I have some AMAZING NEWS to share, and I’ll do my best to answer any questions for those in need in Texas. Charlie, who has profound autism, got an HCS diversion slot in Texas. If your child with autism and intellectual disability is in crisis, in Texas. An HCS Diversion slot may be granted to you and give you access to many services, including respite care and attendance care.
When Charlie received his autism diagnosis at 2 years old, I applied for various services and waivers. Initially, I was informed that the waitlist to access the waiver, which would provide us with respite care, was 5 years. However, as time passed, the waitlist only seemed to grow longer. It went from 5 years to an additional 5, then to an astonishing 15 more years, implying I wouldn’t receive assistance for Charlie until he reached 25-30 years old.
How Charlie got his HCS Diversion Slot
Last year, when things seemed to go from bad to worse, I connected with an incredible autism advocate. She informed me that in severe cases like Charlie’s, where a child is in crisis, a “diversion slot” can be granted, allowing families to bypass the lengthy waiting list, which, in our case, was over 20 years long.
For nearly a year, Charlie has been in crisis, showing behaviors like pica, aggression, and self-injury. As part of the process to get a diversion spot, his evaluation revealed an IQ below 40, classifying him as having a “severe intellectual disability.” The journey has been hard, particularly moments like the intellectual disability appointment where Charlie was hitting me and spitting everywhere.
But today, I received the best news: Charlie has been granted the diversion spot! This means he will finally receive the desperately needed services, including respite care.
While there is still paperwork and appointments ahead of us, knowing that Charlie will receive the support he needs is truly a win our family needs. 
Did I mention it’s a life-long program? I’m immensely grateful for this opportunity and I wanted to share the process with families going through a crisis. Below find a simplified tutorial to get you started. For more in-depth information, check out the HHS website.
Who qualifies for an HCS diversion slot in Texas?
1- HCS diversion spots are reserved for the most extreme cases, for children at risk of institutionalization. Your child won’t qualify if he’s not a danger to himself or others; it’s not enough to have a diagnosis of Level 3 Autism. You need to be able to prove severe and dangerous behaviors and meet the below criteria:
- at risk of institutionalization;
- at risk of institutionalization in a state-supported living center (SSLC); or
- leaving a state hospital who is at risk of re-institutionalization
2- “The number of offers for a Home and Community-based Services (HCS) Crisis Diversion slot made each month is based on budgetary guidelines in accordance with the legislative allocation for the biennium.” Source
What’s the process like to get an HCS diversion slot?
1- If possible, get someone who knows your child’s situation (doctor, therapist, school teacher) to refer your family to the LIDDA (Local Intellectual and Developmental Disability Authority)
2- The LIDDA will schedule an intake appointment to learn more about your child (it takes about 90 minutes)
3- The LIDDA will conduct an Intellectual Disability Determination
4- If the LIDDA considers your child at imminent risk of institutionalization, and if your child meets the criteria for a community intermediate care facility for individuals with intellectual disabilities or related conditions (ICF/IID) level of care (LOC) I, and that adequate and appropriate community resources are not available, as evidenced by attempts to locate and use community-based services and supports, the LIDDA begins the process for requesting a Home and Community-based Services (HCS) Crisis Diversion slot.
5- The LIDDA requests an HCS Crisis Diversion Slot request to the designated staff person in Texas Health and Human Services Commission (HHSC) IDD Services.
6- You wait for the decision!
Good luck!
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