What is the YES Waiver?
The YES Waiver is a 1915 © Medicaid program that allows for more flexibility in the funding of intensive community based services for children and adolescents with severe emotional disturbance and their families.
Who is Eligible for YES Waiver Services?
To participate in the YES Waiver, the child or adolescent must meet the following eligibility criteria:
- Be between the ages of 3-18 years;
- Reside in Travis or Bexar County;
- Reside in a non-institutional setting with the child or adolescent’s Legally Authorized Representative (LAR); or in the child or adolescent’s own home or apartment, if legally emancipated;
- Be eligible for Medicaid, under a Medicaid Eligibility Group included in the approved waiver; Parental income is not counted in financial eligibility;
- Choose, or have the LAR choose, the Waiver program services as an alternative to care in an inpatient psychiatric facility;
- Meets Deptartment State Health Services (DSHS) clinical criteria (including, but not limited to risk of self-harm, risk of severe disruptive or aggressive behavior, family resources, and risk of school behavior); and
- There must be a reasonable expectation that, without Waiver services, the child or adolescent would qualify for inpatient care under the Texas Medicaid inpatient psychiatric admission guidelines
What are the YES Waiver Services?
The following services are provided under the YES Waiver:
- Community Living Supports
- Family Supports
- Transitional Services
- Adaptive Aids and Supports
- Minor Home Modifications
- Non-Medical Transportation
- Paraprofessional Services
- Professional Services
- Supportive Family Based Alternatives
How do I Access Yes Waiver Services?
Families or the Legal Authorized Representative of an eligible child or youth who are interested in referring their child to the YES Waiver Services Program must first contact ATCIC’s YES Waiver Interest List Message Line at 512-804-3191 or e-mail YES@atcic.org. ATCIC maintains an Interest List for individuals interested in receiving YES Waiver services.
The YES Waiver has a limit on the number of children and youth who can be served in Travis County.
There is a first come first serve policy for YES Waiver services. The policy is based on the chronological date of registration on the YES Waiver Interest List.
Families or LARs can also access information on the YES Waiver Services by clicking on ATCIC’s webpage at IntegralCare.org.
What is the Fair Hearing Process?
During the intake process, the Local Mental Health Authority (LMHA) will inform the child or adolescents and LAR of the child or adolescent’s right to a Fair Hearing. If the child or adolescent or LAR needs any assistance with the fair hearing process, the LMHA will provide assistance.
If an individual is denied participation in the YES Waiver, unless the reason for the denial is the program participation limit; or if an individual is denied continued participation in the YES Waiver; or if YES Waiver services for an individual are denied, reduced, suspended, or terminated, the individual is entitled to a fair hearing in accordance with Texas Administrative Code.