Starting a Residential Home in the State of Texas

My husband and I were considering possibly establishing some kind of group home down the road so that after we passed, Christopher could continue living in his home with others he liked and knew. This way he could have a family unit 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 to me, 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.

 

8 Comments

  1. Finece says:

    I want to start a Residential group home for Autism kids, and teens in Texas. I need to know what I need to get Certified, and how much it cost for the two License it is their a study guide, I can learn from? Is there anything else I need to know? Thanks in adavances

    • Emily Tuck says:

      Hi Finece, Good question! The whole landscape has changed since I initially launched my site ten years ago, and DADS is now something else. I am going to research this further and update this page in the next few days.

      Emily

  2. This is not actually the case, you are not unregulated as a microboard provider in the HCS program. You must apply for certification and have your application approved and pass the HCS provider test to obtain a contract #. You must qualify as a Medicaid vendor, just like all other HCS providers. You must apply for a business entity prior to applying to be a microboard of a specific type of non-profit to qualify as a microboard. But you are subject to all the say surveys, audits, citations, etc… as all other providers. But you can cap your program at anytime between 1- 3 persons and do not have to accept any other individuals in the program. I have been a consultant to persons applying to become a Microboard HCS

    • Emily Tuck says:

      Hi Julie,

      I am wondering if you still provide consulting services for parents interested in forming a Microboard. Do you ever give presentations? I would love to learn more. Thanks for commenting on my site.
      –Emily

  3. Katie says:

    Hi iam leaving my contact infor below. I have an 18 nonverbal autistic son and we are in the same boat!

  4. Angela Nwaka says:

    I feel for you. I don’t understand what is going on. Texas is one of the few States still keeping the institutional facilities. I am a nurse with over ten years experience work with both autistic and IDDs . Texas is holding off on the pre test to allow individuals to run a group home. This is seriously needed hopefully when the states starts homes to help take care of this individuals my application has been completed but just waiting on the State approval

  5. Finece Hollis says:

    It’s 2023 I’m just now seeing this

  6. Laney says:

    Does anyone have current information on this? We are looking into the same thing.

Leave a Reply

Your email address will not be published. Required fields are marked *