Texas has a
reputation for being two things: tough and big. Driving
through Texas in the mid-eighties also showed me something else
– the people are friendly, caring and helpful (even to
this California traveler just passing through).
So how do these tough
yet compassionate people take care of their seniors? What programs
are available to help find housing (and
funding) for those who need an Assisted Living Facility? Although
Texas does have some programs available to assist seniors and
the disabled, the fact of the matter is that the programs found
are not as generous as offered in other states.
is help available which cannot be dismissed or minimized.
In Texas, the Community Based Alternatives Waiver (CBA)
will pay for services associated with Assisted Living Facilities.
(Unfortunately, the CBA does not pay the actual room and board
costs). The Star+Plus Waiver is another option available, although
not yet statewide. Another program called Money Follows the
Person (MFP) helps residents of nursing facilities transition
to community based services once moved out of the nursing facility.
Searching for an assisted
living facility through the Texas section of the Assisted Living
can make the process of finding a facility itself a little easier.
The Texas Department of Aging and Disability Services (DADS)
is also a great place to start to see what programs are available
for a variety of situations. Check out their website at http://www.dads.state.tx.us/services/listofservices.html#older.
Texas also has programs
available to help veterans as well
caregivers. Veterans can visit the website of the Texas Veterans
Commission at http://www.tvc.state.tx.us/Home.aspx
and caregivers can find support through the DADS website at
Sorting through the
various programs isn’t always easy but Assisted Living
Directory has partnered with the qualified and experienced consultants
working with the Texas Assisted Living Locator service to provide
an additional resource to help in the search. Find more information
about this service on Assisted Living Directory's Texas
What is CBA?
The Community Based Alternatives Waiver in Texas (http://www.dads.state.tx.us/handbooks/cm-ccad/appendix/XXXIV-A/index.htm)
has been created for individuals to help with alternatives to
nursing home placement. The care can be self-directed or the
recipient can allow state administrators to direct their care.
Some of the services associated with the CBA are payment for
durable medical equipment and services; home delivered meals;
respite care, as well as other services for people choosing
to live in their own home or in an Assisted Living Facility.
As a reminder, this program does not pay for room and board
at an Assisted Living Facility.
What is Star+Plus
Waiver? The Star+Plus Waiver (http://www.dads.state.tx.us/services/listofservices.html)
is available in certain areas of Texas but does not allow the
self-directed care option available under the Community Based
Alternative Waiver. Medical care and personal care costs are
a couple of the services paid for under the Star+Plus Waiver.
What is Money
Follows the Person (MFP)? MFP allows certain qualified
people receiving Medicaid and living in a nursing facility to
receive community support upon leaving the nursing facility.
It is important to note that in order to receive these services
approval must be obtained prior to leaving the nursing facility.
For more information, visit http://www.dads.state.tx.us/news_info/publications/brochures/DADS262_KnowYourOptions.pdf
which explains many of the frequently asked questions about
Who is Eligible?
To be eligible for the Texas CBA, Star+Plus Waiver or the MFP,
the applicant must be Medicaid eligible. There may also be functional
or geographic restrictions and requirements for each of the
programs. If you haven’t yet applied for Medicaid, contact
the Texas Health and Human Services Commission at http://www.hhsc.state.tx.us/medicaid/index.shtml
for more information. The Your Texas Benefits website (https://www.yourtexasbenefits.com/ssp/SSPHome/ssphome.jsp)
also has links available to start the application process. Once
approved by Medicaid, it is necessary to call the local DADS
office (1-855- 937-2372)
in order to start the application process for the various programs.
Bonus Tip: A
Durable Power of Attorney is not recognized by Social Security
which can be a frustrating realization for a caregiver. If the
applicant needs assistance with financial matters, the local
Medicaid system will have their own form to complete in order
to appoint a representative. If assistance is needed with financial
matters at Social Security, it is possible to appoint a Representative
Contact the local Social Security office in order to apply to
become appointed. As a caregiver, these are invaluable tools
when navigating the various programs available through Social
Security or Medicaid.
if I am Denied? There is always an appeals process
and appealing a denial is always strongly encouraged. Keep in
mind, there are specific rules and deadlines for the appeals
process which can bring a reversal of the denial. It is important
to know the appeal process and to follow the instructions and
timeline carefully. Contact the Texas Health and Human Services
for instructions on the appeals process.
Nationwide, over 50%
of residents use some form of Medicaid to pay for nursing home
or assisted living care. Currently, 44 states have Medicaid
or waiver programs designed to assist with the costs associated
with Assisted Living Facilities. It is important to keep in
mind more states are developing waiver programs or are revising
their programs so the information about them changes frequently.
It is entirely possible Texas could expand their programs in
the future to include payment for more of the costs incurred
at Assisted Living Facilities.
In the meantime, take
advantage of the programs that are available now that could
be of help to you or your family.
- Article by Trish
Hughes Kreis exclusively for Assisted Living Directory
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