2018-139 Denton County MHMRDate: September 28, 2018 Report No. 2018-139
INFORMAL STAFF REPORT
TO MAYOR AND CITY COUNCIL
SUBJECT:
On August 28, 2018 during concluding items, Council Member Armintor requested a staff report
to give an overview of what Denton County MHMR (MHMR) is, how it is funded, and any
challenges with funding.
BACKGROUND:
Denton County MHMR is a local non-profit community center designated as the local Mental
Health and Intellectual & Developmental Disabilities Authority for Denton County, Texas. Due
to the high volume of programs that MHMR implements and its diverse funding sources, staff
asked Denton County MHMR’s Executive Director, Pam Gutierrez, to provide the information
requested by CM Armintor. The discussion information attached as Exhibit 1 was respectfully
submitted by Executive Director Pam Gutierrez.
DISCUSSION:
In addition to the information provided to staff by Denton County MHMR in Exhibit 1, staff can
add the following information to describe how the City has worked with MHMR and supported
mental health initiatives in the community.
Funding for MHMR Housing Units: The City of Denton has provided Home
Investment Partnerships Program (HOME) funding to support the Denton Affordable
Housing Corporation’s program to rehabilitate housing units that are made available to
MHMR clients. Two units were rehabilitated in 2017-18. A minimum of one additional
unit is scheduled to be completed during the 2018-19 program year.
Human Services Grant Funding: The City of Denton has provided public services grant
funding support for single programs in MHMR at different intervals in the grant
program’s history as well as current funding. The Human Services Grant funded a
MHMR program from FY00-01 through FY04-05. The program was discontinued and
MHMR did not seek funding again until FY14-15. At that time the Human Services
Grant provided funding for the HCS Residential Care Services - IDD Direct Care
Support. The funding provides salary reimbursement for staff who assist residents with
activities of daily living. The program has been continuously funded through FY17-18.
The HCS Residential Care Services - IDD Direct Care Support program is being
transitioned to a partnership with Texas Woman University so MHMR is not seeking
continued funding for this program. In the application for FY18-19 Human Services
grant, MHMR elected to seek funding for the LOSS Team an on-call team available 24/7
in response to reports of suicide in the amount of $15,000. The application was
recommended for funding by the Human Services Advisory Committee and approved by
City Council with the FY 2018-19 Annual Program Budget Ord # 18-1456.
Behavioral Health Leadership Team
Denton has engaged in collective impact through the Denton County Behavioral Health
Leadership Team. “Collective impact” describes an intentional way of working together
Date: September 28, 2018 Report No. 2018-139
and sharing information for the purpose of solving a complex problem using a
community-wide strategic lens. The approach is more likely to solve complex problems
than if a single nonprofit were to approach the same problem(s) on its own because there
is no single solution—not one entity, or one person—that can solve the crises across the
behavioral health and housing spectrum. This team advocates and facilitates a
collaborative person-centered behavioral health system to repair and restore lives. The
City participates in collaboration with many other public and private partners including
MHMR.
ATTACHMENT(S):
Exhibit 1 - Denton County MHMR Information Document by Executive Director Pam Gutierrez
STAFF CONTACT:
Danielle Shaw
Human Services Coordinator
940-349-7237
Danielle.Shaw@CityofDenton.com
EXHIBIT 1
DENTON COUNTY MHMR MENTAL HEALTH SERVICES
Eligibility and Intake
People with mental health needs access our services through our hotline/intake line (1-800-762-
0157). This line operates 24 hours a day and provides an initial screening for individuals to
determine if clients are in crisis or in need of ongoing mental health services. Individuals who
qualify based on need and diagnosis are referred to our open intake process. Intake consists of a
diagnostic assessment, psychosocial history, and a uniform assessment of level of care that is
required by the state. The Uniform Assessment used is either the Adult Needs and Strengths
Assessment (ANSA) or the Children’s Assessment of Needs and Strengths (CANS). The scores
on the ANSA/CANS determine the level of care that is appropriate for the individual at that time.
Levels of Care Adult
The levels of care for our adult and children’s services are delineated by acuity of need and are
labeled Level of Care 1, 2, 3 or 4. The higher the level of care assigned the more acute the need
of the client and the more services that are available to them. A general outline of the levels of
care and services provided in each level of care is presented below:
Level of Care 1: The general focus of this array of services is to facilitate recovery by reducing
or stabilizing symptoms, improve the level of functioning, and/or prevent deterioration of the
individual’s condition. Natural and/or alternative supports are developed to help the individual in
their recovery. Services are most often provided in outpatient, office-based settings, and are
primarily limited to medication, rehabilitative services, and education. We currently have 1556
clients in this level of care.
