Pathways:Services and Supports
Texas Department of State Health Services’ Children with Special Health Care Needs Program Contract, Federal Maternal Child Health Bureau Family to Family Health Information Center Grant, and private donations
Qualifying for Benefits
The first step in securing the future for your child is learning about supports that might benefit him or her as an adult. Eligibility for most services and benefits available in Texas requires that you prove disability plus low income and limited resources:
- Disability can be proved by referring to a doctor's letter, evaluations from special education services in public school, on-site testing at an agency. The type of proof needed will depend on what service or benefit you are applying for.
- Low income and limited resources are established after your child is 18 by looking at the income and resources of the person with the disability, not the family's. (Before age 18, benefits will be based on family income and resources.) Many people will be eligible after age 18 who were not before. If your youth was receiving SSI before age 18, you will need to reapply after age 18.
- Resource limits in Texas are $2,000 in liquid assets and $733 income per month. Income may vary depending on circumstances; see www.disabilitysecrets.com/resources/social-security-disability/supplemental-security-income-ssi/income-limits.htm for details.
Main sources of public assistance for adults with disabilities in Texas
Here is a list of the main sources of public assistance for adults with disabilities in Texas. You may apply on-line at yourtexasbenefits.com
, but you may need to make some local office appointments also.
Overview of Texas state-wide health and human service agencies:
|State Agency (Abbreviated Name)
||State Agency (Full Name)
||State Agency Internet Address
||State Agency Mission
||Health and Human Services Commission
||HHSC oversees the operations of the health and human services system, provides administrative oversight of Texas health and human services programs, and provides direct administration of some programs.*
||TX Department of Aging and Disability Services
||Provides long term services and supports for people with disabilities and the aged
||TX Department of Assistive and Rehabilitative Services
||Administers programs for people with disabilities and children who have developmental delay; deaf-blind, vocational rehabilitation, Early Childhood Intervention and more
||TX Department of State Health Services
||Improves health and well being in Texas; includes Children with Special Health Care Needs and Mental Health issues
||TX Department of Family and Protective Services
||Protects the unprotected: children, elderly and people with disabilities
*Programs Administered by HHSC
- Children's Health Insurance Program (CHIP)
- Family Violence Services
- Texas Women’s Health Program
- Refugee Services
- Temporary Assistance for Needy Families
- Disaster Assistance
- SNAP Food Benefits and Nutritional Programs
Supplemental Security Income (SSI)
SSI is a Federal income supplement program funded by general tax revenues (not Social Security taxes):
It is designed to help aged, blind, and people with disabilities, who have little or no income;
It provides cash to meet basic needs for food, clothing, and shelter.
For more information, go to http://www.ssa.gov/ssi/
In Texas, SSI provides between $488 and $733 (in 2015) per month plus Medicaid. If your youth over 18 becomes eligible for SSI, he or she will automatically get Medicaid. (See below for more on Medicaid.)
You may be able to increase the amount of SSI your child gets each month from 2/3 of the maximum ($488) to the maximum ($733) by having your child pay "my fair share" of household expenses. Here is the blog of a parent who succeeded in getting the maximum SSI for her son: http://leahandbrandonblog.blogspot.com/2011/03/ssi-and-power-of-attorney.html Here is a worksheet to help you establish that your child will pay "my fair share" of household expenses.
Social Security has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that their conditions obviously meet disability standards. See Compassionate Allowances at www.ssa.gov/compassionateallowances/
To find your local Social Security Office, Google: SSI local office locator.
The Social Security Administration (SSA) has very helpful booklets on SSI and related topics; however, links to the booklets from this page do not work consistently. You are encouraged to go to www.ssa.gov/pubs/ and then click on the topic “SSI,” and scroll down to “What You Need To Know When You Get Supplemental Security Income” or “SSI.” Alternatively, go to a publication number by Goggling:
These publications have great information in an easy-to-read format, are up-to-date, and come straight from the SSA.
Social Security Disability Insurance Program (SSDI)
The SSDI program pays benefits to adults who have a disability that began before they became 22 years old. The Social Security Administration considers the SSDI benefit as a “child’s” benefit because it is paid on a parent’s Social Security earnings record. For a disabled adult to become entitled to this “child” benefit, one of his or her parents:
- be receiving Social Security retirement or disability benefits; or
- Must have died and have worked long enough under Social Security. (from SSA booklet ssa pub NO-05-10026.pdf page 11;)
Also an adult with a disability, regardless of the age when he or she became disabled, can also apply to receive SSDI based on his or her own work history.
