in the affected area to come with us and bring their families; we need our staff with us, and we know they will not be comfortable leaving their own family members behind. During Hurricane Harvey, our Beaumont area individuals evacuated to Louisiana until the Beaumont city water supply was back on and safe. We will spare no expense to make sure our individuals are comfortable, safe, and remain in our care at all times during any crisis, and all staff and family members are invited and encouraged to join us.

What procedures will staff implement in a crisis situation? How are staff trained to address potentially aggressive behavior?

We provide extensive training in prevention of aggressive behaviors, focusing on recognizing the signs of possible aggression and simple effective communications strategies for de-escalation of agitation. Recognizing the source of upset, validating the emotions associated with such upset, and carefully developing strategies to address the problem. Staff are taught how to interact with an upset individual in a calm, interactive, non-threatening, and non-judgmental manner. Staff are also taught how to document such episodes in order to facilitate the development of specialized behavior plans that more effectively address recurring target behaviors.

What provisions are made for individuals to attend a religious service of choice?

We inquire of families and individuals about religious preference, as well as level of activity and religious involvement for the individual and then we make it happen. Many of the individuals we serve choose to attend church together at a non-denomination service so that they can be together and enjoy the sense of community and comradery that participating together in religious activities can provide. However, we understand and greatly respect the many individual difference in religious background and level of related activity….and we will accommodate those differences to ensure that everyone can participate as he or she chooses. We understand, for example, that some individuals may choose not to participate at all, in which case we will accommodate those individuals to stay home. Conversely, we also understand that some individuals may wish to attend a service more often than just on Sundays…and we are happy to take such individuals during the week, as desired (e.g., for a Catholic mass). We also appreciate that not everyone is of a Christian faith or background, and we approach individuals of all faiths in a completely non-discriminatory manner, as well as individuals who choose not to participate in any religious activity. Nothing is forced.

What special activities will your company facilitate for my loved one, in addition to more typical activities?

We aim to choose cost effective activities that are affordable to your loved ones. However, we know that sometimes a special event may come around only once and awhile and just can’t be missed. So every now and then (perhaps quarterly), we take all that wish to go to something special…including but not limited to public arts events (symphony, theater, musicals), sporting events (Spurs games in San Antonio, Astros in Houston, etc.), the local zoo, special holiday dances, local fireworks displays, annual rodeos, and many other special events. We all have financial constraints and we all can’t go to very special event that comes through town. However, most of us at least go to some such events and out individuals should, too. For those who can afford them, there is no problem. For those who can’t, we frequently chip in to make sure no who wants to attend one feels left out.

What training subjects does your agency provide to new employees?

We maintain records of training for all employees on all subjects related to their specific jobs. Training occurs in a variety of formats, including interactive group seminars, video-based instruction, and specialized one-on-one between new staff and professional staff (particularly nurses). Topics include, but are not limited to:- Medication protocols- Preventing, detecting, and reporting abuse, neglect, and exploitation- individuals’ rights, confidentiality, and HIPAA rules and related policies and procedures- grooming, hygiene, and general bathing assistance- toileting assistance- meal planning, specialized diets, and related grocery shopping- fire safety and evacuation procedures- maintaining a clean, orderly, and well-structured group homes- individual and group schedules- transportation routes and driving safety- specialized medical procedures, as needed for assigned individuals…such as diabetic care, CPAP machine, etc.- Infection control and universal precautions to prevent the spread of disease- guidelines for quality interactions between staff and individuals handling of aggressive behavior- dealing proactively with problem behavior, including safe- emergency procedures, CPR, and when to call 911 immediately- recreational and community integration activities- contact list; who to call when and for what issue- Individuals’ training goals and related tasks to promote learning and overall independence- Assigned individuals’ “need to know” info, including special needs, likes and dislikes, etc.- reporting incidents, accidents, and illness- shopping with individuals and assisting in managing individuals’ funds safely and securely- professionalism in dealing with group home neighbors and related issues- house maintenance procedures and related reporting procedures- effective communication with family members- specialized documentation requirements.

What type and/or length of experience do your staff members have serving individuals with intellectual and developmental disabilities?

Many of our professional and management staff have been working with our agency for several years. Most of our Program Directors have been with us for five plus years. In addition, we have a team of caseworkers and nurses who have been with is for one or more years, but we acknowledge that the turnover rate among them is higher, as there are many opportunities that open up to them as they gain experience working at an agency such as ours that has 25 years in operation and provides valuable training that increases the marketability of some of those other professional staff. Our President, CFO, and CEO have all been with our agency for 20 plus years. We strive to hire Direct Care Staff who have experience in working directly with individuals with intellectual disabilities in a caregiving capacity.

What type of leisure / recreational activities does your agency provide, and how do individuals choose?

We provide a wide variety of activities and outings, ranging all the way from simple get-togethers with other homes (within our program) for dinner to semi-formal dances, professional sporting events, theatrical events, symphony, etc. Many activities are free or fairly inexpensive, and other may be less frequent, but sometimes more expensive such as special concerts, professional sporting events, etc. We schedule additional staff, if necessary, to support more complex outings. But more frequently, a couple of homes get together for a local movie, dinner out, or even dinners at each other’s homes. We have a fleet of vans to facilitate all related transportation needs. And we can accommodate anyone who wants to stay back and do something else at home.

What type of transportation does your agency provide?

We maintain a fleet of minivans and some full sized vans to transport groups of individuals to and from day activities, employment sites, recreational activities, medical appointments, and therapies, as needed. As necessary, we have specialized vehicles with wheelchair lifts and related modifications to be able to safely transport individuals with specific physical needs. Our vehicles are properly insured, well maintained, and carefully inspected on a regular basis. All of our drivers receive specialized driving training, and are carefully screened for good driving history with thorough driving history checks. We maintain a current copy of a valid Texas driver’s license for all employees, including all drivers. We provide additional training in the areas of safe driving and avoiding distractions while driving. We participate in a “Safety First” program that utilizes bumper stickers on all company vehicles for other motorists and pedestrians to report any unsafe activity associated with any of our vehicles. Finally, we maintain a “zero tolerance” policy regarding employees who violate any of our policies and procedures regarding safe driving.

What will happen to my loved one if your company has a bad inspection?

We will correct whatever issues are deficient in our program within the allotted time frame. Specifically, we take immediate steps to correct the specific issue at hand. In addition, we will make systematic changes to prevent any such issues from reoccurring going forward. We will always make mistakes, but we will hard to correct them.

Who inspects your company? Are such inspections made public?

The Texas Health and Human Services Commission conducts annual inspections of all of our programs, as well as unannounced residential site inspections to ensure our homes are in proper condition with adequate food, medications and supplies…and that our staff are properly trained in all key are. In addition, financial auditors inspect our management of individual’s funds and cost report auditors inspect our financial data to ensure that we are spending our income properly to meet the needs of the individuals we serve, and the staff who provide care.

Will a full or queen-sized bed fit in a typical bedroom, or must my loved one sleep in a twin-sized bed?

A full or queen sized bed will definitely fit in most bedrooms, and many of the individuals we serve have them. In the worst case scenario, the larger bed may fit better placed against a corner of the room with a single nightstand on the opposite (open) side. This configuration usually works well.

Will the group home be located in close proximity to the school / day program / place of employment?

Will your company provide me with information and guidance even if I don’t think you company is the best program for my loved one or doesn’t currently have a vacancy in a group home?

With whom can I file a complaint outside your company if I can’t get a concern resolved through the management channels within your company?

There are two complaint hotlines hosted by HHSC, one for ICF and one for HCS. We provide these numbers to all families at the time of enrollment and keep them posted at every office and group home.

Medical / Professional Services

Are meals planned and menus developed by a professional dietitian? How does your company ensure a healthy well-balanced diet for my loved one?

We use a menu system designed by a licensed dietician that includes only healthy, well balanced meals that are relatively simple to prepare. We allow individuals who don’t care for specific menu items to request appropriate substitutions (i.e., substitute a protein for a protein, a starch for a starch, and/or a green for a green). We provide significant oversight in the grocery shopping experience to ensure that the necessary items are purchased to facilitate the developed menus, and to ensure that shoppers minimize unhealthy snacks and desserts, etc. For those on special diets, we provide extensive training to staff to ensure that menu items are modified, as necessary to meet specialized dietary needs (e.g., no added salt, substituting salty food items for less salty alternatives, etc.). We work with individuals on specialized diets to find out what they do like to eat within the limitations for a specific dietary restriction to avoid overall dissatisfaction and promote choice, even in the face of restriction.

Are medical staff available on site or on call to respond to medical needs?

Our nursing staff is on call, not on site after hours. However, they can be onsite in a relatively short timeframe, whenever necessary to assess a situation in person. In addition, in regions where our day programs are adjacent to our local office, we likely have a nurse within walking distance during the day on weekdays. At other times, our nurses communicate effectively via telephone with our caregiver staff to give and receive necessary medical information, and make decision about care. Of course, we will activate emergency medical treatment without delay whenever the situation requires it…and let the nurse know what’s happening after the call to 911; our staff are authorized and encouraged never to wait to call 911 when necessary, and certainly do not require the authorization of a nurse or administrator to activate any emergency services.

Are there limits for Minor Home Modifications?

Minor home modifications includes common items like bathroom renovations for wheelchairs, wheelchair ramps, door widening, etc. Is limited to $7,500 for a lifetime.

Can I still get assistance with Medicaid paperwork if I remain the representative payee?

