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By Stephen Schoen, Program Consultant
Deaf-Blind Multiple Disabilities Medicaid Waiver Program

Texas is the only state in the U.S. to have a Medicaid Waiver Program specifically for persons who are deaf-blind with multiple disabilities. The waiver program had its roots in a deaf-blind program that began in 1984 as a result of self-advocacy by parents of children who were deaf-blind with multiple disabilities due to Rubella Syndrome. As their children graduated from public special education, parents realized there would be no specific program that could serve their grown children. The parents advocated to the Legislature for the development of a residential program tailored to meet the needs of adults with deafblindness. The Texas Commission for the Deaf and Hard of Hearing (TCDHH) first administered the program in three group homes located in Houston, San Antonio, and Dallas. After one year, the Texas Rehabilitation Commission (TRC) took over administration duties. Under TRC's direction, the program expanded service area to more areas of the state. In 1995, TRC converted the program into the Deaf-Blind Multiple Disabilities Medicaid Waiver program, which expanded the number of people served and the types of services delivered. In 1999, the Legislature moved the program to the Texas Department of Human Services (TDHS). The program is currently serving 143 individuals.

Frequently Asked Questions

1) What is a Medicaid Waiver?

A Medicaid Waiver is a long-term care program, which provides services in order to prevent people from being institutionalized.

2) Which waiver should I choose for my son or daughter?

There are 4 major waivers operated by the Texas Department of Human Services (DHS) and 1 waiver operated by Texas Mental Health and Mental Retardation (MHMR). The DHS waivers are: Community Based Assistance (CBA), for adults eligible for nursing home care); Medically Dependent Children's Waiver Program (MDCP), for children eligible for nursing home care; Community Living Assistance & Support Services (CLASS), for people of all ages who have developmental disabilities other than mental retardation; and the DB-MD waiver for people who are deaf-blind with multiple disabilities. The Home & Community Support (HCS) Waiver operated by MHMR serves people who have mental retardation. A â¬SConsolidated Waiver⬠combining all of the above-mentioned waivers is being piloted in the San Antonio area. Frequently, people who are eligible for the DB-MD Waiver are also eligible for some of these other waivers. Factors in making a choice between waivers include: your number on the waiting list, private provider choice in your geographic area, and services available from each waiver. One thing is clear: Most people are better off with waiver services than without. I would advise people to get on all interest lists for which they may be eligible. Before making a choice of waiver, I would talk to professionals from school, public agencies, advocacy groups such as the Deaf-Blind Multihandicapped Association of Texas (DBMAT), and other parents.

3) Who is eligible for the DB-MD Waiver?

Consumers must be age 18 or over and have a disability of deafblindness with a third developmental disability such as mental retardation or autism. This disability must result in a need for long-term care to prevent institutionalization.

4) How are services provided in the DB-MD Waiver?

Services are provided by private vendors who contract with the Department of Human Services to provide all services from a menu of services.

5) What choices are available?

Within the DB-MD Waiver, individuals have a choice of private providers, type of residence, type of support service received, and location of delivered service. Providers are available in all major Texas metropolitan areas and in many rural areas.

6) What services are available in the DB-MD Waiver?

Services include: assisted living (24 hour care); residential habilitation (support to help individuals do activities for themselves); intervener (assistance in relating to other people and the community); orientation and mobility (training to navigate more independently); therapies (including occupational therapy physical therapy, and speech therapy); and behavior communication specialist (consultation with specialists in the field of deafblindness).

7) Where are the individuals served?

Individuals can be served in the home of their parents or guardians, an apartment, or a group home with six or less people.

8) Are there other services provided by the DB-MD Waiver?

The DB-MD Program provides an annual summer week-long camping experience for people who are deaf blind. It also partners with the DBMAT and other Texas state agencies to conduct an annual family conference, which is usually held in early October.

9) How long may a person receive services from the DB-MD Waiver?

Services from the DB-MD Waiver program may last for a person's lifetime.

10) When should a person apply for the DB-MD Waiver?

A person should put their name on the DB-MD Interest List or database immediately. Even though the waiver only serves individuals who are 18 years old and over, we encourage children who are younger to be on the database so we can plan for future services.

11) What is the difference between the DB-MD Database and the DB-MD Interest list?

The DB-MD database is used to plan requests for future funding for the DB-MD Waiver. People under 16 years of age are placed on the DB-MD database. The DB-MD Interest List is the official on-line list of people interested in DB-MD services. People who are age 16 and over are placed on the DB-MD Interest List. When a person on the database turns 16 years old their families are contacted. If the families continue to desire DB-MD services, the person's name is placed on the DB-MD Interest list. When funding becomes available, people on the interest list are offered slots in the waiver.

12) How long will I need to wait if I put my name on the Interest List?

At this moment, the DB-MD Waiver has filled all 143 slots allocated by the Legislature. If any slots open up, people on the interest list will be contacted in the order of their application to the waiver or the date of their sixteenth birthday. While there are few names on the interest list, we can't predict when funding will be available.

13) I'm already in another Medicaid Waiver (or Intermediate Care [ICF] group home). Can the DB-MD Waiver also provide services?

No. All Medicaid Waiver or ICF services are delivered using the same type of Medicaid Long Term Care funding. A person can only receive one of these types of programs at any time. A person can switch from one waiver to another as long as he is eligible. But, he must realize that he will be subject to a long waiting list if he tries to switch back.

14) My child receives services from Texas Department of Assistive and Rehabilitative Services (formerly known as Texas Commision for the Blind) (TCB), and/or the school system. Can she also receive services from the DB-MD Waiver?

Yes. Programs from the TCB and the DB-MD Waiver can supplement each other to the benefit of consumers. For example, job placement and supported employment may be provided by TCB while long-term support is provided by the DB-MD Waiver.

15) How do I apply for or get more information about the DB-MD Waiver?

Call me, Steve Schoen, the Program Consultant for the DB-MD Medicaid Waiver, at (512 ) 438-2622; or send an e-mail to <>. I will send you a brochure and Interest List Survey Form. Once I receive your completed survey form, your name will be placed on the DB-MD Interest List or database.

Updated 12/29/03