YES Youth Empowerment Services A Medicaid Waiver Program for Children with Severe Emotional Disturbance June 11,2012 Mental Health Connection

Texas Department of State Health Services (DSHS) What is the YES Waiver? The YES (Youth Empowerment Services) Waiver is a 1915c Medicaid Home and Community-Based Services Waiver that allows for more flexibility in the funding of intensive community-based services to assist children and adolescents with severe emotional disturbances to live in the community with their families. 2

Texas Department of State Health Services (DSHS) 33 Medicaid Waiver Basics Provide home and community-based services to children who otherwise need institutional care (e.g., psychiatric inpatient care) or whose parents would turn to state custody for care Must be cost neutral to Medicaid (average Medicaid service cost with waiver less than or equal to average Medicaid service cost w/o waiver) A few states use 1915(c) waivers to serve children with severe emotional disturbance

Texas Department of State Health Services (DSHS) Goals Reducing the out-of –home placement and inpatient psychiatric treatment by all child-serving agencies. Providing a more complete continuum of community- based services and supports. Ensuring families have access to parent partners and other flexible non-traditional support services as identified in a family-centered planning process. Preventing entry into the foster care system and relinquishment of parental custody. Improving the clinical and functional out-comes of children and adolescents. 4

Texas Department of State Health Services (DSHS) 5 Potential Participants/Eligibility To participate in the YES Waiver, the child or adolescent must meet the following eligibility criteria: Age 3-18; Reside in Tarrant county and in a non-institutional setting with the individual’s legally authorized representative (LAR); or in the individual’s own home or apartment, if legally emancipated Be eligible for Medicaid, under a Medicaid Eligibility Group included in the approved waiver. Parents income is not included in this eligibility process. Meet DSHS clinical guidelines and be reasonably expected to qualify for inpatient care under the Texas Medicaid inpatient psychiatric admission guidelines, as defined in the waiver, in the absence of waiver services Choose, or have the LAR choose, the waiver program services as an alternative to care in an inpatient psychiatric facility, in accordance with the provisions of the waiver.

Texas Department of State Health Services (DSHS) 66 Waiver Services Respite Community Living Supports Family Supports Specialized Psychiatric Observation Transitional Services Adaptive Aids & Supports Minor Home Modifications Non-Medical Transportation Paraprofessional Services Professional services Supportive Family Based Alternatives

Texas Department of State Health Services (DSHS) Waiver Entry Timeframe Once the LAR or client has phoned the interest line and left their contact information they will be contacted within 24 hours. If demographic criteria is met, a Licensed Professional Counselor will contact the family to arrange the clinical/Medicaid eligibility assessment. Once all necessary documentation is received the assessment is sent into the State for approval of the Waiver services. This process may take up to 2-3 weeks. Waiver treatment team will initiate services with client and family immediately following State approval. 7

Texas Department of State Health Services (DSHS) Service Initiation To initiate Waiver services the interested youth or LAR must contact the Interest Line. Interest Line:

Texas Department of State Health Services (DSHS) 9 Discussion

Texas Department of State Health Services (DSHS) 10 Contact Information Brandice Mueller (MHMR)Kim Garrett (YAP) YES Waiver Website