Moving from SSI to SSDI
When a parent decides to draw Social Security retirement, usually between ages 66 to 70, there is a mandatory question in the process of applying: “Do you have any children with a disability where the onset was prior to age 22?” If yes, that child begins to draw SSDI based on the parent's earning history. The amount will be half of the amount the parent is drawing from Social Security. In 24 months the child will also start to receive Medicare.
How does this change affect the child's eligibility for other services? If the disabled adult child's monthly income goes up because of receiving SSDI, he or she is in danger of losing services based on low income, particularly the child's SSI, which comes with regular Medicaid benefits. Loss of Medicaid will mean loss of Medicaid Waiver services (CLASS, HCS, DBMD, MCDP, etc.). However, there is a way to avoid this series of losses: file an application for the DAC, Disabled Adult Child Program, with Texas Department of Health and Human Services along with supporting documents, i.e. letter of guardianship (or have your child sign it) and copies of bank account statements, etc. This form should be completed and filed with the HHSC office at PO BOX 149024, Austin, TX 78714 or online at www.yourtexasbenefits.com. If you have questions you may contact any local office:
The Bryan/College Station office number is 979-776-1510.
Texas Medicaid is the State and Federal cooperative venture that provides medical coverage to eligible needy persons and pays for health care expenses. In Texas, access Medicaid through Health and Human Services Commission: http://www.hhsc.state.tx.us/medicaid/
You may become eligible for Medicaid by applying directly or through becoming eligible for a Medicaid Waiver program or SSI (Supplemental Security Income). Medicaid eligibility is useful not just as health insurance but also as a way to establish eligibility for other services; see list of services at http://www.dads.state.tx.us/services/listofservices.html
There are four Medicaid programs in Texas: STAR, STAR+PLUS, STAR Health and traditional Medicaid. The type of Medicaid coverage a person gets depends on where the person lives and what kind of health issues the person has.
- Traditional Medicaid —Traditional Medicaid is for those who can't be in managed care. Traditional Medicaid is also called fee for service
- STAR —STAR is Medicaid for children, newborns, pregnant women and some families and children. People in STAR get their services through health plans, also called managed care plans.
- STAR+PLUS (http://www.hhsc.state.tx.us/medicaid/managed-care/starplus/client-information.shtml)— STAR+PLUS is a Medicaid program for people over age 21 who have disabilities or are age 65 or older. STAR+PLUS is only available in certain areas of the state. People in STAR+PLUS get Medicaid basic medical services and long-term services through a health plan, also called a managed care plan. Long term services and support include
- help in their home with basic daily activities
- help making the home safer
- respite care for care providers
- help with things that need to get done
- service coordination
- STAR Health — STAR Health is Medicaid for Children who get Medicaid coverage through the Texas Department of Family and Protective Services. One Medicaid plan provides both medical and dental services for all children in STAR Health.
The Medicaid Buy-In Program
(From http://www.hhsc.state.tx.us/MBI.shtml) is another Medicaid program that helps people with disabilities who work. It offers low-cost Medicaid health care services — including community-based services and supports. Some people might have to pay a monthly fee. Who can be in the Medicaid Buy-In program?
A person who:
- Has a disability,
- Is working,
- Lives in Texas, and
- Does not live in a state institution or nursing home all the time.
Medicaid Waiver Programs
Under Texas Department of Aging and Disability Services or DADS, Medicaid Waiver Programs are the best long-term help for children and adults with disabilities in Texas! Call NOW to get on the years-long waiting lists.
- Purpose: to keep a person with disabilities living in the community instead of a nursing home or institution.
- Services may include nursing care, attendant care, respite, therapies, adaptive aids, medical equipment, home modifications, service coordination, pre-vocational services, community living supports, supported employment, assistive technology and more.
- Eligibility is based on the child’s income whether under or over age 18 (not the parents) (except for Texas Home Living; based on family income for a minor)
- Medicaid Waiver Programs have waiting lists that could be up to 10-13 years, depending on the program.
- Families MUST keep current their contact information on the waiting lists.
- Families MUST respond to any letters or phone calls from waiting list management agencies.
