YES Waiver 101 Youth Empowerment Services A Medicaid

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 youthserving 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 familycentered 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: o A non-institutional setting with the youth’s legally authorized representative (LAR), or o The youth’s own home or apartment, if legally emancipated, or o 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 • Deemed eligible via Clinical Eligibility Assessment • YES Services are specific to expanded service array (i. e. Paraprofessi 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) Wraparound TRR (State Plan Services) • 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) • Paraprofessional Services • Adaptive Aids and Supports • • Community Living Supports • Family Supports Specialized Therapies o Animal Assisted Therapy o Art Therapy o Music Therapy o Recreational Therapy o Nutritional Counseling • Minor Home Modifications • Supported Employment • Employment Assistance • Transitional Services • • Non-Medical Transportation Supportive Family-Based Alternative *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