Our benefits coordinating department has over 20 years of experience in working through Medicaid issues, and we are here to help you in any way that we can. We prepare over 250 Medicaid applications and renewals annually and will be glad to assist you with your paperwork.

Can I suggest or choose a professional or specialist for my loved one?

Definitely, however that professional must be able to provide services at a unit (hourly) cost that is within our reimbursement rate for that service. For example, if the maximum we are reimbursed for a specific professional service is $75 per hour, we will not contract with a professional insists on charging us more than that. As long as we are within the Texas Health and Human Services (HHSC) established rates, we are happy to contract with any professional who doesn’t have any barring credential issues (e.g., history of Medicaid fraud, etc.).

Can I use my own doctors and nurses?

We maintain a network of physicians, dentists, specialists, and professional therapists. However, we encourage families to stay with their chosen medical providers, as needed. In fact, our service network has only grown as new families have chosen our program and brought with them new medical providers that have been able to serve others in our program.

Can my loved one get braces or cosmetic dental care with HCS dental funds?

No. Braces and cosmetic dentistry are not covered by HCS funds and require out-of-pocket funding.

Does your company have its own network of professional therapists and specialists?

We do maintain a list of professional providers of all services required in both the HCS and ICF programs. If you do not have someone specific from whom you wish for you loved on to receive a particular professional services (e.g., physical therapy), we are happy to take your loved one to any on our list, as needed.

Does your company provide guidance in helping me choose a MCO for my loved one’s medical needs?

We are not legally authorized to encourage you to choose one Managed Care Organization over another for the management and authorization of medical services. However, we are happy to relay to you our experience with any particular MCO with regard to medication formularies in relation to your loved ones current medication prescriptions.

Does your company provide supervision and assistance to my loved one during a hospital stay?

When hospitalization is needed, our nursing staff will assist an individual in the admission and discharge process, including providing all of the necessary information necessary at the time of admission, as well as collecting all relevant information at discharge. However, we do not provide assistance to the individual during the stay because the individual is technically discharged from our program and the hospital team will provide sitters, if there is a need.

How and where will an individual be cared for when ill?

How are physicians chosen? Does your agency offer options for using alternate physicians?

How does our agency incorporate the family’s wishes, when those wishes are different from what the agency believes is best?

How does your agency get adaptive equipment for my loved one?

How does your company address my loved one’s challenging behaviors?

Most importantly, we strive to get to know your loved one, particularly what triggers behavior problems, and what works to prevent those events. Of course, we provide a full array of behavioral supports, including psychological services, coordination with psychiatric services, and individualized formal behavior intervention planning. Furthermore, we provide initial and ongoing training to our staff to fully understand all of the structured plans that are designed to prevent or intervene, as necessary. In addition, we focus on every environmental factor within our control to shape that might be contributing to behaviors, including trying different residences and/or day programs that are a better fit to ensure that individuals are paired with peers who don’t trigger behaviors and are engaged fully in activities that are suited to their skills and interests (i.e., not bored).

How far will your company drive my loved one to an appointment; how far is too far?

Generally, we will drive as far as we can without disrupting the schedule for transportation for the vehicle is needed to get the rest of the individuals we are serving to and from day programs and group homes…with enough time to get there be seen by the professional and return in time to get the rest of the group home from day services. Specifically, this distance is approximately 30-40 miles, but could be less depending on the traffic congestion in the area. Presumably, our Houston area location experiences the most significant traffic. In that area, we can usually get to and from the medical center if the appointment is scheduled close to noon, and the physician in questions doesn’t keep patients waiting too long in the waiting room. We can’t go much further than that area.

How is my loved one’s medical information handled?

The Health Insurance Portability and Accountability Act (HIPAA) was enacted in August of 1996 and outlines two rules that companies in possession of sensitive health information must protect. Privacy and Security. Our companies extensively train our staff to protect the privacy and security of health information of our clients. Information is only accessible and shared on a need-to-know basis. All client information, including protected health information, is locked away and requires permission to view or access the information. For both paper-based information and information in electronic form, we train our staff to prevent unauthorized viewing or access and underscore the importance of private health information remaining just that – private. Whether it is something as simple as turning medical orders face-down when working with them at a desk, or not accessing electronic records from un-protected computers, our staff are trained to be diligent in their actions. Severe penalties for violations, including termination are tied to this awareness. We conduct regular audits of our electronic systems to detect unauthorized access. We regularly audit current access permissions to ensure that only our staff members that need access are allowed. We also maintain and audit our systems constantly to ensure they are protected against anticipated threats like unauthorized electronic access and viruses. If you would like to know more about HIPAA and how it pertains to your loved ones’ Health information, please check out The Texas Health and Human Services Commission https://www.HHSC.state.tx.us/providers/hipaa/index.html or The U.S. Department of Health & Human Services (HHS.gov) information for Individuals on Health Information Privacy at http://www.hhs.gov/hipaa/for-individuals/index.html

How often can my loved one do to the dentist?

As often as necessary to ensure the dental health of your love one, but within the cost limit of what the HCS program offers for dental services, which is $2,000 per year.

How often will your company take my loved one to a recurring appointment (e.g., speech therapy sessions, etc.)?

As often as necessary to achieve the anticipated therapeutic outcome. We don’t impose a limit; the course of such treatment should be part of the treatment plan determined by the licensed professional at the onset of treatment, and may be extended at any time during the course of the treatment. We have the same hopes as family members for the achievement of therapeutic outcomes, and we will assist in any way possible these goals.

If sick, how will my loved one me monitored?

If sick, will my loved one be required to go to the day program sick, or be allowed to remain home with a staff person?

May I attend my loved one’s medical appointments?

Family members are always encouraged to attend medical appointments. If unable to attend due to scheduling conflicts or for any other reason, family members are encouraged to let the nurse know what outcomes are expected at the appointment so that the nurse and/or our medical appointment transportation aid can inform the physician of the family member’s concerns. In addition, we are implementing an electronic communication system for all medical appointments for the individuals we serve that involves an advanced email to the family member informing of the time and date of every medical appointment, and with medical documentation attached that will be presented to the physician at the time of the appointment. This electronic system further enables the family member’s awareness of the appointment and serves as an invitation, with time, date, and even directions and maps. We take the desire for family participation in medical services very seriously and have invested in a new infrastructure, training, and even new personnel just to address this very issue…and we have so far had great success in improving family involvement in medical services for those who wish to have that involvement.

My loved one has frequent constipation, and I am worried about bowel impactions. How will your company monitor my loved one’s bathroom usage to prevent from dangerous impactions?

My loved one has high blood pressure and high cholesterol. How will your company ensure my loved one maintains an appropriate diet and gets regular exercise?

My loved one is diabetic and needs to have blood sugar monitored regularly. Who will monitor my loved one’s blood sugar and how will that person be trained?

What are adaptive aids?

Adaptive Aids includes common items like diapers, wipes, ensure, multi-vitamins, thick-it, hearing aid batteries, glasses, walkers, van lifts, etc. and is limited to $10,000 per year.

What are your policies regarding visitors?

We encourage visitation, and we do not have set hours for visitation you are welcome in our homes anytime! We do request that visitors are not disruptive to other individuals, especially during sleep time hours. We also ask that families who have concerns regarding any observations during visits report those concerns to our management staff instead of the caregiver staff on duty, which will help us be more aware of those concerns and better able to address them rather than rely on the caregiver staff to relay important messages. We also ask that facility members refrain from giving cash to individuals or staff, but rather send any additional cash that you want your loved one to have to the proper management staff in order to facilitate our ability to safeguard those funds and prevent theft. Similarly, we ask that new possessions (e.g., clothing, gifts, etc.) are properly checked in to your loved one’s personal belongings inventory in order to facilitate our ability to safeguard those items and ultimately allow us to be accountable for those items. Most importantly, we want you to feel welcome and embraced in the home, as if it is an extension of your own home. Have a good time and spread joy in the group home environment!

What fees do I have to pay?

None. Medicare and Medicaid cover your loved ones basic needs. There are no fees involved with using our programs.

What home modifications do we do?

Minor home modifications are adaptations to the home environment that facilitate safer mobility and greater ease of access throughout the home for individuals with more significant physical limitations and related needs. Minor Home Modifications are not necessarily minor; they can range in scope from a simple grab bar in a shower to help an individual avoid falling all the way to widening doorways, adapting bedrooms and bathrooms for wheelchairs, and building substantial wheelchair ramps for safe and easy access in and out of homes. In the HCS program, an individual with a professionally identified needs for such modifications is eligible for up to $7,500 per lifetime for the costs associated with such modifications, including parts, labor, and warranties.

What if my loved one needs a higher quality adaptive aid item than what Medicaid will pay for?

What is a special needs trust?

A special needs trust is an account managed by a qualified third party for excess funds that may be accumulated by your loved one that could otherwise put your loved one’s benefits at risk due to an accumulation of assets in excess of the allowable amount by Medicaid to maintain eligibility. This account will secure those funds, and prevent them from being counted as assets in determining eligibility for benefits. There are several rules about what the money, once deposited in the trust account, can be used for. These rules govern withdrawals, but the rules do not preclude the use of the funds for most needs. There are some minor fees associated with the maintenance of a special needs trust, but we believe the advantages far outweigh the disadvantages for those who are at risk of loss of benefits due to excess assets.

What is an MCO?

