The Home and Community-Based Services – Adult Mental Health (HCBS-AMH) 1915(i) program provides care for adults with serious mental illness (SMI), who have cycled in and out of institutional settings such as jails, emergency rooms and long term psychiatric hospitals.
HCBS-AMH is the first initiative in Texas to promote recovery in adults with serious mental illness by using a comprehensive service array to ensure successful reintegration into each individual’s community of choice. The program operates from a person-centered approach to recovery and provides comprehensive care to participants in their
HCBS-AMH is the first initiative in Texas to promote recovery in adults with serious mental illness by using a comprehensive service array to ensure successful reintegration into each individual’s community of choice. The program operates from a person-centered approach to recovery and provides comprehensive care to participants in their homes and communities. This program enables individuals to work with a team of supports who ensure that all aspects of the recovery plan are individualized and person-centered.
Each program participant will work in conjunction with a Recovery Manager (RM) and a Provider Agency (PA). The RM will collaborate with participants to create and carry out an Individual Recovery Plan (IRP) and navigate between all points of contact involved in service provision; the RM acts as a case manager monitoring progress and advo
Each program participant will work in conjunction with a Recovery Manager (RM) and a Provider Agency (PA). The RM will collaborate with participants to create and carry out an Individual Recovery Plan (IRP) and navigate between all points of contact involved in service provision; the RM acts as a case manager monitoring progress and advocating for participant success. Program participants will receive HCBS-AMH services by a PA. The PA is responsible for ensuring that all services are available to program participants either by providing them directly or by subcontracting with other providers in the community..
Texas Community Care pledge to deliver quality services through partnerships with individuals, families, and community stakeholders. We are advocates for promoting and enhancing access to intellectual, developmental, and behavioral health services that improve the lives of those in our community.
HCBS-AMH services can be provided in home and community-based settings, including individual homes, apartments, assisted living facilities, and small community-based residences.
1. Community Psychiatric Supports and Treatment (CPST) are goal-directed supports and solution focused interventions intended to achieve identified goals or objectives as established in the individual’s recovery plan (IRP). CPST addresses specific individual needs with evidence-based and evidence-informed psychotherapeutic practices designed to specifically meet those needs. CPST is provided face-to-face with the participant; however, family or other persons significant to the participant may also be involved.
2. Psychosocial Rehabilitation services utilize evidence-based or evidence-informed interventions to support the individual’s recovery. These interventions are used by helping develop, refine and/or maintain the skills needed to function successfully in the community to the fullest extent possible. A variety of evidence-based practices may be used as appropriate to individual needs, interests and goals.
3. HCBS-AMH Substance Use Disorder (SUD) services are specialized to meet the needs of individuals who have experienced extended institutional placement. They assist in achieving specific recovery goals and in preventing relapse; and are provided using a team approach with other HCBSAMH services, such as peer support.
To learn more, click here: https://centralizedtraining.com/hcbs-amh/service-array.pdf
1. Host Home / Companion Care will provide personal assistance with activities of daily living (ADLs) and functional living tasks.
2. Supported home living is provided to individuals living in the individual’s own or family residence which are not provider owned or operated. The services in this setting are designed to support rather than supplant the family and natural supports.
3. Supervised living provides residential assistance as needed by individuals who live in residences in which the HCBS-AMH provider holds a property interest and that meet program certification standards. This service may be provided to individuals in one of two modalities: A. By providers who are not awake during normal sleep hours but are present in the residence and able to respond to the needs of individuals; B. By providers assigned on a shift schedule that includes at least one complete change of staff each day.
To learn more, click here: https://centralizedtraining.com/hcbs-amh/service-array.pdf
1. Peer Support is a service which assists the individual with tasks such as setting recovery goals, developing recovery action plans, and solving problems directly related to recovery. Peer support is available daily, limited to no more than four hours per day for an individual client.
2. Respite is a service that provides temporary planned or emergency short-term relief to the primary natural (unpaid) caregiver of an individual. Respite is limited to 30 days annually of any combination of in-home or out-of-home respite.
3. The HCBS-AMH Nursing service covers ongoing chronic conditions such as wound care, medication administration (including monitoring & evaluating side effects), and supervising delegated tasks.
4. Flexible Funds are the monies utilized for non-clinical supports that augment the Individualized Recovery Plan (IRP) to reduce symptomatology and maintain quality of life and community integration.
To learn more, click here: https://centralizedtraining.com/hcbs-amh/service-array.pdf
1. Employment services help people with severe mental illness work at jobs of their choosing and achieve goals that are meaningful to them.
2. Supported Employment includes adaptations, assistance, and training essential for individuals to sustain paid employment at or above the minimum wage and benefits provided to non-disabled workers performing similar jobs.
3. Employment Assistance Services consist of developing and implementing strategies for achieving the individual’s desired employment outcome, including more suitable employment for individuals who are already employed..
4. Transportation services are defined as non-medical transportation provided to the individual that enable individuals to support their recovery goals and gain access to services, activities, and resources, as specified in the Individualized Recovery Plan (IRP).
To learn more, click here: https://centralizedtraining.com/hcbs-amh/service-array.pdf
1. Minor home modifications are those physical adaptations to an individual’s home that are necessary to ensure the individual’s health, welfare, and safety, or that enable the individual to function with greater independence in the home. In order to receive minor home modifications under this program, the individual would require institutionalization without these adaptations.
2. Home Delivered Meal services provide and deliver nutritionally sound meals to individuals in their homes. The individual has met needs-based criteria if the individual: A. Is unable to do meal preparation on a regular basis without assistance; B. Does not have access to alternate resources for the provision of the meal; and C. Does not have natural supports that are willing/able to provide meal preparation.
3. Adaptive Aids work to improve the well-being of individuals within their home settings. Adaptive Aids support individuals to successfully thrive in their home / community environment.
To learn more, click here: https://centralizedtraining.com/hcbs-amh/service-array.pdf
Individuals must be 18 years or older and have a serious mental health (SMI) diagnosis. HCBS-AMH defines SMI as an illness, disease, disorder, or condition (other than a sole or primary diagnosis of epilepsy, dementia, substance use disorder or intellectual or developmental disability). Additionally, individuals must have or be in the process of getting Medicaid. Individuals must also have an income that is at or below 150% of the federal poverty limit. To determine federal poverty limit, please visit www.uscourts.gov/file/document/150-percent-hhs-poverty-guidelines
Individual must have been hospitalized for 3 out of the last 5 years (1095 days cumulative or consecutive).
Individual must have 4 arrests and 2 psychiatric crisis episodes within the last 3 years.
Individual must have 15 or more ED visits and 2 psychiatric crisis episodes within the last 3 years.
To Schedule a screening appointment or for more information, please contact Texas Community Care’s HCBS-AMH inquiry line at 832-771-8598.
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To learn more about the HCBS-AMH program, you can download the HCBS-AMH Participant Handbook and Brochure here:
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