Level of Care 2: The overall focus of services in this level care is to improve level of functioning
and/or prevent deterioration of the individual’s condition so that the individual is able to continue
to work towards identified recovery goals. Natural and/or alternative supports are developed to
help the individual in their recovery process. Services are most often provided in outpatient,
office-based settings and include psychotherapy services in addition to those offered in LOC-1.
We currently have 126 clients in this level of care. We have and five PRN counselors who
provide cognitive behavioral therapy.
Level of Care 3: Services in this level of care are generally intended for individuals who enter
the system of care with moderate to severe levels of need who require intensive rehabilitation to
increase community tenure, establish support networks, increase community awareness, and
develop coping strategies in order to function effectively in their social environment (family,
peers, school). This may include maintaining the current level of functioning. A rehabilitative
case manager who is a member of the therapeutic team provides supported housing and Co-
Occurring Psychiatric and Substance Abuse Disorders (COPSD) services, if needed. We
currently have 199 clients in this level of care.
Adult case managers have mixed caseloads and see individuals in all levels of care. We currently
have 19 case managers in this program.
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Level of Care 4: Using an integrated services approach, the Assertive Community Treatment
team (ACT) merges clinical and rehabilitation staff expertise (e.g., psychiatric, substance abuse,
employment, and housing) within a mobile service delivery team that works in partnership with
the person in recovery from his or her home. Accordingly, there will be minimal referral of
individuals to other programs for treatment, rehabilitation, and support services. Limited use of
group activities designed to reduce social isolation or address substance use/abuse issues is also
acceptable as part of ACT. We currently have 41 clients in this level of care. We have 5 case
managers, 2 nurses, and 1 psychiatrist for this team. The psychiatrist for this team is Denton
County MHMR’s medical director.
Clients in all the above levels of care also receive psychiatric, nursing, peer support, medication
management and crisis services as part of their level of care.
These services are funded through general revenue funds for uninsured or reimbursed through
Medicaid or Medicare. Only 23% of our current adult client population has Medicaid.
Levels of Care Children
Level of Care 1: The services in this LOC are intended to meet the needs of the child/youth
whose only identified treatment need is for medication management. Children/youth served in
this LOC may have an occasional need for routine case management services but do not have
ongoing treatment needs outside of medication related services. While services delivered in this
LOC are primarily office based, services may also be provided at school or in the community.
We currently have 103 clients assigned to this level of care.
Level of Care 2: The purpose of this LOC is to improve mood symptoms or address behavioral
needs while building strengths in the child/youth and caregiver. The services in the LOC target a
specific, identified treatment need. Services should be provided in the most convenient location
for the child/youth and caregiver, including the office setting, school, home, or other community
location. We currently have 141 individuals assigned to this level of care.
Level of Care 3: The purpose of this LOC is to reduce or stabilize symptoms and/or risk
behaviors, improve overall functioning, and build strengths and resiliency in the child/youth and
caregiver. Services should be provided in the most convenient location for the child/youth and
caregiver, including the office setting, school, home, or other community location. Providers
may need to consider flexible office hours to support the complex needs of the child/youth and
caregiver. We currently have 52 individuals in this level of care.
Children’s case managers have mixed caseloads and see individuals in all levels of care. We
currently have 9 case managers in this program.
Level of Care 4: The purpose of this LOC is to reduce or stabilize symptoms and/or risk
behaviors, improve overall functioning, and build strengths and resiliency in the child/youth and
caregiver through a treatment team approach. Services should be provided in the most
convenient location for the child/youth and caregiver, including the office setting, school, home,
or other community location. Providers may need to consider flexible office hours to support the
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complex needs of the child/youth and caregiver. We currently have 5 individuals assigned to this
level of care.
Level of Care Young Children
The services in this LOC are intended to meet the needs of the young child (ages 3-5) with
identified behavioral and/or emotional treatment needs. The young child may also exhibit a
moderate degree of life domain functioning impairments that require multiple service
interventions. The purpose of this LOC is to reduce or stabilize symptoms, improve overall
functioning, and build strengths and resiliency in the child and caregiver. The focus of services is
placed on the dyad relationship as this relationship is the primary context for young children.