A Managed Care Organization is a branch of a major insurance company that is contracted with the state of Texas to manage Medicaid services. Right now, MCO’s only manage physician services, prescription medications, and some specialized equipment, otherwise referred to as acute services. In the future, MCO’s will manage all Medicaid services, including the services we provide, including group home services. MCO’s receive the funds for such services up front, and then determine how to distribute those funds, based on what they believe individuals need. MCO’s authorize acute Medicaid services now, and will ultimately authorize all Medicaid services in the future. MCO’s employ service coordinators to help determine what they believe individuals need.

What is the availability of a nurse if my loved one becomes sick or injured?

What is the role of the Nurse in your program?

The Nurse, not surprisingly, oversees the medical care of assigned individuals. That care primarily involves medications, physician’s appointments, and staff training of direct care staff who are performing a variety of “medical” tasks under the Nurse’s supervision. In addition, the Nurse is available at all times to address emergent medical needs, and also serves as a primary contact for family members regarding medical issues.

What procedures will staff implement in a behavioral crisis situation, and how are staff trained? How does your agency develop behavioral support plans?

In a behavioral crisis, staff are trained to implement the strategies outlined in an individual’s behavior support plan. If the crisis includes imminent danger to the individual acting out and/or others, staff are trained to detect this emergency and respond accordingly. In a behavioral crisis, as defined by such imminent danger, the staff are trained to take the least restrictive actions necessary to control the behavior and prevent injuries. However, as an absolute last resort, staff me be required to physically restrain and individual briefly until the situation is safe for release. Staff who are assigned to work with individuals known to have situational dangerous behavior receive specialized training in how to de-escalate behavior, as well as contain dangerous behavior, as a last resort, with safe physical restraint that never includes pain or potentially dangerous holds, and is never used for the convenience of staff or as a punishment or consequence for assaultive behavior. Physical restraint is only to be used if an individual is actively engaged in a dangerous behavior, not afterword, and only to stop the individual from hurting someone (or self). The development of a behavior support plan is a step-by-step process. First, it’s important to rule out any underlying causes of a problem behavior that can be more easily addressed, such as a medical problem causing discomfort or an environmental concern, such as an uncomfortable temperature or excessive noise. It’s also necessary to determine if a behavior is rooted in an organic condition, such as a serious mental health problem, including schizo-affective disorder. Once all such potential causes are ruled out, and the behavior has been determined to be “behavioral” in nature by a professional behavior support specialist, such as a psychologist, then the process of developing a plan begins. A thorough behavioral assessment must be completed by the professional, which may include observation of the individual, review of documentation describing the behavior, and interviews with people who know the individual best. The professional will like initiate a “baseline,” during which caregiver staff are instructed to document incidents on behavior reports, including narrative explanatory reports about the behavior each time it occurs. This baseline documentation is typically collected for a designated time period (perhaps a month or two). With that information, which should include time, place, environmental description, and many other aspects of each incident recorded by the staff, the professional can make a determination of the “function” of the behavior. This “function” is a technical term for understanding when and under what conditions the behavior is likely to occur in order to understand what the individual is ultimately trying to accomplish by exhibiting the problem behavior. Once this functional analysis is complete, the professional can complete the plan by determining what triggers the behavior and how to adapt the environment when those triggers are present, as well as what to do if the staff are unable to actually prevent the behavior and find themselves dealing with it full blown. The plan will include steps for addressing the full blown behavior that are designed to de-escalate and reward positive replacement behaviors, which are more appropriate ways for the individual to achieve the same outcome without displaying the problem behavior. In addition, the plan will typically include instructions for how to document each behavioral occurrence, how often such documentation is reviewed, and how often the plan should be revised if it is determined to be insufficiently effective, based on a measurable reduction objective…such as “we expect the behavior problem will decrease in frequency by 50 percent in the next 6 months.”

What procedures will staff implement in a crisis situation? How are staff trained to address potentially aggressive behavior?

What provisions will your company make for my loved one and the caregiver staff in the event of an emergency or natural disaster?

We are committed to ensuring that everyone involved in the care of your loved one is safe and secure in the event of an emergency or natural disaster. Some such issues are less significant, but still important. For example, if the air conditioner stops functioning in a group home, we will make arrangements for the individuals and staff to be relocated to either another existing group home with available bedrooms, or we will make hotel arrangements. In a more significant situation, such as a hurricane, we will engage in all necessary efforts to safely evacuate individuals, staff, staff’s families, and individual’s families, as needed and/or wanted. We typically set up shop temporarily in another of our regions across the state, utilizing hotel rooms at night and our day programs during the day. If such an event were to occur (and it did during Hurricane Ike), we will make the experience fun and memorable for everyone involved while we wait for the “all clear” to return home.

What training subjects does your agency provide to new employees?

What type of dental services are available to my loved one through the HCS program?

An array of dental services is available to any individual receiving HCS services, from treatments and operative procedures to preventative cleanings and bite therapy. Treatment of conditions where social development is impaired are also covered. Please see the Texas HHS website for a compressive list of available HCS Services. https://hhs.texas.gov/laws-regulations/handbooks/home-community-based-services-hcs-program-billing-guidelines/hcsbg-section-6000-adaptive-aids-minor-home-modifications-dental-treatment (see section 6330 Billable dental Treatment).

Who pays for adaptive aids?

Adaptive Aids furnished through the HCS Program provide a direct medical or remedial benefit to the person and are in addition to any medical equipment and supplies furnished under the State Medicaid Plan.

Will you complete the Medicaid paperwork for my loved one?

Will your company assist me in securing a special needs trust for my loved one, if needed?

Absolutely. We fully support the use of special needs trusts and have helped many of our individuals and their families secure one. In addition, if we are your loved one’s representative payee and account manager, we will coordinate with the special needs trust in every way necessary to maximize its benefit.

Day Services

Are medical staff available on site or on call to respond to medical needs?

Are sufficient staff available to support my family member in additional activities in the community? (i.e. Girl Scouts, religious activities, sports teams, etc.)?

Can my loved one stay back from an outing? If my loved one stays back from an outing, how will your company provide supervision in that situation?

Can my loved one work in the community?

If your loved one would like to work in the community, our case manager will set up an appointment with DARS (Department of Assistive and Rehabilitation Services) to complete an application. DARS is connected with many local employers and will match your loved one with the perfect employer based on their skills and desires. After the DARS application is complete, we will be able to provide Supported Employment and Employment Assistance through the HCS waiver program while they wait for DARS assistance.

Can your company transport my loved one to a relative’s home for a visit when I am unable to provide that transportation?

Does your agency employ staff who speak other languages?

Does your company encourage/help my loved one with developing social skills?

Does your company ever employ family members of loved ones served?

We generally do not employ family members of loved ones served, and in some cases, our billing guidelines prohibit it.

Does your company provide supervision and assistance to my loved one during a hospital stay?

How are non-verbal individuals accommodated?

How are physicians chosen? Does your agency offer options for using alternate physicians?

How do staff train individuals to be more independent in their daily living?

How do you accommodate non-ambulatory individuals?

How far will your company drive my loved one to an appointment; how far is too far?

How is a day program chosen?

How often will your company take my loved one to a recurring appointment (e.g., speech therapy sessions, etc.)?

If a client already has graduated, will DARS and the school district assist with the employment process?

The Department of Assistive and Rehabilitative Services, or DARS may assist; however, once the individual graduates from high school, the school district has no more responsibility for assisting with the employment services and supports.

If sick, how will my loved one me monitored?

If sick, will my loved one be required to go to the day program sick, or be allowed to remain home with a staff person?

If transportation has to be provided to support the individual’s efforts to be self-employed, work from home or perform in a work setting. Is the HCS provider agency responsible for transporting the client or just making transportation arrangements?

The HCS program staff or CDS (Consumer Directed Services) employer provider is responsible for transporting the individual specific to the service definition for Employment Assistance (EA) and Supported Employment (SE). The program provider would provide the transportation or explore and coordinate other transportation arrangements with people who normally provide natural supports, such as family members, friends or co-workers who may be willing to fulfill this need to some degree.

Must individuals start at DARS before receiving EA or SE from us as the HCS provider?

Individuals can receive waiver-provided Employment Assistance (EA) through the HCS provider until DARS has developed an Individualized Plan for Employment (IPE) and the individual has signed the document. The local authority service coordinator is responsible for developing the PDP (Personal Directive Plan) which authorizes Employment Assistance (EA) and Supported Employment (SE) services to be provided by the HCS.

My loved one has a unique hobby (e.g., fishing) that most people is group homes are not interested in. How will your company encourage and facilitate my loved one’s ongoing interest and participation in hobbies?

We absolutely encourage the individuality and creativity of everyone we serve. We understand that we must support and facilitate creative and recreational interests, and that sometimes means we must put some extra effort into assisting individuals with unique activities. We strive to work out the details, including transportation and supervision, so that everyone can participate in chosen activities with minimal disruption to the rest of the group that might be less interested. We frequently find, however, that peers may also become interested in new activities, and then the group can participate together.

My loved one is a participant in a variety of community activities, probably independent from other activities provided by your company. Can my loved one still participate?

We are located in a rural area where the unemployment rate is quite high and there are few places to work. How long would the HCS provider be expected to help find the individual employment?

We recognize that employment opportunities vary greatly around the state. Employment Assistance (EA) initially will be authorized for a minimum of 10 hours so that individuals’ preferences and skills can be thoroughly assessed and the specific training needs and employment goals can be agreed upon. Additional Supported Employment (SE) hours will be available up to 150 hours, and there is no service authorization limit for hours of service. However, there is a maximum of 180 days that may be authorized.

