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?

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?

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 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 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 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.

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?

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.

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?

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 determined during an unannounced visit. Host providers are expected to embrace such visitation, although we promise it will not be intrusive or excessive.

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.

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 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 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 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?

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 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

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 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 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 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 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 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.

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 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 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?

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.

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?

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.

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?

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 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 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.

Nicholas F. | ICL Texas

Nicholas joined our program in 2012 after some difficulty acclimating at another agency. For the first couple of years in our program, he spent the majority of his free time alone in his room, mostly playing video games. However, in recent years, Nicholas has put aside his shyness, and has become a true friend to his housemates and peers from other homes in our program. He now spends more time helping in the kitchen, interacting with his housemates, and attending more outings.

Nicholas won our prestigious “Person of the Year Award” in 2016 after he demonstrated significant empathy toward a housemate who was struggling during a medication change. Without any request from staff, Nicholas helped his peer calm down with a hug and a smile, and the compassionate words. “It’s going to be alright…I’m here for you and I’m your best friend. Nicholas has overcome his own insecurities in relating to members of the opposite sex; he now engages in healthy dating and is considered a true gentleman among his female peers. He also volunteers regularly at an assisted living facility, where he has the extraordinary opportunity to perform functions for residents that are not unlike the functions that his staff have performed for him, giving him an enormous sense of accomplishment, purpose, importance, and maturity.

Nicholas F.

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