Intellectual and Developmental Disabilities (IDD)

IDD Services are available in all eight BTCS counties: Bastrop, Burnet, Caldwell, Fayette, Gonzales, Guadalupe, Lee, and Williamson Counties

Bluebonnet Trails Community Services (BTCS) supports the Texas Health and Human Services Commission (HHSC) in maintaining statewide interest lists for Long-Term Services and Supports (LTSS) waiver programs, including Home and Community-based Services (HCS) and Texas Home Living (TxHmL). These interest lists consist of individuals who have requested services and are waiting for resources to become available for their preferred program. BTCS encourages anyone who believes they, or a family member, may need long-term services and supports in the future to add their name to the interest list(s) as soon as possible. To do so, please call our intake line at 844-309-6385 and request an IDD interest list service. This service is readily available and does not require a determination of program eligibility.

*Other HHSC waiver program interest lists maintained in CSIL are Medically Dependent Children Program (MDCP), Community Living Assistance and Support Services (CLASS), Deaf Blind with Multiple Disabilities (DBMD), and State of Texas Access Reform Plus (STAR+PLUS) waiver programs. To request placement on these HHSC waiver programs, the person, LAR or actively involved party must call the CSIL hotline at 877-438-5658.

The IDD Intake and Eligibility process is both informational and functional. It provides individuals and families with an overview of the service delivery system, as well as referrals and support to help move individuals toward an eligibility determination.

To proceed to an appointment with an Authorized Provider for a Determination of Intellectual Disability (DID), specific documentation is required. This includes school records, medical records, and relevant clinical assessment information. Intake staff play a key role in guiding and supporting families as they gather these documents, ensuring that prior or current school testing and any applicable medical diagnoses are available to support eligibility for IDD services. 

Determination of Eligibility (DID)

A determination of eligibility is a formal assessment process used to establish whether an individual has an intellectual disability or meets the criteria for the HHSC priority population for IDD services.

This process is conducted by a qualified professional and involves the use of standardized assessments to evaluate intellectual functioning (IQ) and adaptive behavior (the ability to perform daily life skills).

The assessment typically includes:

• A review of medical and school records and any other psychological assessments completed
• An interview with the individual and their Legally Authorized Representative (LAR), or others actively involved in the individual’s life, if no LAR is designated
• Administration of standardized tests

Once completed, a final report is usually available within approximately 30 days. This report is shared with the individual or the LAR and should be retained as part of the individual’s records. It serves as official documentation of eligibility at that point in time and may be required for future program enrollment or services.

(requires completion of intake and eligibility services)

Respite: Our Respite services provide temporary non-routine assistance to the caregiver by assisting the individual with needed supervision and basic daily living tasks while the caregiver may be unavailable.

Community Supports: Our Community Supports offers small group or one-on-one activities conducted in the individual’s home, or in the community to support the individual’s ability to live with the maximum amount of independence. This service is available as funding allows and has potential for a waitlist.

Employment Services: Bluebonnet Trails provides assistance to help individuals sustain competitive employment or self-employment, and to individuals who, because of disability, require intensive, ongoing support. Services include employment adaptions, supervisor training related to individuals’ assessed needs, and earning at least a minimal wage (if not self-employed). For more details, visit our Employment Services webpage. This service is available as funding allows and has potential for a waitlist.

Day Habilitation: Provided through network provider contracts, this service provides assistance with self-help, socialization and adaptive skills necessary to live successfully in the community and to participate in home and community life. Activities are consistent with achieving the outcomes identified in the person-directed plan. Day habilitation is provided in a group setting, other than the person’s residence. This service is available as funding allows and has potential for a waitlist.

Pre Admission Screening Resident Review (PASRR): PASRR is a process to identify people with a mental illness (MI), intellectual disability (ID), or developmental disability (DD), which is also known as a related condition (RC), who apply to, or reside in, a Medicaid-certified nursing facility (NF) to ensure that NF admission is appropriate. PASRR is also intended to ensure that people with MI, ID or DD are receiving all the necessary specialized services required while at the NF.

Service Coordination (SC): Our Service Coordination services help people access medical, social, educational, and other services and supports that will help an individual achieve desired quality of life and community participation. Service coordination is provided at least every 90 days by a staff person who is referred to as a Service Coordinator. This person will visit your home and/or other locations where services are being provided. Service Coordination is a required service while enrolled in IDD Services.

Service Authorization and Referral to ICF/IID Homes: Community intermediate care facilities for individuals with intellectual disability (ICF/IID) are licensed residential group homes that provide 24-hour supervision, services and supports to people with an intellectual disability or related condition. BTCS completes the eligibility, service referral, and billing authorization to these Medicaid-funded homes in our local communities.

Please see the HHS Provider search tool for more information.

Program Overview: OBI provides outpatient mental health services for people with intellectual and developmental disabilities (IDD) and co-occurring mental health or substance use needs.

Eligible Recipients: Children and adults who have, or presumed to have IDD, and who have a co-occurring mental health condition, substance use disorder, or behavior support needs.

OBI Services Biopsychosocial Approach: A three-dimensional approach (medical, psychological, and social) focusing on the critical areas of a person’s life that impact mental well-being by identifying goals to reduce mental health symptoms and increase overall wellness.

• Completion of a Biopsychosocial assessment to identify needs
• Development of a person-centered recovery plan

Collaborative Care Case Management: This approach focuses on increasing access to care and creating a team of medical, psychiatric, mental health, and paraprofessionals to address the unique needs of each person.

Education and Training: We provide education and training to both internal and community partners of mental health care, substance abuse treatment, or other related fields on topics related to co-occurring IDD and mental health conditions.

Skills Training: We provide training to the enrolled person and their support system on specific person-centered strategies to address target behaviors and diagnosis while promoting advocacy, improved communication, and developing independent living skills.

Locations: Guadalupe, Gonzales, Caldwell, Fayette, Bastrop, Lee, Williamson, and Burnet Counties

For More Information or to Request Services: Please contact your Service Coordinator or Case Manager if currently enrolled in BTCS services.

If new to our system of care, BTCS offers a centralized appointment and information line: 844-309-6385

We provide up to 90 days of crisis prevention services, including:

• • Crisis assessment
  • creation of behavioral strategies to reduce crisis behaviors
  • training to the individual and support system to utilize the strategies to prevent escalation of behaviors, law enforcement engagement, and reduce need for inpatient care services
  • Support in attending psychiatric appointments, School ARDs, and any other related appointments to increase self-advocacy.
  • Provide referrals and resources for any unmet needs