We do not compensate Host providers for day services provided in the home, nor do we bill for such services through the HCS program. In a select few extreme circumstances, we would have to get pre-authorization from HHSC.

As a Host provider, can I also provide day programming in our home and get reimbursed for the day activities by your company?

What are your emergency back-up procedures when there is crisis or the home is short staffed?

What choices will my family member have concerning day programming, vocational training, supported employment, etc.?

What does “Supported Employment” mean?

Supported employment involves time spent, per the number of units pre-approved on the plan of care, and unobtrusively monitoring an individual’s success at a job on an on-going basis. Specifically, Supported Employment may include transportation to and from work, coordinating with an individual’s work supervisor to determine any performance issues, and working with the individual to overcome those issues.

What does your company do during holidays?

What experience does the EA and SE service provider have?

Employment Assistance (EA) and Supported Employment (SE) require the service provider to have at least two years of paid or unpaid experience providing services to people with disabilities. This experience could include such areas of work as day habilitation, attendant services, educational services, social work, case management and nursing services.

What geographic locations do you serve?

What is “Employment Assistance”?

Employment Assistance (EA) involves time spent, per the number of units pre-approved on the plan of care, in helping an individual develop skills necessary to obtain gainful employment. Such skills may include learning how to find job postings, how to complete a job application, how to make an initial contact with a potential employer and related interview skills, how to dress for an interview, how to research the job to have a successful interview, etc. More importantly, Employment Assistance may be used to help promote a specific job skill or further develop an individual’s self-awareness of interests and goals necessary in choosing a specific job or actual career.

What is the availability of a nurse if my loved one becomes sick or injured?

What is the difference in Supported Employment (SE) and Employment Assistance (EA)?

Employment Assistance helps an individual get the job. Supported Employment helps the individual keep the job. Both involve assistance from our staff to support an individual with a desire to be employed.

What is the level of education, training, experience, and credentialing for staff?

What is the ratio of staff to individuals?

What is the role of the Day-Hab position?

Personal care of individuals with developmental disabilities in an adult day activity setting. The ideal candidate should have caregiver experience, and be fun, clean, mature, dependable, organized, respectful, and patient in challenging situations. On-the-job training is provided. Duties include General supervision and monitoring of individuals served, Teaching specialized training objectives to acquire independent living skills, Assistance with grooming and toileting, Supervision and assistance during meals, Supervision during recreational activities, Facility and/or house cleaning, Driving company vehicles, Communication with co-workers and office staff, and Specialized documentation completion.

What specific services would my loved one receive at the day program?

Individual enjoy a variety of recreational and learning activities in a safe and supervised environment, as well as develop skills necessary to obtain gainful employment in any of our day habilitation programs. Day habilitation also typically includes a variety of community activities or “outings” that promote learning and physical exercise. Individuals also receive whatever care and supervision is necessary throughout the day, based on individual level of need, to ensure maximum safety…including but not limited to assistance with meals, toileting, hygiene, ambulation, and transportation.

What training subjects does your agency provide to new employees?

What type of leisure / recreational activities does your agency provide, and how do individuals choose?

What type of transportation does your agency provide?

When the HCS provider is providing SE/EA, what are the qualifications for this person?

The HCS program offers these services using a service provider with the qualifications found in the Texas Administrative Code, Title 40, Chapter 51, Rule §51.485, Service Provider Qualifications for Providing Employment Assistance (EA) and Supported Employment (SE).

Will your company assist in transportation to additional activities?

Absolutely. All individuals living on our group homes will be transported by our staff to all activities in which they participate. We also check the driving history of all of our staff to ensure that we only employ safe drivers.

Financial / Eligibility

Am I able to remain control of my loved one’s money?

You have a choice to allow us to be representative payee or for you to be representative payee. If you remain representative payee, you will be responsible for all money and obligations required by Social Security, Medicaid, Medicare, Food Stamps, and other government entities

Am I responsible for any expenses if my loved one is in your group home?

Are there other options beyond HCS and ICF services?

Can any of my relatives provide in-home care to my loved one? If so, are there any restrictions?

Can I decorate my loved one’s room?

Can I monitor my loved one’s incoming and outgoing money?

You may request a quarterly or annual report including all relevant information regarding income and expenditures, and this can be set up to be sent to you automatically via email, regular mail, or fax.

Can I still get assistance with Medicaid paperwork if I remain the representative payee?

Can my loved one have cable TV and/or Internet service in the home?

Can you help me get adaptive aids and adaptive equipment?

Adaptive Aids includes common items like diapers, wipes, ensure, multi-vitamins, thick-it, hearing aid batteries, glasses, walkers, van lifts, etc. and is limited to $10,000 per year.

Does your company actually provide employment assistance?

We provide employment assistance if the Texas Department of Assistive and Rehabilitative Services (DARS) does not accept the individual. We can also provide it while the individual is waiting to find out if DARS will accept them.

Does your company do all of the shopping for my loved one’s needs and wishes (e.g., clothing, music, etc.), or may I participate in in shopping for my loved one’s needs and wishes, as I see necessary?

Does your company ever employ family members of loved ones served?

We generally do not employ family members of loved ones served, and in some cases, our billing guidelines prohibit it.

Does your company furnish the house? If so, how often does your company replace furniture as it gets older and worn?

Does your company have any policy regarding whether my loved one can have a cell phone?

We are happy to assist an individual in having a cell phone if that individual is functionally capable of using it. Many individuals we serve have mobile devices and use them every day. We do want to make sure individuals can afford them, and we sometimes assist individuals in setting plan limits that work with their income to make sure that the luxury of a cell phone does not replace the necessity of rent, food, etc. For some, family members choose to pay related expenses, which we fully support, as well.

Does your company provide guidance in helping me choose a MCO for my loved one’s medical needs?

Does your company provide respite in my loved one’s home? Does your company ever provide respite in its own group homes?

How are individual finances managed? Can I manage the finances and money for my loved one?

How do I get on the HCS interest list?

Contact your local authority and let them know you would like to be placed on the HCS interest list ( HCS Waiting List ). We can help guide you to the right person within that entity.

How do I lose an HCS slot – can we be removed from the interest list?

How does your agency get adaptive equipment for my loved one?

How does your company assist my loved one in making purchases in the community?

Once the purchase has been properly requested by the authorized party (e.g., family member, guardian, etc.) and then authorized by one of our internal account managers upon verification of the availability of the funds and the appropriateness of the purchase, caregiver staff will assist your loved one with making the purchase, ensuring that the item(s) purchased are successfully in the possession of your loved one, and that the necessary receipts are returned to the account manager for proper accounting.

I do not have Medicaid. Can you help me obtain Medicaid?

I have been out of work for a while and don’t have a lot of extra funds to help my loved one with special purchases, including clothing, etc. Will your company help to ensure my loved one’s most important needs are met?

I’m interested in HCS services, but I don’t know a whole lot about the program or where to begin. How should I proceed, and how can your agency help me in this early stage?

If I am unable to decorate my loved one’s room, will your company provide furniture and décor for my loved one’s room?

If I choose your company for my loved one, what paperwork do I need to provide?

If take my loved one on a vacation, what expenses can my loved one pay for on that vacation?

Individuals who have the funds available can pay for all of their own travel-related expenses, as well as the expenses of one family member who will serve as the primary caregiver on the trip; allowable expenses include airfare, other travel, lodging, food, airport parking, etc.

Is my loved one eligible for food stamps?

Is there an ICF interest list?

What are adaptive aids?

Adaptive Aids includes common items like diapers, wipes, ensure, multi-vitamins, thick-it, hearing aid batteries, glasses, walkers, van lifts, etc. and is limited to $10,000 per year.

What are the requirements to get on the HCS interest list?

What expenses am I responsible for? What expenses is my loved one responsible for? What expenses is the program responsible for?

The individual receiving services, with some financial assistance from our agency, is generally able to cover all expenses, with few exceptions, as long as those expenses are within the scope of what is reasonable. For example, regularly priced shampoo that is affordable and typically purchased at a grocery store is within the scope of what our agency will pay for if the individual cannot afford it. However, if the individual (or family) chooses a special hair product that can only be purchased at a fancy salon and is quite a bit more expensive, then the agency will not be responsible for the purchase. There is usually enough money available for most outings, but occasionally, a family member may choose to chip in for a special event if that event is quite expensive. But the basics of room and board, and all of the staff and professional services are never charged to the family unless the family has extraordinary requirements or choices. There are also some differences in how these expenses are covered for individuals receiving IFC services, vs. HCS services, but those differences are better explained via meeting or telephone conference. One of the more common expenses incurred by family members is for clothing, although we will assist individuals who don’t have family involvement or whose families cannot generally afford to asset in this area.

What fees do I have to pay?

None. Medicare and Medicaid cover your loved ones basic needs. There are no fees involved with using our programs.

What if my loved one needs a higher quality adaptive aid item than what Medicaid will pay for?

What is a special needs trust?

What is an MCO?

What is DARS?

The Department of Assistive and Rehabilitative Services, or DARS, administers programs that ensure Texas is a state where people with disabilities, and children who have developmental delays, enjoy the same opportunities as other Texans to live independent and productive lives. As of September 1, 2016, programs and services have been transferred by the Texas Legislature to the Texas Workforce Commission or the Texas Health and Human Services Commission. Please consult www.dars.state.tx.us for program and contact information.

What is respite and under what circumstances am I eligible to receive respite services?

