How to get started


Many families and even Special Education Teachers do not always understand the Home and Community Based Services (HCS) enrollment process. The enrollment process described below is germane to the North Texas Region. In some regions of the state, parts of the process may vary significantly.

How does HCS work?

The State of Texas contracts with providers such as A.B.L.E. Family Services to ensure services under the umbrella of HCS is provided to individuals that have received an HCS slot (funding) from the State of Texas. Although there are programs that are similar in other states, your HCS slot (funding) does not go with you if you move to another state. If you move or do not like your provider, you can change providers at anytime as long as you reside within the State of Texas. The State of Texas funds a certain amount of HCS slots each year and that number is split among the local MHMR centers. To find out how many new HCS slots are to be given out to your local MHMR center, please go to http://www.dads.state.tx.us/services/interestlist/index.html. Example: If a local MHMR center indicates you are number 300 on the waiting list and there are only 22 slots for fiscal 2010. You can expect it may take several years for you to finally come up on the waiting list for funding.”If a consumers name is passed over do to various circumstances (e.g., moved out of state), then the next person on the list will receive funding unless he/she is also passed over.

How do I get Started?

The first thing we suggest you do in order to receive an HCS slot (funding) is to go to your local Mental Health and Mental Retardation center. For example for Dallas County, you would go to Dallas MetroCare Services and request that you (consumer) be put on the HCS waiting list. There have been reports that there are more than 30,000 people in Texas waiting to get an HCS slot. Based upon our experience, it can take on average up to 7 years before a person becomes eligible to receive an HCS slot. There are very few cases in which a person can receive an HCS slot without having to wait as long (e.g., a person coming out of a state hospital). Do not confuse HCS program with other programs in the state such as an Intermediate Care Facility for the Mentally Retarded (ICF-MR), general revenue funding, or state schools. HCS is a specific program that many in our industry consider it the GOLD standard for services in Texas. Depending upon what type of statistic, Texas is generally ranked between 42nd to 47th regarding services to people with developmental disabilities.

I am on the HCS waiting list with my local MHMR center, now what do I do?

The MHMR center will contact each family as his/her number comes up on the waiting list. However, you will need to keep your contact information current with the MHMR center because if you don’t and your number gets called with no answer, you may be taken off of the list and the next person will get your slot.

My family member/friend received an HCS slot and the MHMR center stated I have been assigned a Level of Need (LON) 5. What is a Level of Need?

A level of need directly correlates to “How much money” is funded to an HCS slot. He/She will still get the same array of services, however, it may cost more to provide a particular service. A Level of Need is based upon an individual’s abilities and needs. A Level of Need in large part is based upon an assessment tool called and ICAP (Inventory for Client and Agency Planning). The ICAP is initially conducted by an MHMR center and thereafter is usually completed every 3 years no matter who your provider is. An ICAP can be completed earlier than 3 years if a person has a significant change in his/her life (e.g., persons legs become amputated and now needs a wheelchair). Anyways, a Level of Need is assigned 5 different numbers in the following order

  • 1-Intermittent
  • 5-Limited
  • 8-Extensive
  • 6-Pervasive
  • 9-Pervasive Plus

An example of a Level of Need 1 would consist of an individual that would generally be described as a person with a high level of functioning and needs some assistance to complete daily living skills. A Level of Need 9 is an individual that is both medically and behaviorally challenged. An example of this is someone that needs total assistance in bathing, hygiene, use of a wheelchair, and has significant inappropriate behaviors such as hurting oneself or others. It is estimated that less than 1 percent of people receiving services fall into this category.

I have been called from my local MHMR center and have to choose a provider from a list of at least a 100 HCS providers. How would I go about picking one that is right for me?

There is not a right/wrong answer. There are several techniques. One is to call all of the providers until you feel you have a good interaction. Another technique is to randomly pick a few until you find one you are comfortable. We believe the best technique is to compare “apples to apples” and “oranges to oranges.” We suggest a list of 5-10 questions that you ask each provider and try to come up with the provider that answers your questions to your liking.