- Call waiting-list numbers to find out what your child's number is on the list.
- For more information about each Waiver Program, go to http://www.dads.state.tx.us/providers/waiver_comparisons/index.html Click on Texas Long-term Services and Supports Waiver Programs for a comparison of all waivers and much information. Note list on left-hand side for an explanation of each waiver program.
- Texas has 10-13 year long waiting lists for these out-standing services; for the advocate's perspective to communitynowfreedom.org
Overview of Texas Medicaid Waiver Programs:
|Medicaid Waiver Program
|Community Based Alternatives
||Call your Local Authority
||21 or older
||Meet medical necessity for nursing home; Medicaid eligible
|Community Living Assistance and Support Services
||Diagnosed with a related condition, manifested before age 22; Medicaid eligible
|Deaf Blind with Multiple Disabilities
||For people who are deaf-blind with multiple disabilities; disability before age 22; Medicaid eligible
|Home and Community-based Services
||Call your Local Authority
||Diagnosis of an intellectual disability or a related condition with an IQ of 75 or below; Medicaid eligible
|Medically Dependent Children's Program
||For children who are medically dependent; Medicaid eligible
|State of Texas Access and Reform (STAR)+PLUS
||Call your Local Authority
||21 or older
||Must have disabilities and be Medicaid eligible
|Texas Home Living
||Call your Local Authority
||Exception to other waivers: Based on family income if child is below age 18; diagnosis of an intellectual disability or a related condition with an IQ of 75 or below; Medicaid eligible
|Youth Empowerment Services
||Call your Local Authority
||Up to age 18
||For children with serious emotional disturbances, available in Bexar, Tarrant and Travis Counties
Notes: To find your Local Authority office, go to http://www.dads.state.tx.us/services/contact.cfm Related Condition is a disability, other than an intellectual disability, that originated before age 22 that affects the ability to function in daily life.
The individual cannot be enrolled in another Medicaid Waiver Program.
The individual's income and resources cannot exceed specified limits.
Local Authorities or DADS local offices
Your Local Authority is under the Texas Department of Aging and Disability Services or DADS. For more information, go to http://www.dads.state.tx.us/services/ and http://www.dads.state.tx.us/services/quicklinks.html Local authorities (LAs) serve as the point of entry for publicly funded intellectual and developmental disability (IDD) programs, whether the program is provided by a public or private entity.
What services are available?
- Behavioral support
- Community support
- Day habilitation
- Eligibility determination
- Employment assistance
- Service coordination
- Specialized therapies
- Supported employment
- Vocational training
Call your Local Authority for an in-take meeting to see if your child is eligible for services. Find your local intake office at http://www.dads.state.tx.us/services/contact.cfm
DARS and Vocational Rehabilitative Services
DARS (Texas Department of Assistive and Rehabilitative Services) provides a variety of services, pertaining to the following areas:
- Blind & Visually Impaired
- Deaf & Hard of Hearing
- Disability Determination
- Early Childhood Intervention
- Vocational Rehabilitation
To learn more, go to http://www.dars.state.tx.us
The DARS program usually accessed for transition purposes is the vocational rehabilitation program:
The Vocational Rehabilitation (VR) Program helps people who have physical or mental disabilities prepare for, find or keep employment. Gaining skills needed for a career, learning how to prepare for a job interview or getting the accommodations needed to stay employed are just a few of the ways this program helps people with disabilities increase productivity and independence.
The Vocational Rehabilitation Program serves people with a wide variety of disabilities, including:
- mental illness,
- hearing impairment,
- impaired functioning of arms or legs,
- back injury,
- alcoholism or drug addiction,
- intellectual and developmental disabilities,
- learning disability,
- traumatic brain injury and
- other physical or mental disabilities that prevent the person from finding and keeping a job.
For more information go to http://www.dars.state.tx.us/drs/index.shtml
The DARS Division for Blind Services (DBS) assists blind or visually impaired individuals and their families. Depending upon their goals and needs, DBS offers services to help regain independence or find a job. (http://www.dars.state.tx.us/dbs/)
Low income assistance
Other funding may be available after you have proved that your child has low income through becoming eligible for SSI/Medicaid; for example, your child after age 22 might be eligible for food stamps (SNAP) and low-income housing. To learn more, call 211 and ask for information on low income assistance or look on-line at https://www.211texas.org/cms/
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