What is the Texas Home Living Program?

A Medicaid waiver program in Texas that provides a variety of services to an eligible individual, but does not include the same level of residential assistance as is offered in the HCS program.

What is your Host (foster) program?

What special activities will your company facilitate for my loved one, in addition to more typical activities?

What steps will your company take to help my loved one get a job?

If employment is identified as a goal, we will help an individual obtain a meaningful job in several steps. First, we will utilize specialized assessment and training services through the Texas Department of Assistive and Rehabilitative Services (DARS). Once those services are exhausted, we will utilize Employment Assistance (to help find a job) and Supported Employment (to help maintain the job) services through the individual’s care plan to help find the job, prepare the individual for the job, provide significant initial assistance at the beginning of the job, and ongoing support through communication and occasional intervention (e.g., to address a minor behavioral issue, such as falling off task) with the on-site supervisor.

Will you complete the Medicaid paperwork for my loved one?

Will your company assist me in securing a special needs trust for my loved one, if needed?

Will your company provide me with information and guidance even if I don’t think you company is the best program for my loved one or doesn’t currently have a vacancy in a group home?

Family Involvement

Can I take my loved one on a vacation with me and our family?

Absolutely. All family vacations are encouraged and cherished by loved ones.

Am I able to remain control of my loved one’s money?

Am I responsible for any expenses if my loved one is in your group home?

Are state inspections and audits available to family members?

Absolutely. We can provide written evidence, or we can direct anyone to the State’s websites that contain all such reports online, public record for anyone to view.

Are there any restrictions on visitation?

None, unless there is a court order with a specific (e.g., a particular family member, etc.) restriction.

Can I assist my loved one in choosing a day program? Does my loved one have to attend your company’s day program?

We encourage individuals and family members to choose all of the services that are available to them, and we do not push anyone to attend a day program that is not their first choice. We strive to provide interesting and rewarding services in all of the day programs we operate, but we also fully appreciate that there are some compelling alternatives in each of the regions in which we operate…especially for individuals that have unique interests that can be accommodated by unique programs (e.g., sports oriented or computer oriented, etc.). We can facilitate the choice of a day program by assisting a family member in scheduling visits to a variety of day programs, including our own as well as others in the area. Because we typically know the directors of other day programs, we frequently can expedite the process of a visit.

Can I decorate my loved one’s room?

Can I monitor my loved one’s incoming and outgoing money?

Can I visit my loved one at the group home at any time, unannounced?

Absolutely any time, and unannounced, if you wish. We only ask that if you come during sleep hours, you are careful not to wake the other residents.

Can your company transport my loved one to a relative’s home for a visit when I am unable to provide that transportation?

Does your company do all of the shopping for my loved one’s needs and wishes (e.g., clothing, music, etc.), or may I participate in in shopping for my loved one’s needs and wishes, as I see necessary?

Does your company encourage/help my loved one with developing social skills?

Does your company ever employ family members of loved ones served?

We generally do not employ family members of loved ones served, and in some cases, our billing guidelines prohibit it.

How are complaints addressed?

How are individual finances managed? Can I manage the finances and money for my loved one?

How are physicians chosen? Does your agency offer options for using alternate physicians?

How are program suggestions, comments, and/or concerns addressed?

How can I help your company and my loved one? Can I volunteer or otherwise be a part of the services provided by your company?

We encourage all family members to participate in F.A.C.T., the Family Action Coalition of Texas, which is a family advocate organization that can help shape legislation that will determine the future of services for individuals with intellectual disabilities in Texas. F.A.C.T. is an organization that is part of the Provider Alliance for Community Services in Texas (PACSTX), which is a professional trade association focused on the interests of persons with intellectual disabilities receiving community supports in Texas, and the provider agencies that serve them. There are Special Olympic events that are a wonderful opportunity for helping out, as well as occasional camp experiences.

How do your more experienced and professional staff mentor new staff?

How does our agency incorporate the family’s wishes, when those wishes are different from what the agency believes is best?

How does our agency involve the individual/guardian/family into the development of the individual’s program plan?

How does your company monitor the content of entertainment for my loved one? Can I have input in minimizing my loved one’s exposure to entertainment that I don’t think is appropriate?

How does your company prevent theft of my loved one’s property?

How does your organization tailor services to someone with autism spectrum disorder, apart from someone with an intellectual disability?

How far will your company drive my loved one to an appointment; how far is too far?

How often can I take my loved one from the group home to my home for a weekend or holiday, and for how many days in a row?

How will your company include me in important decisions?

I am interested in your program, but not yet ready to make a decision. Can I talk to other family members of individuals already receiving your company services to learn more about their experiences with your company?

I’m interested in HCS services, but I don’t know a whole lot about the program or where to begin. How should I proceed, and how can your agency help me in this early stage?

If I am interested in exploring services for my loved one through your company, but I am not entirely sure if your company is the best fit, how can I explore your services without actually making a firm commitment?

If I am unable to decorate my loved one’s room, will your company provide furniture and décor for my loved one’s room?

If I choose your company for my loved one, what paperwork do I need to provide?

If take my loved one on a vacation, what expenses can my loved one pay for on that vacation?

In addition to my loved one, can I take another housemate for an activity or a weekend visit to my home?

Absolutely. We encourage strong bonds between housemates, as well as between their respective families. Housemates become like family to each other, and it is only natural for them to want to share their own outside relationships with each other.

May I attend my loved one’s medical appointments?

What are your policies regarding visitors?

What choices will my family member have concerning day programming, vocational training, supported employment, etc.?

What expenses am I responsible for? What expenses is my loved one responsible for? What expenses is the program responsible for?

What is your Host (foster) program?

What kind of meetings do I have to attend, how often, and where are meetings held?

What provisions are made for individuals to attend a religious service of choice?

What type of leisure / recreational activities does your agency provide, and how do individuals choose?

Who pays for adaptive aids?

Will your company provide me with information and guidance even if I don’t think you company is the best program for my loved one or doesn’t currently have a vacancy in a group home?

With whom can I file a complaint outside your company if I can’t get a concern resolved through the management channels within your company?

There are two complaint hotlines hosted by HHSC, one for ICF and one for HCS. We provide these numbers to all families at the time of enrollment and keep them posted at every office and group home.

Service Planning

Can I take my loved one on a vacation with me and our family?

Absolutely. All family vacations are encouraged and cherished by loved ones.

Am I responsible for any expenses if my loved one is in your group home?

Are meals planned and menus developed by a professional dietitian? How does your company ensure a healthy well-balanced diet for my loved one?

Are there limits for Minor Home Modifications?

Minor home modifications includes common items like bathroom renovations for wheelchairs, wheelchair ramps, door widening, etc. Is limited to $7,500 for a lifetime.

Are there other options beyond HCS and ICF services?

Can any of my relatives provide in-home care to my loved one? If so, are there any restrictions?

Can I assist my loved one in choosing a day program? Does my loved one have to attend your company’s day program?

Can I suggest or choose a professional or specialist for my loved one?

Can my loved one get braces or cosmetic dental care with HCS dental funds?

No. Braces and cosmetic dentistry are not covered by HCS funds and require out-of-pocket funding.

Can my loved one receive in-home support during sleep hours?

Can my loved one work in the community?

Can you help me get adaptive aids and adaptive equipment?

Adaptive Aids includes common items like diapers, wipes, ensure, multi-vitamins, thick-it, hearing aid batteries, glasses, walkers, van lifts, etc. and is limited to $10,000 per year.

Does your company actually provide employment assistance?

Does your company have any policy on switching between residential models (e.g., between Host, in-home supports, or group home)?

Does your company have any policy regarding whether my loved one can have a cell phone?

Does your company have its own network of professional therapists and specialists?

Does your company provide respite in my loved one’s home? Does your company ever provide respite in its own group homes?

How are physicians chosen? Does your agency offer options for using alternate physicians?

How do I get on the HCS interest list?

Contact your local authority and let them know you would like to be placed on the HCS interest list ( HCS Waiting List ). We can help guide you to the right person within that entity.

How do I lose an HCS slot – can we be removed from the interest list?

How do staff train individuals to be more independent in their daily living?

How do you accommodate non-ambulatory individuals?

How does our agency incorporate the family’s wishes, when those wishes are different from what the agency believes is best?

How does our agency involve the individual/guardian/family into the development of the individual’s program plan?

How does your agency get adaptive equipment for my loved one?

How does your company address my loved one’s challenging behaviors?

How does your company assist my loved one in making purchases in the community?

How does your company manage the needs of the individuals it serves 24/7?

We maintain a team of professional and management staff on call all day and night, weekdays and weekends. We rotate those responsibilities so that someone is always immediately available to address any need. In addition, our direct care staff assigned to provide care to you loved one work on site at all times.

How does your company pair housemates…is it based on age, gender, level of functioning, or some combination of these factors?

How does your organization tailor services to someone with autism spectrum disorder, apart from someone with an intellectual disability?

How dos your company facilitate my loved one in making choices in daily decisions about activities, food, and other such matters that are important to my loved one?

We encourage all individuals to participate in as many choices as possible, Of course, we know that not everyone makes the best choices all the time. But we train our staff to assist in encouraging healthily choices, as well as trying new things. To avoid power struggles, it is often helpful to pre-identify 2 or 3 options, and let an individual choose from among them. We also train staff to create opportunities for choices whenever possible.

How easily can my loved one switch homes if there is a problem in the current home that cannot be resolved any other way?

