Yes Waiver: Next Steps.

Our previous post introduced you to the Yes Waiver, the State sponsored program for children and adolescents (aged 3 – 18) with chronic mental health issues. The program provides an array of home and community-based services that assist Medicaid beneficiaries to successfully live in the community and avoid institutionalization.

For those caregivers that may want or need to seek out this service, the first step is to visit the Texas Department of State Health Service Yes Waiver’s page to see if your county participates in the program. If so, the next step is to click on the Find your Local Mental Health Authority; the local mental health authority in your county is the organization that handles the application process and facilitates the Yes Waiver program. The Bexar County Mental Health Authority is The Center for Health Care Services and we spoke with Randa Gipson, the Contract Compliance and Operations Manager for the Yes Waiver Program, to get further details. 

If I want to apply for a Yes Waiver for my dependent, how do I do it?

RG:  The state requests that the legal guardian make the referral. They must call the Yes Waiver Legal request line at 210.261.1135. We take that message and phone them back within 48 hours to talk through the program. If we feel the caller’s dependent is a good candidate we place them on the inquiry list. When there’s a spot available, they meet with a counselor to determine eligibility.

How long does it take from the time someone applies to know whether or not they are accepted into the program?

RG: Usually we’re able to tell the family the same day they come in for their interview. We submit our paperwork to the state and the state has a 48- to 72-hour turnaround window to confirm acceptance, but we generally know whether or not the applicant will qualify. So the day they first come in, we often assign them a Case Manager and schedule their first home visit.

What are some of the program’s requirements?

RG: The children and adolescents that are accepted into the program must live in Bexar County, be aged 3 -18, on Medicaid and they must currently reside in the home of their legal guardian. If the legal guardians are not eligible for Medicaid, the child or adolescent can apply to be on Medicaid and we can help families with that application process.

In your opinion, what’s the most challenging part of the Yes Waiver process for a legal guardian?

RG: The difficult part isn’t within the application and acceptance portion of the program. That comes when the services begin. Some parents aren’t prepared for how intensive and involved it is. The legal guardian is as important as the child in the program. Just as an example, a case manager may need to meet at least once a week for an hour with the legal guardian in addition to all the services that are being scheduled and provided for the dependent.

Anything else you’d like to add?

RG: There are no hard and fast rules about the time between applications. So if for some reason a child isn’t accepted into the Yes Waiver program, they can always apply at another time. We know life and circumstances can change quickly and the Yes Waiver gives families additional chances for acceptance into the program.