These primary relationship(s) set the stage for future social-emotional behavior and future
relationship behavior. Services should be provided in the most convenient location for the child
and caregiver, including the office setting or home. We currently have 12 individuals in this level
of care.
Children’s case managers have mixed caseloads and see individuals in all levels of care. We
currently have 9 case managers in this program.
Clients in all the above levels of care also receive psychiatric, nursing, medication management,
family partner services, and crisis services as part of their level of care.
These services are funded through general revenue funds for uninsured or reimbursed through
Medicaid or Medicare. 77% of our current client children’s population has Medicaid.
Our Crisis services are provided 24 hours a day, throughout the county. These services are
typically provided in the community or in alternative treatment environments such as schools,
hospitals, and jails. The initial assessment through crisis services is to help people experiencing a
psychiatric crisis through assessment and problem solving. Our crisis services help facilitate
higher levels of care such as hospitalization, if needed. These services can include facilitation of
those needing hospitalization who have insurance or payment for hospitalization for those who
are uninsured. As the initial crisis period is alleviated clients are transitioned to outpatient crisis
services (that can last up to 90 days) that include psychiatric, nursing, case management and
skills training, cognitive behavioral therapy and referrals. Once a client is finished with
outpatient crisis services they are transitioned to the appropriate level of care within our
outpatient services or referred to the community.
Continuity of care and court liaisons work with clients who are going to local hospitals or to state
hospitals to ensure that there is continuity of their inpatient care and outpatient services.
Additionally, they monitor the care at the state hospital and are part of the treatment team at the
state hospital.
There are two Licensed Chemical Dependency Counselors (LCDC) on staff. One LCDC
facilitates substance abuse groups four times a week and meets with individuals in all levels of
care. Our other LCDC position is grant funded by Health and Human Services Commission
(HHSC) and is dispatched with the Mobile Crisis Outreach Team to conduct substance abuse
assessments and facilitate placement if needed.
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YES WAIVER
The YES Waiver is a Medicaid waiver program for children with mental health. This programs
provides services including intensive case management, psychiatric services, wraparound
services, adaptive aids and supports, community living supports, family supports, respite, and
many other types of alternative therapies with the goal of helping a child who is at risk of
placement. The waiver services are funded through Medicaid. Denton County MHMR contracts
with other providers to provide choice for clients in their service providers. We currently have 18
individuals in this program. We have three staff dedicated to these clients.
Pre-Admission Screening and Resident Review (PASRR)
This service is provided by the center for clients who are in nursing homes who may have mental
health needs. Our role is to assess if the client does have mental health issues, monitor the
current treatment of the services being provided, and supplement the care that is received if it is
determined that the nursing home or facility cannot accommodate all of the mental health needs.
The initial assessments for these clients is a fee for service payment model, however the ongoing
service coordination is funded through general revenue.
Texas Correctional Office on offenders with Medical or Mental Impairment (TCOOMMI)
The purpose of this program is twofold. The first purpose is to coordinate transitioning of mental
health care for offenders leaving the state correctional department and reintegrating back to their
communities. The second purpose is to have collaborative approach with Parolees, their parole
officer and our services to ensure that the specific needs of this population are met. The goal of
this collaboration is safe reintegration to the community and to cut down on jail recidivism. The
funding for this program comes mainly through a contract with Texas Department of Criminal
Justice. We have one case manager assigned to the clients in this program dedicated to teaching
skills needed to safely and successfully reintegrate into the community. The program also has a
continuity of care coordinator responsible for intakes into the program. The number of clients in
this program varies between 25-35 clients. TCOOMMI contracts with the center for these
services.
Youth Mental Health First Aid
This program is an 8-hour evidenced-based public education program that introduces participants
to risk factors and warning signs of mental illnesses for adolescents and transition you, ages 12-
18. The course builds an understanding of the importance of early intervention and teaches
participants how to offer initial help to a young person experiencing a mental health challenge.
This program is taught by our trained staff to educators throughout the county. The recent
legislative session also made it possible for us to deliver this training to those who teach in the
university or college settings. The materials, training, and staff are funded through our mental
health contract with Health Human Service Commission (HHSC).
Local Psychiatric Bed Days/Diversion Beds
This program is designed to allow clients to receive inpatient psychiatric care in local hospitals
rather than being sent to the state hospital. Keeping an individual closer to their community and
support systems helps to ensure better integration back to the community upon discharge from a
psychiatric facility as well as helping to cut down the number of beds used at the state facilities.