How is a day program chosen?

How is my loved one’s medical information handled?

How many staff will be working at any given time in my loved one’s home?

How often can I take my loved one from the group home to my home for a weekend or holiday, and for how many days in a row?

How often can my loved one do to the dentist?

As often as necessary to ensure the dental health of your love one, but within the cost limit of what the HCS program offers for dental services, which is $2,000 per year.

How often will your company take my loved one to a recurring appointment (e.g., speech therapy sessions, etc.)?

How will your company include me in important decisions?

I am an older parent of my loved one. How will your company ensure the continuity of care of my loved one if anything should happen to me?

We will offer to assist you, to whatever extent you wish, with our expertise and experience regarding guardianship and/or identifying appropriate family members to step in to the role of advocating for the needs of your loved one. We are, of course, thrilled to be a long-term provider for your loved one and will honor your wishes as you express them to us.

I’m interested in HCS services, but I don’t know a whole lot about the program or where to begin. How should I proceed, and how can your agency help me in this early stage?

I’m not sure if a group home is the best residential option for my loved one. Can I try it out for a period of time, and switch to another residential option (e.g., Host or in-home support) provided or contracted through your company if the group home doesn’t work out? If so, is there a specific amount of time required by your company before such a switch is made?

If I choose to participate in an ICF/IID program will it keep me from receiving an HCS slot?

If needed, what types of special assistance will your company provide to my loved one to meet special needs and challenges?

We expend a considerable effort upon enrollment in getting to know your loved one. Through extensive interview with primary family members, we complete a lengthy document that we call “All about me” that identifies all of an individual’s needs, as well as what interests and motivates your loved one and what might need to be avoided. Once this document is complete, we use it as a training tool for all staff and outside contractors (e.g., behavior specialists, medical professionals, etc.) to ensure that everyone involved in serving an individual is consistent and aware. Then, we provide ongoing monitoring and supervision of all staff to ensure that staff continue to be knowledgeable and follow the procedures developed to meet special needs successfully.

If transportation has to be provided to support the individual’s efforts to be self-employed, work from home or perform in a work setting. Is the HCS provider agency responsible for transporting the client or just making transportation arrangements?

If we choose the group home option, can I have input in selecting the housemates of my loved one?

Must individuals start at DARS before receiving EA or SE from us as the HCS provider?

My loved one doesn’t like loud noise and crowds, but loves classical music and Disney movies. How will your company address the likes and dislikes of my loved one?

My loved one has a unique hobby (e.g., fishing) that most people is group homes are not interested in. How will your company encourage and facilitate my loved one’s ongoing interest and participation in hobbies?

My loved one has high blood pressure and high cholesterol. How will your company ensure my loved one maintains an appropriate diet and gets regular exercise?

My loved one is fairly high functioning, and many people cannot even tell there is any disability. How can your staff tailor their interactions with my loved one to avoid being accidentally insulting, stereotyping, or otherwise treat my loved one the same as all other loved ones at your company?

My loved one is mostly independent in grooming and hygiene, but needs some assistance that is consistent, but not intrusive or offensive to my loved one. How will your company provide this delicate balance between ensuring my loved one’s grooming and hygiene needs are met without seeming too controlling or “parental”?

My loved one is particularly vulnerable and probably not capable of self-defense if challenged by a peer. How does your company protect my loved one from potential aggression from peers?

We are located in a rural area where the unemployment rate is quite high and there are few places to work. How long would the HCS provider be expected to help find the individual employment?

We do not compensate Host providers for day services provided in the home, nor do we bill for such services through the HCS program. In a select few extreme circumstances, we would have to get pre-authorization from HHSC.

As a Host provider, can I also provide day programming in our home and get reimbursed for the day activities by your company?

What are adaptive aids?

Adaptive Aids includes common items like diapers, wipes, ensure, multi-vitamins, thick-it, hearing aid batteries, glasses, walkers, van lifts, etc. and is limited to $10,000 per year.

What are your policies regarding privacy?

What expenses am I responsible for? What expenses is my loved one responsible for? What expenses is the program responsible for?

What geographic locations do you serve?

What happens if I move out of state?

What home modifications do we do?

What if my loved one needs a higher quality adaptive aid item than what Medicaid will pay for?

What is a special needs trust?

What is an IQ? How do I arrange get my loved one evaluated?

What is respite and under what circumstances am I eligible to receive respite services?

What is the difference in Supported Employment (SE) and Employment Assistance (EA)?

What is the ratio of staff to individuals?

What is the role of the Case Manager?

The Case Manager is responsible for designing the plan for services for each assigned individuals, and for overseeing the timely implementation of those services. Case Managers generate a lot of the documentation that shows how services are planned and delivered. In developing such plans, the Case Manager is responsible for setting attainable goals and milestones for assigned individuals in order to measure the effectiveness of services periodically throughout the year. Also, the Case Manager serves as a primary contact for family members to share information and resolve concerns.

What is the role of the Direct Care Supervisor?

The Direct Care Supervisor is responsible for the recruiting, hiring, and training new employees. In addition, the Direct Care Supervisor manages the staff schedule to ensure adequate staff coverage in assigned homes, as well as ensuing that those staff are performing their job duties in an exemplary manner.

What is the role of the Program Manager?

The Program Manager is a director level position in each of our geographic regions. The Program manager is responsible for the entire overall operations in the assigned regions, as well as serving as a liaison to the community, at large…including working with potential families seeking information or placement in our program

What is the Texas Home Living Program?

A Medicaid waiver program in Texas that provides a variety of services to an eligible individual, but does not include the same level of residential assistance as is offered in the HCS program.

What is your Host (foster) program?

What kind of meetings do I have to attend, how often, and where are meetings held?

What procedures will staff implement in a behavioral crisis situation, and how are staff trained? How does your agency develop behavioral support plans?

What special activities will your company facilitate for my loved one, in addition to more typical activities?

What steps does your company take to ensure my loved one is free from abuse, neglect, and exploitation?

Our company provides initial and ongoing training to all employees regarding detection, prevention, and reporting of abuse, neglect, and exploitation. In addition, our company conducts thorough background checks on all employees, including but not limited to criminal background checks and additional checks of state databases for confirmed perpetrators of abuse, neglect, or exploitation. Our company reports all known suspicions, regardless of how seemingly minor or unlikely. Most importantly, our company management staff provide significant supervision in group homes and at day programs to detect potential signs of trouble, as indicated on the website of the Texas Department of Family and Protective Services (which includes Adult Protective Services).

What steps will your company take to help my loved one get a job?

What type of dental services are available to my loved one through the HCS program?

What type of leisure / recreational activities does your agency provide, and how do individuals choose?

When the HCS provider is providing SE/EA, what are the qualifications for this person?

Will the group home be located in close proximity to the school / day program / place of employment?

Will you complete the Medicaid paperwork for my loved one?

Will your company assist me in securing a special needs trust for my loved one, if needed?

Hiring and Staff

Do you have bilingual employees?

Yes. Si.

Does your agency employ staff who speak other languages?

How are new staff selected?

First, we recruit though several means, including multiple online and print ad sources. All applicants are required to apply online through our company website. We utilize a specialized Human Resources software solution to manage the processing of all applicants to facilitate a more organized approach to understanding applicants’ related experience and/or assets that might be suitable to the job for which they are applying. This hiring software also stages the processing of applicants consistently and thoroughly ensures that no one who is ineligible for any reason whatsoever can ever make it through our screening process. More directly to the question, we are always recruiting for all positions, even when they might not be open at the time…and we are screening for people who are genuinely compassionate, friendly, and extroverted. We further prefer people with related experience (i.e., working directly with individuals with intellectual disabilities or autism spectrum disorder), and of course only those who pass through a series of background checks, including criminal history check, Employee Misconduct Registry check (database of confirmed perpetrators of abuse/neglect/exploitation not otherwise indicated as a criminal offense), driving history check, Medicaid Fraud check, and more. Once applicants are cleared through all such checks, we interview and investigate thoroughly the validity of claims made on applications. As we get closer to hiring, we make a considerable effort to expose applicants to the work that will be required of them, including but not limited to “shadowing” an experienced staff, to see first-hand how each applicant interacts with individuals we serve, as well as with potential co-workers and supervisors. If everything works out, we try to offer the applicant temporary work for a reasonable period before making an offer for a full time commitment. At that point, we provide considerable on-the-job training.

How are your company staff trained in dealing with challenging behaviors?

Yes, our staff receive specialized training in dealing with challenging behaviors…training that focuses on prevention and understanding people’s individual differences. Knowing behavioral triggers and strategies for addressing them that promote safety without undermining self-esteem or reinforcing problem behaviors unintentionally is at the heart of our training. The key to success is being proactive and intervening before challenging behaviors become full blown.

How do your more experienced and professional staff mentor new staff?

How does your company ensure that my loved-one’s home environment is clean and free of maintenance problems?

How does your company prevent theft of my loved one’s property?

How many staff will be working at any given time in my loved one’s home?

How often do your supervisory staff monitor group homes on site?

How will your company ensure that my loved one gets around safely?

If needed, what types of special assistance will your company provide to my loved one to meet special needs and challenges?

In the group home, is my loved one expected to do the cooking and the cleaning?

My loved one is fairly high functioning, and many people cannot even tell there is any disability. How can your staff tailor their interactions with my loved one to avoid being accidentally insulting, stereotyping, or otherwise treat my loved one the same as all other loved ones at your company?

