Staff may request a Home and Community-Based Services (HCS) waiver slot for youth aging out of care or for children who reside in a general residential operation (GRO) for children with intellectual and developmental disabilities. Individuals gain access to the HCS waiver program through the HCS interest list or by being a member of one of the several targeted groups identified by the Health and Human Services Commission (HHSC). Children and youth in DFPS conservatorship are one of the identified targeted groups.

The caseworker must contact the regional developmental disability specialist (DDS) for guidance on determining the child’s eligibility and appropriateness for an HCS waiver.

If the youth meets the criteria for an HCS waiver slot, the regional DDS then requests one through the state office DDS.

See the Home and Community-Based Services (HCS) Resource Guide for information on HCS eligibility.

Supplemental Security Income (SSI)

SSI covers the room and board for the HCS placement. Once the caseworker, supervisor, and regional DDS agree to place the youth with an HCS provider, the regional DDS must immediately contact the SSI coordinator, and copy the caseworker, to determine if the youth has active SSI benefits. See 10341.2 Ensuring Funding and Eligibility for Services.

Accepting or Declining an HCS Waiver Slot

Once an HCS slot is released to a youth, the local authority sends a Verification of Freedom of Choice form to the regional DDS and caseworker. Staff uses this form to accept or decline the waiver slot and grant permission to begin the enrollment process.

The caseworker must contact the regional DDS within two business days before making the decision to accept or decline the slot. The caseworker must not decline an HCS slot without first consulting the regional DDS. Once the caseworker decides to accept or decline the HCS slot, the regional DDS must notify the state office DDS of the caseworker’s decision within two business days.

Conservatorship (CVS) staff or the regional DDS must sign and return the Verification of Freedom of Choice form to the local intellectual and developmental disability authority, indicating if the slot was accepted or declined.

Selecting an HCS Provider

The caseworker must consult with the regional DDS for guidance in selecting an HCS provider.

See the Home and Community-Based Services (HCS) Resource Guide for more information.

Before considering a pre-placement or placement in HCS, CPS staff must take the following actions:

• Conduct appropriate background checks.
• Conduct an inspection of the HCS home.
• Schedule a pre-placement visit.

Background Checks

Before having a pre-placement visit or making placement in an HCS home, the caseworker must conduct a DFPS History check and a DPS Name-Based Criminal History Check on the following people:

• All staff working in the home.
• Anyone in the home over the age of 14 (this includes other HCS residents in the home).

The HCS program administrator or home staff can facilitate obtaining this information.

If the HCS agency fails to provide the information necessary to conduct background checks, DFPS must not allow placement.

The caseworker must meet with regional leadership if there are concerns with results of background checks. The regional DDS must attend the meeting to facilitate conversation with the HCS agency about staffing issues.

Home Inspections

Before pre-placement, a regional DDS must conduct a home inspection of an HCS home being considered. The regional DDS must provide his or her findings and recommendations to the caseworker, supervisor, and program director for consideration in an email. This includes if the HCS is an option, if there are any concerns, and the HCS home’s plan to rectify any concerns. The program director consults with the program administrator (PA) if there are any identified concerns.

Pre-Placement Visit

Once the caseworker has selected and vetted the HCS provider, the regional DDS or caseworker must schedule a pre-placement visit for the child or youth. This pre-placement visit allows both the child or youth and the provider to become familiar with each other. Pre-placement visits generally last anywhere from one to six days.

Transferring the Child or Youth to a New HCS Provider

If it becomes necessary to move the child or youth to a new HCS provider agency, the caseworker must contact the regional DDS to assist in setting up a transfer meeting with the local authority and new provider agency.

Health and Human Services (HHS) requires a transfer to be planned in order for the receiving provider to be knowledgeable about the child or youth’s needs and to be prepared to deliver necessary services. Therefore, the transfer effective date must be a future date to allow for adequate planning. DFPS may make an exception for an emergency transfer.