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What Does All This Mean

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Medicaid Waivers, SSI, SSDI, Guardianship,

Guardianship Alternatives

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Texas Medicaid Waivers

Waivers let states use Medicaid funds for long-term home and community-based services to help people with disabilities live in the community. They are named “waivers” because certain Medicaid requirements are waived (family income). Each waiver has it’s own interest list. Parents should consider adding their child to all the interest lists. When the child’s name comes to the top they will come off the list for the program with the opening. You can choose to continue to leave the child’s name on the interest lists for other waiver programs.

It is better to be able to decline services once eligible than to be in need of services after graduation. The wait time is between 15-18 years.

HCS/CLASS Compare List� https://docs.google.com/document/d/1jPeRXU2Yej8g03SRLsyv3PHHsxgH2g1FBKJHMeBwcJs/edit

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Texas Medicaid Waivers

Community Living Assistance and Support Services (CLASS)

Gives home and community-bases supports to children and adults with related conditions (cerebral palsy, spina bifida) There are over 200 related conditions that must have occurred before 22.

Home and Community-based Services (HCS)

Gives services and supports to children and adults with intellectual disability or a related condition who live with their families, in their own homes, or in a small group homes with no more then 4.

Deaf Blind with Multiple Disabilities (DBMD)

Gives services for children and adults who are deaf-blind or have a related condition that leads to deaf-blindness, and who have another disability.

Medically Dependent Children Program (MDCP)

Gives services for children and adults who are 20 and younger who are medically fragile as an alternative to receiving services in a nursing facility.

STAR+PLUS Home and Community-bases Services (HCBS)

Gives services to adults over the age of 21 to keep them in their community and not in a nursing facility.

Texas Home Living (TxHmL)

Gives services for children and adults with an intellectual disability or related condition who live in their own home or their family home.

Youth Empowerment Services (YES)

Gives home and community –based services to children under the age of 19 who otherwise would need psychiatric inpatient care or who parents would turn to state custody for care.

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Medicaid Waviers

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Medicaid Waivers

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Supplemental Security Income (SSI)/Medicaid�Age 18

  • SSI is designed to help those who are aged, blind, and have disabilities, who have little or no income; it provides cash to meet basic needs for food, clothing, and shelter.
  • Provides a monthly check plus Medicaid, which provides managed health care and Long Term Services and Supports (LTSS), through the Social Security Administration.
  • Eligible Individual receives $794, Couple $1,191, Essential person $397 (someone who lives with an SSI beneficiary and provides essential care) Must keep assets under $2000.

To get full amount declare that your child will pay his/her “fair share” of household expenses. Determine amount by adding household expenses and dividing by # in household. You can go to https://www.ssa.gov/pubs/EN-05-11005.pdf to get a brochure on “What You Need To Know About Your Supplemental Security Income (SSI) When You Turn 18”

You can apply for SSI one month after your child’s 18th birthday.

To apply for SSI/Medicaid you can call the Social Security Office or apply online

https://www.ssa.gov//disability/disability.html

Travis Co. 866-627-6991

Williamson Co. 877-531-4699

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Social Security Disability Insurance �SSDI

  • SSDI program pays benefits to you and certain family members if you are “insured”, meaning that you worked long enough and recently enough and paid Social Security taxes on your earnings.
  • While the Social Security Disability Income and Supplemental Security Income programs are different, the medical requirements are the same.
  • An adult who became disabled prior to age 22 may qualify for benefits on a parent’s record. “Disabled Adult Child” (DAC) gets 50% of parent’s monthly SS; Medicare after 2 years.
  • If benefit from parent’s work history exceeds the SSI income limit, Medicaid can continue; apply for continued Medicaid under Section 1634(c) of Social Security Act

SSA will always check SSDI entitlement when someone files for SSI

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SSI vs SSDI

SSI SSDI

Based on Needs Based on work

Must have limited income and Need not have

limited resources(no more then limited resources

$2000 in account) Payment amount

Maximum monthly payment $794 based on past

earnings

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Guardianship

  • At age 18 an individual is considered an adult who can give informed consent and make legal/financial/medical decisions.
  • You can petition court to become legal guardian at age 18 or after. This empowers you to make decisions for an “incapacitated person”
  • You can get limited guardianship which spells out in what areas you do/do not have legal decision making power

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The best thing to do is to investigate finding the right lawyer and what the costs will be in your county, including court costs and bond.

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Alternatives to Guardianship

  • Conservatorship or Guardianship of the Property:

A conservator is appointed through the courts to manage a person’s financial affairs. A conservator is not allowed to make decisions about that person’s personal life.

  • Power of Attorney:

A power of attorney is a written document giving one person the power to act as an “agent” for another person. To give power of attorney you must be considered capable of understanding the document. You can revoke at any time.

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Supported Decision-Making Agreement

Supported Decision Making allows individuals to make their own decisions and stay in charge of their lives, while receiving any support they need to do so. All people need support to make important life decisions. Even if a person with a disability needs extra help to make significant life decisions, their right to make their own choices should not automatically be taken away. Using a supported decision making agreement, a person with a disability chooses someone they trust to serve as their supporter.

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