The state hospitals are almost always full and this funding helps to keep individuals from waiting
EXHIBIT 1
for inpatient services. This local hospitalization also cuts transportation costs for agencies
involved in the clients care. This is funded through our mental health contract with the state. This
funding does not cover all the costs occurred by Denton County MHMR for bed day utilization.
The state hospitals are often full, or on diversion which means that a individuals who needs state
hospital care may be diverted as far away as El Paso or continue to utilize a local psychiatric bed.
The cost to the center for these local beds far exceeds the amount funded through this program.
The safety of individuals and communities is at risk when individuals are unable to access
inpatient psychiatric care. North Texas State Hospital (NTSH) is the Center’s catchment hospital.
These services are funded through HHSC competitive grant.
Connections: Housing and Urban Development (HUD)
The connections program is a permanent supportive housing grant that is managed by Denton
County MHMR. The goal is to move chronically homeless individuals with disabilities towards
self-sufficiency and independence by using an integrated approach. The services include case
management, life skills, psychiatric services, housing, therapy, transportation and food pantry.
This program has two fulltime staff and approximately 20 clients and 1 family. The funding for
this program comes from a grant through HUD.
Local Outreach to Suicide Survivors (LOSS TEAM)
Our LOSS team is a program that works to reach out to families and loved ones who have
experienced a recent suicide loss. The LOSS team responds with the medical examiner to
provide comfort and support for families who have lost someone to suicide. This team, made up
of a suicide survivor and a trained clinician respond and work with family members so that
police and medical examiners can do their job at a suicide scene. The goal of the LOSS team is
to begin the process of healing for the family and to make sure that they have resources and
access to ongoing care that they may need following the traumatic event of suicide. The LOSS
team also provides delayed response activities that help support and link affected family
members with appropriate resources. The team conducts follow up calls for up to 1 year
following the suicide death, providing loved ones with much needed support. This program is
funded through donations and fundraising at the local level.
PROJECTS FUNDED THROUGH THE 1115 WAIVER
Crisis Residential
The Crisis residential program is a psychosocial rehabilitation program providing treatment for
12 individuals (6 females and 6 males) who pose some risk of harm to themselves, posing some
functional impairment, and are unable to be stabilized in a less restrictive environment. This
program provides up to 8 hours a day of skills training, process groups, and substance abuse
groups. Individuals are also able to see a psychiatrist and receive nursing services. The facility
itself is not locked however it is a monitored 24 hours a day by staff to ensure that individuals
are safe and not in need of a higher level of care. This program offers services for individuals
between 7-14 day stay. This program has been funded by the 1115 grant and will require
additional funding to continue operating past 2019.
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Psychiatric Triage Center
The Psychiatric triage center offers a 24 hour walk-in option for people who are in psychiatric
crisis. Individuals can come to the psychiatric triage for an assessment which determines the
least restrictive environment the person can receive care. The psychiatric triage allows for law
enforcement to bring individuals to the facility rather than hospital emergency rooms cutting
down on both law enforcement time and hospital utilization. This process allows for individuals
to begin receiving appropriate services within minutes of arrival rather than waiting for care in
settings that might not be appropriate such as jails, hospitals, or other community settings. This
program has been funded by the 1115 grant and will require additional funding to continue
operating past 2019.
Integrated Health Clinic
The Integrated clinic provides individuals with a one stop option for both psychiatric and
physical health needs. Individuals in this clinic have access to a psychiatric provider, a general
practitioner, and a case manager. This integrated approach allows for tremendous and efficient
collaboration between the treatment team that is beneficial to both the providers and the
individuals. The clinic is accepting individuals with Medicaid and Medicare only at this time.
The Integrated Clinic has been funded with 1115 Federal funding which ends in 2019. Without
additional funding this program is in jeopardy of continuing.
First Episode Psychosis
This is a new program serving 20-30 individuals experiencing their first psychotic episode. This
program will consist of a Licensed Professional of Healing Arts (LPHA), who will serves as the
team lead and two case managers focusing on employment and skills training. Individuals in this
program must be between the ages of 15 and 30. Individuals in this program will also have
access to our Psychiatrist, Nurses, Peer Support Specialist, and Family Partner. This program is
funded by HHSC.
Psychiatric Services
Individuals are provided an evaluation and treatment options that may include medication and
possible monitoring by an advanced nurse practitioner or a psychiatrist. Individuals may also
receive medication monitoring from registered nurses within the clinic. These services are
funded through HHSC.