My loved one is mostly independent in grooming and hygiene, but needs some assistance that is consistent, but not intrusive or offensive to my loved one. How will your company provide this delicate balance between ensuring my loved one’s grooming and hygiene needs are met without seeming too controlling or “parental”?

What are your policies regarding privacy?

What experience does the EA and SE service provider have?

What is our staff policy on drugs and alcohol?

We are a drug-free workplace. Our company performs random and as-needed (e.g., based on reasonable suspicion, pattern of absenteeism, etc.) drug screening to ensure that employees are not under the influence of drugs or using drugs in any way that might adversely affect the performance of their work duties and the safety of the individuals to whom they provide care. In addition, our employees may be required to take a drug test after an accident or employee injury.

What is the average length of employment of a caregiver staff at your company? How does your company minimize employee turn-over?

What is the level of education, training, experience, and credentialing for staff?

What is the ratio of staff to individuals?

What is the role of the Case Manager?

What is the role of the Direct Care Supervisor?

What is the role of the Group Home Caregiver Position?

What is the role of the Live-In position?

Personal care of individuals with developmental disabilities in a group home setting. The ideal candidate should have caregiver experience, and be fun, clean, mature, dependable, organized, respectful, and patient in challenging situations. On-the-job training is provided. Each Live-in Staff resides at an assigned group home to provide care to three other residents during waking hours. Each Live-In is provided with a master bedroom and bathroom, free rent and utilities, plus significant overtime pay for any (or all) weekends that the Live-In chooses to work. Duties include:- Assistance with grooming and toileting- Assistance with meal preparation and mealtime monitoring- Assistance with medications- Supervision during recreational activities- House cleaning- Driving company vehicles- Communication with outside family members and office staff- Specialized documentation

What is the role of the Program Manager?

What procedures will staff implement in a behavioral crisis situation, and how are staff trained? How does your agency develop behavioral support plans?

What procedures will staff implement in a crisis situation? How are staff trained to address potentially aggressive behavior?

What screenings do you require, when staff are hired (drug screen, criminal background check, abuse/neglect)?

We conduct a variety of required background checks, and some additional non-required checks that we think make good sense to protect the individuals we serve. First, we conduct a thorough criminal background check through the Department of Public Safety. We also conduct a background check on the Employee Misconduct Registry / Nurse Aid Registry, hosted by the Texas Health and Human Services Commission, for confirmed perpetrators of Abuse/Neglect/Exploitation…which may include such offenses that were not criminally prosecuted, but nonetheless would bar such an applicant from employment at our agency. We also complete a Medicaid Fraud check and Debarred Vendor check to ensure that no applicant is listed in either of these databases, which helps us prevent from hiring a dishonest applicant who might be more likely to steal from an individual or our company. Also, we complete a motor vehicle safe driving history check, and will not employ any applicant with a pattern of negative driving events in order to protect the safety of the individuals we serve during transportation. Finally, we complete thorough reference checks to verify the claims made on applications and assure that the people we hire truly have the experience they claim to have. We conduct random and situational (based on reasonable suspicion) drug testing of employees once hired. And finally, we repeat most of these checks periodically to ensure that our employees remain employable according to our standards.

What steps does your company take to ensure my loved one is free from abuse, neglect, and exploitation?

What training subjects does your agency provide to new employees?

What type of transportation does your agency provide?

When the HCS provider is providing SE/EA, what are the qualifications for this person?

Host Provider

As a Host provider, am I responsible for providing all of the transportation needs of my loved one, or does your company assist with the transportation needs of individuals receiving Host services?

Our Host providers are responsible for providing all transportation needs; our agency does not assist with the transportation needs of the individual served by the Host provider. We know this might be a deal breaker for some Host providers who are expecting transportation assistance form our agency.

As a Host provider, am I responsible for taking my loved one to medical appointments?

Our Host providers are responsible for taking loved ones to medical appointments. We are usually able to help in the event of an emergency where the Host provider has a conflict. But that help would be the exception, not the norm.

As a Host provider, can I choose any day program for my loved one, regardless of the daily rate charged to your company for day program services?

Yes. An individual and the Host provider can choose the best day program available. If the costs of the day program exceed the daily HCS reimbursement rate, the Host provider can pay the difference through the Host agreement with us, the provider agency. Also, the Host provider is responsible for any late fees charged by the Day Program due to late pick up.

As a Host provider, how often should I expect visitors…either from your company or the State?

As a Host provider, how often will I be paid and can I receive my compensation through direct deposit?

Our Host providers are paid monthly, upon submission of all of the previous month’s required documentation. Unfortunately, we do not offer direct deposit to Host providers or any other contractors.

As a Host provider, what documentation must I maintain in our home at all times?

Host providers should be ready for a visitor at any time. The State will likely show up unannounced at least once a year. We will come more often in order to provide training and support. However, we will always come announced unless we suspect a significant problem that can only be verified during an unannounced visit. We have mostly been very fortunate in serving individuals in the Host environment who have very dedicated fine Host providers. But as the certified provider, we are ultimately responsible for the care of all of the individuals we service…even on the Host environment…and we take that responsibility very seriously.

As a Host provider, what regular documentation does your company expect of me and how often will I be required to submit it?

Monthly, we receive an invoice for services provided the previous month attached to weekly service log progress reports. These reports are fairly simply with codes numbers for services provided, and checkboxes that have to be initialed. In addition, we require a monthly fire drill, and some simple training data (also coded with initials. There may be some additional non-routine documentation if there is a need for an incident report or a behavior note. Finally, we request a copy of any medical consultations forms completed by any physician that the individual may have seen the previous month.

As a Host provider, what training will I receive from your company to help me do the best job I can do?

We provide Host providers with all of the training necessary to be excellent caregivers, as well as follow all of the related rules and regulations. Host training focuses on daily care, related documentation, medication storage and management, communication methods with our agency’s professional and management staff, prevention of abuse/neglect/exploitation, fire safety, and several other key topics that will help a Host provider have the knowledge necessary to do an outstanding job.

We do not compensate Host providers for day services provided in the home, nor do we bill for such services through the HCS program. In a select few extreme circumstances, we would have to get pre-authorization from HHSC.

As a Host provider, can I also provide day programming in our home and get reimbursed for the day activities by your company?

What is the level of education, training, experience, and credentialing for staff?

What is the role of the Group Home Caregiver Position?

What is the role of the Live-In position?

Personal care of individuals with developmental disabilities in a group home setting. The ideal candidate should have caregiver experience, and be fun, clean, mature, dependable, organized, respectful, and patient in challenging situations. On-the-job training is provided. Each Live-in Staff resides at an assigned group home to provide care to three other residents during waking hours. Each Live-In is provided with a master bedroom and bathroom, free rent and utilities, plus significant overtime pay for any (or all) weekends that the Live-In chooses to work. Duties include:- Assistance with grooming and toileting- Assistance with meal preparation and mealtime monitoring- Assistance with medications- Supervision during recreational activities- House cleaning- Driving company vehicles- Communication with outside family members and office staff- Specialized documentation

What is your Host (foster) program?

Emergencies

Are medical staff available on site or on call to respond to medical needs?

If sick, how will my loved one me monitored?

If sick, will my loved one be required to go to the day program sick, or be allowed to remain home with a staff person?

What are you doing about COVID ( corona virus ) in your homes?

COVID-19: What we are doing to protect your loved ones and our communities, see http://icltx.net/covid19

What are your emergency back-up procedures when there is crisis or the home is short staffed?

What is the availability of a nurse if my loved one becomes sick or injured?

What is your plan in the event of a hurricane?

What procedures will staff implement in a behavioral crisis situation, and how are staff trained? How does your agency develop behavioral support plans?

What procedures will staff implement in a crisis situation? How are staff trained to address potentially aggressive behavior?

What provisions will your company make for my loved one and the caregiver staff in the event of an emergency or natural disaster?

What training subjects does your agency provide to new employees?

Careers

Can I use my nick name to complete the Employment Application?

No, you must use your legal given name as it appear on your driver’s license and social security

Do I have to have a Texas Driver’s License?

Yes. You must hold a valid Texas Driver’s License to be employed with us.

Do I need an email address in order to apply for employment? What if I do not have one?

Yes, you’ll need an email address to complete an employment application. If you do not already have an email address, you can create a free account with google, yahoo and other providers on the Internet.

Do you offer a Flexible Spending Account to employees?

At this time, our company does not offer flexible spending account compatible plans to it’s employees.

Does the employer cover any of the premium cost for dependents?

No, the employee is responsible for 100% of the premium for dependent spouse and children

Does your agency employ staff who speak other languages?

Does your company offer Health Insurance? When will my insurance start?

You will be notified of your eligibility within 60 days upon hire and must be enrolled into the medical benefit plan the 1st day of the month before your 90th day of employment.

Employment Contact Information?

IDDLiving.com, Click on Employment

How are new staff selected?

How do I add a family member to my benefits?

Complete an enrollment application listing dependent spouse or child and submit enrollment form to Human Resources for processing

How do your more experienced and professional staff mentor new staff?

How much do I pay for my benefits?

Medical – The employer covers 60% of the monthly premium and the employee is responsible for 40%. Premiums are deducted weekly from the employees paycheck once enrolled in the plan of your choice.Dental – The employee pays the entire cost of monthly dental premiums for you and your family members.Vision – The employee pays the entire cost of monthly vision premiums for you and your family members. Supplemental Insurance – i.e Whole Life and Term Insurance, Accident, Cancer, Critical Illness and Hospital Confinement – The employee pays for supplemental life insurance for you and your eligible family members. Premium is based on your age and annual salary. Supplemental Disability Insurance – You pay for supplemental disability insurance for yourself. Premium is based on your age, your annual salary,

How often do we get paid?

