Texas Health and Human Services YES Waiver 101 Youth Empowerment Services A Medicaid Waiver Program for Children with Severe Emotional Disturbances Texas Health and Human Services

YES Waiver Youth Empowerment Services (YES) serves to prevent or reduce institutionalization of children and adolescents ages 3 – 18 with Serious Emotional Disturbance (SED). The YES Waiver enables more flexibility in providing intensive community-based services for children and adolescents with SED, and provide support for their families by improving access to services. The YES Waiver is administered under Social Security Act §1915(c) which allows for a child to receive long-term care services within the home and community based settings.

History April 2010-March 2013: Pilot phase with three sites April 2013-April 2015: Six sites added April 2015-April 2016: Statewide expansion

Goals of YES Waiver Reduce and prevent out-of-home placements by all youth-serving agencies Prevent or reduce inpatient psychiatric admissions for children and adolescents with SED Provide a more complete continuum of community-based services and supports for youth with SED and their families Ensure families have access to parent partners and other flexible non-traditional support services identified in a family-centered planning process Prevent entry and recidivism into the foster care system and relinquishment of parental custody Improve the clinical and functional outcomes of children and adolescents with SED

General Eligibility Requirements Between the ages of 3-18 Must reside in: A non-institutional setting with the youth’s legally authorized representative (LAR), or The youth’s own home or apartment, if legally emancipated, or If youth is in a private residential facility and has a discharge date pending within the next 30 days, an intake can be completed Be eligible to receive Medicaid, under a Medicaid Eligibility Group included in the Waiver May not be a recipient of other 1915(c) or 1915(i) Waiver programs

Clinical Eligibility Criteria Criteria A: Score within specified range on CANS for developmental domain Criteria B: Score within specified range on CANS for specified child risk, caregiver strengths and needs, and life domain functioning Criteria C: Must have attempted outpatient therapy or partial hospitalization or have documentation by a psychiatrist as to why inpatient care is required Criteria D: Must be reasonably expected to qualify for inpatient care under the Texas Medicaid inpatient psychiatric admissions guidelines Criteria E: Have a valid mental health diagnosis as the principle admitting diagnosis (Axis 1)

Entry in to Services Legally Authorized Representative (LAR) calls the Inquiry Line LMHA returns call within one business day Youth is placed on Inquiry List Assessment to be scheduled within seven business days of call

Service Breakdown YES Wraparound TRR (State Plan Services) Deemed eligible via Clinical Eligibility Assessment YES Services are specific to expanded service array (i.e. Paraprofessional, Art Therapy, and Respite) Conduct Individual Plan of Care (IPC) review every 90 days for authorization of services Utilize CMBHS to enter YES specific documentation (CE, IPC, and YES service array service notes) Follow National Wraparound Implementation Center model to provide wraparound using state plan ICM/ TCM Services Utilize support of Texas Institute for Excellence in Mental Health Model guidelines are congruent with TAC guidelines Guidelines established by TAC, Title 25 Complete CANS Assessment at initial and every 90 days, always requesting a deviation to LOC-YES LOC-YES includes all TRR state plan services Youth is entitled to all state plan services, which includes required ICM/TCM services for YES Waiver

YES Service Array Respite (In-Home & Out-Of-Home) Adaptive Aids and Supports Community Living Supports Family Supports Minor Home Modifications Non-Medical Transportation Supportive Family-Based Alternative Paraprofessional Services Specialized Therapies Animal Assisted Therapy Art Therapy Music Therapy Recreational Therapy Nutritional Counseling Supported Employment Employment Assistance Transitional Services *The types of YES Waiver services may vary depending upon which Waiver Provider is selected*

YES Contact Information Department of State Health Services YESWaiver@dshs.state.tx.us http://www.dshs.texas.gov/mhsa/yes