Current Issues:
The Center currently does not have a waitlist for services however overserves for children and
adults. Health and Human Services Commission contracts with the Center to provide services to
individuals with behavioral health needs.
Our Psychiatric Triage Facility, Crisis Residential Facility and Integrated Clinic are at risk of
losing the current funding and operations.
We struggle daily with enough inpatient psychiatric beds to meet the needs of our community.
Denton currently does not have any regulated low cost housing options and this creates a
tremendous burden for the individuals we serve.
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INTELLECTUAL AND DEVELOPMENTAL DISABILITY (IDD) SERVICES
The following information provides a brief description of services and supports for individuals
with intellectual and developmental disabilities (IDD) provided by the Denton County MHMR
Center (Center.) Some of the following services and supports have an interest list because they
are not currently available.
Eligibility Determination
Eligibility determination involves assessing the individual to determine eligibility for IDD
services. The process includes evaluating the person for the presence of intellectual and
developmental disorders and determining the level of support needed for the person to function
and remain in the community. The individual’s intellectual and adaptive strengths are evaluated
to determine the appropriateness of admission and guide recommendations for services and
further assessments. Approximately twenty-five to thirty individuals are assessed each month for
an average of 300-360 individuals annually. This service is funded with state General Revenue
(GR.)
Service Coordination
Service Coordinators assist individuals to access medical, social, educational, and other
appropriate services and supports that will help achieve a quality of life and community
participation desired by the individual. The service coordinator links individuals to service
providers and other agencies to meet their support needs. The Service Coordination department
also provides Continuity of Care, Permanency Planning, Enhanced Community Coordination,
and Nursing Facility Pre-Admission Screening and Resident Review (PASSRR) Service
Coordination. In total, the Center currently provides Service Coordination for 984 individuals,
including 572 people in Home and Community-based Services (HCS), 157 people in Texas
Home Living (TxHmL), 210 people in General Revenue (GR), and 45 individuals in Nursing
Facility Pre-Admission Screening and Resident Review (PASRR). Sixty-seven percent of the
individuals in General Revenue services have Medicaid. This service is funded with state
General Revenue funds for individuals who do not have Medicaid. For individuals who have
Medicaid, this service is funded by Medicaid through the Texas Medicaid Health Partnership
(TMHP.)
Home and Community Based Services (HCS)
This is a Medicaid waiver program funded with state and matching federal dollars which offers
the following services to enrolled individuals: adaptive aids, minor home modifications, dental,
audiology, dietary, nursing, specialized therapies, day habilitation, respite, employment
assistance or supported employment, Community First Choice, Host Home (Foster Care), and
group home residential options. HCS is funded with state, and matching federal funds. There are
three residential types in HCS:
Group homes – The Center operates eight group homes with a maximum of four beds in
each home. Thirty-two people currently receive this service, and there are no vacant beds.
These homes are staffed with around the clock, awake staff.
Host Home – The Center currently serves sixty-seven people in Host Home (formerly
known as Foster Care.) One or two individuals live in a contract provider’s residence and
EXHIBIT 1
the contractor provides all of the daily living supports. The Center has fifty-six regular
contracts, and eight relief contracts.
Community First Choice – Personal Assistance Services and Habilitation (PAS/HAB)
services provide individualized supports and activities based on the individual’s desired
personal goals. Services are provided at the individual’s home and at community
locations. Supports include activities that foster and promote people’s ability to perform
functional living skills. Supports also include transportation to work and community
activities. Community support promotes participation in the community and activities
that help preserve the family unit and community placement. Forty-four people currently
receive this Medicaid funded service.
Texas Home Living (TxHmL)
This is a Medicaid waiver program funded with state and matching federal dollars which offers
the following services to enrolled individuals: adaptive aids, minor home modifications, dental,
audiology, dietary, nursing, specialized therapies, day habilitation, respite, employment
assistance or supported employment, and Community First Choice. Individual’s can live in their
own home or their family’s home. The Center currently has thirty-six individuals enrolled in
TxHmL.
Specialized Therapies
This service provides assessment and treatment by licensed or certified professionals in the areas
of: nursing, counseling, occupational therapy, physical therapy, speech and language therapy,
audiology, dietary and behavioral supports.
