The vast majority of Texans do not have the means or ability to leave for another state...
Fast forward to 2015 and county evaluators are saying Dawson’s IQ was too high to qualify for this program.Houston Chronicle investigation
If residents don’t qualify at the time they reach the top, they’re booted from the list and have to start the process all over again. While someone found ineligible for a waiver program can request to be added back on that list and placed at the bottom, Young said if someone is denied based on level of care, diagnosis, or other functional eligibility requirements, they can be registered on a different list using their original request date.
The fourth time was the charm for Dawson, who is now getting services through one of the Medicaid waiver programs.“I was holding my breath when I got calls from the state,” Cynthia said. “Has his name come up? Will he qualify?”They would be in the grocery store — the same one they went to every single week — and Dawson would have an absolute meltdown, screaming and crying for an unknown reason.
“You’re not going to get the services anyway, so put your child on every list,” Cynthia remembers the panelists saying. “As their name comes up, you’re going to go through an eligibility process and then they’ll let you know if he fits.”In a statement, Young with HHSC said that local intellectual and developmental disability authorities work with individuals to be placed on the Texas Home Living and Home and Community-based Services waitlists.
Dawson’s legs were slightly different lengths, and he had gross motor difficulties. He had an unrelated condition that caused an overload of iron in his body.The family was back to waiting, trying to scrape together enough money for all his therapies and doctors appointments and school tuition.“Your son, Dawson, is being offered the Texas Home Living program,” the caller said. “We’ll need to evaluate your household income.
In fact, 60 percent of individuals on one waiver program waitlist were also on another during the 2018-2019 biennium, a study published by the Texas Health and Human Services Commission in September 2020 found. “It’s really not a system that is set up to ensure that we’re really helping people where they need it, when they need it,” said Ford, with The Arc of Texas. “It’s so unorderly. It is something that is a nightmare situation.”
The HHSC study published in September 2020 examined how nine other states overhauled their Medicaid waiver waitlists. One of the major themes of these states’ success was that waiver services were prioritized by urgency of need, not first come, first serve, like in Texas. Also confusing, experts say, is who operates which waiver program waitlist. The Home and Community-based Services waiver, as well as Texas Home Living, are operated by the local intellectual and developmental disability authorities. The authorities contact individuals on the waitlist every two years by phone to update families on their spot.
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