Weekly via check or Direct Deposit

How to apply for a Job?

Go to icltexas.com and click on “Careers” – There are two links at the bottom of the page. One for our McAllen & San Antonio locations and another for all others. Click on “Apply now” link for the location you are interested in working with. This will take you to our online application portal for that area. Select the position you’re applying for and you will be prompted to login or register a login to complete the application process. You will need an email address to complete your application. You may, of course, use a free online email provider like google, yahoo or others if you do not already have an email address.

What are the employee benefits available when working for your company?

Eligible employees are entitled to participate in our Medical, Dental and Vison Benefits Plan effective the first day of the month after 60 days of employment. Other benefits include paid vacation (2 weeks at 1yr of service, 3 weeks at 5yrs of service), and 401K plan participation after 1yr and 1000 hours worked. Ask your interviewer if you have any specific benefit question.

What if I do not have access to a computer?

Each of our offices have laptops that are accessible for your use.

What if I have a Driver’s License from another state?

You must apply for a Texas Drivers’ license before completing application process.

What is our staff policy on drugs and alcohol?

What is the 401k Benefit Plan?

Eligibility starts: After 1 year of employment and 1000 hours worked and the employee must be 21 years of age or older. Our company matching is 100% for the first 3% and 50% for the next 2% of employee’s contribution.

What is the beginning salary for Caregiver Staff positions ?

Our direct care staff positions both full and part-time start at $8.00/hr. Weekend staff and live-in staff have overtime opportunities.

What is the company culture like?

When you join our team, you join our family. It’s more than a job; it’s a meaningful experience that can grow into a rewarding career. You will help people to achieve independence and gain the skills needed to thrive and feel proud. What’s more fulfilling than helping improve someone’s life? Your feeling of self-purpose and personal happiness will grow stronger every day because of your hard work care for others. We take pride in giving you an opportunity to work as a caregiver, and we will support you in your journey with us. We provide on-going hands-on training and we will continue to support you in all of your efforts to support our individuals as long as you are with us. We will be available 24/7 to answer your questions and address your concerns.

What is the level of education, training, experience, and credentialing for staff?

What is the role of the Appointment Runner position?

Provides personal care of individuals with developmental disabilities during transportation to and from medical appointments. The ideal candidate should have caregiver experience, and be fun, clean, mature, dependable, organized, respectful, and patient in challenging situations. On-the-job training is provided. Duties include Driving company vehicles, Supervising and monitoring of individuals served during medical appointments, Assisting with ambulation of individuals served (in and out of company vehicles and medical office waiting rooms), Assisting with grooming and toileting, Scheduling medical appointments, Facilitating communication between office nursing personnel -outside medical professionals- and family members, Providing specialized documentation and organization of records, Maintaining receipts for purchases, and assisting office personnel with clerical functions during free time (e.g., days without scheduled medical appointments).

What is the role of the Case Manager?

What is the role of the Day-Hab position?

What is the role of the Direct Care Supervisor?

What is the role of the Group Home Caregiver Position?

What is the role of the Live-In position?

Personal care of individuals with developmental disabilities in a group home setting. The ideal candidate should have caregiver experience, and be fun, clean, mature, dependable, organized, respectful, and patient in challenging situations. On-the-job training is provided. Each Live-in Staff resides at an assigned group home to provide care to three other residents during waking hours. Each Live-In is provided with a master bedroom and bathroom, free rent and utilities, plus significant overtime pay for any (or all) weekends that the Live-In chooses to work. Duties include:- Assistance with grooming and toileting- Assistance with meal preparation and mealtime monitoring- Assistance with medications- Supervision during recreational activities- House cleaning- Driving company vehicles- Communication with outside family members and office staff- Specialized documentation

What is the role of the Program Manager?

What is the role of the Registered Nurse?

Coordination of a variety of nursing services for individuals with intellectual disabilities in group home and natural home settings. This position is similar to home-health nursing, with some duties and documentation specific to meet the unique requirements of HCS (Home and Community-Based Services) or ICF/ID (intermediate Care Facility for the Intellectually Disabled) regulations. Our program provides a rewarding job experience for anyone interested in promoting the independence of people with disabilities. Duties include nursing assessment, delegation of tasks, training of direct care staff, supervision of LVN(s), coordinating medications, supplies and medical appointments, medical emergency management and over-the-phone triage, and general nursing quality assurance.

What is the Vacation benefit Policy?

You’ll receive 2 weeks (80 hours) of vacation time after 1 year of service. After 5 years of service, you will receive 3 weeks (120 hours) vacation.

What locations am I expected to work?

We have many locations all within driving distance of our Regional Offices in Abilene, Beaumont, McAllen, Harlingen, North Houston, and San Antonio. Please see our locations page for the locations in your city. {Link to Locations}

What screenings do you require, when staff are hired (drug screen, criminal background check, abuse/neglect)?

What shifts do you have available?

We have a variety of shifts for M-F staff and a variety of shifts for Weekend staff. Please see the job description on IDDLiving.com

What training subjects does your agency provide to new employees?

Local Authority Engagement

Are state inspections and audits available to family members?

Absolutely. We can provide written evidence, or we can direct anyone to the State’s websites that contain all such reports online, public record for anyone to view.

Are there other options beyond HCS and ICF services?

Can my loved one get braces or cosmetic dental care with HCS dental funds?

No. Braces and cosmetic dentistry are not covered by HCS funds and require out-of-pocket funding.

Do you lease or own your residential homes? Do you have short term or long term leases?

How are complaints addressed?

How do I get on the HCS interest list?

Contact your local authority and let them know you would like to be placed on the HCS interest list ( HCS Waiting List ). We can help guide you to the right person within that entity.

How do I lose an HCS slot – can we be removed from the interest list?

How does our agency incorporate the family’s wishes, when those wishes are different from what the agency believes is best?

How does your agency build community awareness about persons with disabilities moving into their neighborhood? How does your agency resolve concerns?

How long has our organization been serving persons with intellectual disabilities?

Since 1991. In early 2017 we were proud to announce our 25th year successfully serving others.

How many individuals does your program serve at the present time, and what is your capacity to serve more individuals in the future?

How often can my loved one do to the dentist?

As often as necessary to ensure the dental health of your love one, but within the cost limit of what the HCS program offers for dental services, which is $2,000 per year.

How often is your company inspected by regulatory authorities?

I do not have Medicaid. Can you help me obtain Medicaid?

I’m interested in HCS services, but I don’t know a whole lot about the program or where to begin. How should I proceed, and how can your agency help me in this early stage?

If I choose to participate in an ICF/IID program will it keep me from receiving an HCS slot?

If I choose your company for my loved one, what paperwork do I need to provide?

If transportation has to be provided to support the individual’s efforts to be self-employed, work from home or perform in a work setting. Is the HCS provider agency responsible for transporting the client or just making transportation arrangements?

Is there an ICF interest list?

Must individuals start at DARS before receiving EA or SE from us as the HCS provider?

My loved one is diabetic and needs to have blood sugar monitored regularly. Who will monitor my loved one’s blood sugar and how will that person be trained?

We are located in a rural area where the unemployment rate is quite high and there are few places to work. How long would the HCS provider be expected to help find the individual employment?

We do not compensate Host providers for day services provided in the home, nor do we bill for such services through the HCS program. In a select few extreme circumstances, we would have to get pre-authorization from HHSC.

As a Host provider, can I also provide day programming in our home and get reimbursed for the day activities by your company?

What activities are offered to enhance the lives of individuals?

What are the requirements to get on the HCS interest list?

What are your policies regarding visitors?

What does “Supported Employment” mean?

What geographic locations do you serve?

What happens if I move out of state?

What if I move to a different town in Texas?

What is “Employment Assistance”?

What is an IQ? How do I arrange get my loved one evaluated?

What is the difference in Supported Employment (SE) and Employment Assistance (EA)?

What is the ratio of staff to individuals?

What is the Texas Home Living Program?

A Medicaid waiver program in Texas that provides a variety of services to an eligible individual, but does not include the same level of residential assistance as is offered in the HCS program.

What is your organization’s Mission Statement or general philosophy?

Our mission and philosophy is simply to provide a safe, fun, rewarding, and enriching experience for the individuals we serve that promotes choice, growth, maturity, self-esteem, sense of normalcy and adulthood, with maximum family involvement.

What procedures will staff implement in a behavioral crisis situation, and how are staff trained? How does your agency develop behavioral support plans?

What screenings do you require, when staff are hired (drug screen, criminal background check, abuse/neglect)?

What steps will your company take to help my loved one get a job?

What type of dental services are available to my loved one through the HCS program?

What will happen to my loved one if your company has a bad inspection?

When the HCS provider is providing SE/EA, what are the qualifications for this person?

Who inspects your company? Are such inspections made public?

Will the group home be located in close proximity to the school / day program / place of employment?

Will your company provide me with information and guidance even if I don’t think you company is the best program for my loved one or doesn’t currently have a vacancy in a group home?

With whom can I file a complaint outside your company if I can’t get a concern resolved through the management channels within your company?

There are two complaint hotlines hosted by HHSC, one for ICF and one for HCS. We provide these numbers to all families at the time of enrollment and keep them posted at every office and group home.