Behavioral Health (Psychiatric)
Individuals are provided evaluation and treatment options that may include medication,
monitoring, and clinical consultation by a qualified professional Seventy-one people receive this
service at the Morse Street clinic, and approximately thirty additional people receive this service
at the Denton and Lewisville outpatient clinics. This service is billed to private insurance,
Medicaid Card for individuals with Medicaid, or state General Revenue for individuals who do
not have Medicaid or insurance.
Day Habilitation
Day habilitation provides assistance with acquiring and improving self-help, socialization and
adaptive skills related to community living. Day habilitation is provided in a group setting on a
regularly scheduled basis and includes personal assistance for individuals who need help
managing their personal care needs. The Center currently serves (through contracts with ten Day
Habilitation providers in eleven locations) 76 individuals in HCS, 16 individuals in TxHmL, and
83 individuals in General Revenue.
Vocational Training
This service provides vocational skills training in a sheltered workshop in order to provide
individuals with work-oriented experiences. This service is only available to people funded with
state General Revenue. The Center is currently serving eight individuals in this service.
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Respite Services
This service provides either regular or crisis relief to the unpaid caregiver on a short-term basis
when the caregiver is temporarily unavailable. Respite is provided by trained staff and can occur
in the individual’s home or another location. The Center operates one home where Respite
services are provided. In 2018, 92 individuals were provided Respite services, eighteen of which
received in-home respite services.
Employment Assistance
Employment assistance helps individuals obtain paid, competitive employment in the
community. It includes helping identify employment preferences, job skills, and work
requirements. The Center is currently providing this service to two individuals. This service is
funded through HCS, TxHmL, or GR until the Texas Workforce Commission makes contact
with the individuals to open a case then funding is provided through the Texas Workforce
Commission.
Supported Employment
This service is provided to an individual who has paid competitive employment in the
community. It provides support to help sustain that employment. The Center is currently
providing this service to twenty-two individuals. This service is funded through HCS, TxHmL,
or GR until the Texas Workforce Commission makes contact with the individuals to open a case
then funding is provided through the Texas Workforce Commission.
Community Living Options Information Process
This service provides information to 449 people residing at the Denton State Supported Living
Center that enables them and their families to make informed decisions about living options
outside the State Supported Living Center. Each individual is assessed each year, and staff attend
their Annual Planning Conferences to present information and provide any requested resources.
The service is provided by Center staff for Denton County residents, and through Inter-local
Agreements with neighboring Centers in Dallas, Tarrant, and Collin Counties.
Crisis Intervention Services
IDD Crisis Intervention Services utilizes therapeutic and habilitative interventions to holistically
address the stressors for individuals that result in significant behavioral and psychiatric
challenges. The Crisis Intervention Specialist collaborates with Local Authority Staff and the
Transition Support Team to identify individuals with IDD who are experiencing crisis. The
Crisis Intervention Specialist provides education and training through the use of prevention and
stabilization strategies, such as coping techniques. The Crisis Intervention Specialists assists
individuals, caregivers, providers, and the community on how to manage potential crisis events,
as well as refer to appropriate service providers. In 2018, Crisis Intervention Services were
provided to 91 individuals.
Current Issues
The center has experienced a decrease in the transportation services rate. This service allows for
the center to provide transportation to individuals, many times transporting to community jobs,
dayhabs, and other integrated settings that could not be completed for these individuals without
this service. In 2017 a 20% reduction was applied to this service. This dropped rates by $4.68 per
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hour. Also at this time billing guidelines were updated to only allow billable time when the
individual was present in the vehicle. This cut automatically cut our billing by 50% in many
cases. Individuals within our center and community continue to rely on this service to maintain
community jobs and integration.
TxHmL continues to see extremely low billing rates and was deeply affected by the rate cuts in
transportation services. Additionally no TxHmL slots have been awarded to Denton County
within the past few years. TxHmL population continues to decrease and have become continually
more difficult to serve due to low rates and transportation cuts.
The Texas legislature has not funded any additional slots since August 2016. Applicants in
Denton County are placed on an interest list for waiver services. Individuals may be on this list
for well over a decade before receiving an HCS slot. Currently the wait list for Denton residents
is at 2,363. In August 2016 10 slots were released to Denton County residents. The last
significant release was in 2015 but mainly affected TxHml with 100+ slots released at that time.
In the fall of 2016 all slots were frozen for the next two years. Texas Legislature will consider
and vote on the potential release of 2,375 HCS slots statewide this January in the 86th
Legislative session. There is however no guarantee of these slots to be approved for release.
Respectfully Submitted:
Pam Gutierrez
Executive Director
Denton County MHMR