Starting a Residential Home in the State of Texas

My husband and I were considering possibly establishing some kind of group home so that after we passed Christopher could continue living in his home, with others he liked who also has autism. This way he could have “a family” of his own, and would increase the likelihood that someone would be looking in on him in the event his brother was away or busy starting his own career and family. What makes things more complicated is that Christopher cannot “inherit” the home. It would have to go to his brother, or go to a nonprofit. This latter scenario is called a “Microboard.”

Obtaining information on how to set up a residential home for people with Intellectual Disabilities in Texas is a surprisingly tall order. The local MR authorities were not helpful, but referred me to the legal clinic at UH, and the Department of Aging and Disability Services in Austin, who chiefly manage Medicaid programs. There seem to be two main programs licensed by DADS: HCS (Home and Community-Based Services) and Assisted Living.

To my knowledge, neither of these programs make any effort to match up people with like ages or disabilities, but as my son’s name has not yet popped up on any of the statewide “interest lists” for services, I don’t want to be too cynical.

DADS doesn’t really license the home but the provider, who more often than not manages multiple homes. DADS couldn’t answer some of the questions I had about set up of the home, for example, about fences (how much freedom to come and go should clients be given, or do they need to be supervised at all times when out of the house?) and liability if someone wanders off. How are they regulated? Is a caretaker required to be in the house at all times?

On its website, DADS has links to how to become an HCS provider, but they do not explain all that being an HCS provider entails. Apparently HCS providers are required to take anyone whose name comes up on the interest list (cannot discriminate), and they must provide a whole array of services, including transportation to and from work or day hab, not just room and board. An HCS provider can’t contract with another provider for services, but have to provide everything. I couldn’t get this information in writing anywhere on the DADS site.

I was also told, however, that if I just wanted to take in three (or less) people with IDDs, I was not required to be licensed at all by the Department of Aging and Disability Services. I would be an unregulated provider. This was pretty shocking to me, given the opportunity for someone to take advantage of persons with IDDs. Seems that anyone with an IDD living in group home should be visited by a social/case worker at least once/year, and that those running homes even with one person who is not a family member should be documented in some database, if not licensed.

The other option is to establish an Assisted Living facility. However, Assisted Living operates under the premise that the person can take care of himself and needs assistance only occasionally. Yet it seems unsound that persons with intellectual disabilities should be treated the same way as those with physical disabilities, but the guidelines for AL doesn’t lay out different guidelines for different types of clients.

 

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