Medically Dependent Children Program (MDCP)

Service Description
The Medically Dependent Children Program (MDCP) provides a variety of services to support families caring for children who are medically dependent, and to encourage de-institutionalization of children in nursing facilities.

Funding Source
Title XIX (Medicaid 1915(c) Home and Community-Based Services Waiver), and State Funds

Covered Services
Adaptive Aids are:

• necessary to treat, rehabilitate, prevent or compensate for conditions resulting in disability or loss of function; or
• devices that enable you to perform the activities of daily living or control the environment in which you live.

Adjunct Support Services - are individualized and disability-related services that include personal care supports for basic activities of daily living (ADL) and instrumental ADL, skilled care and delegated skilled care supports to:

• assist an individual to participate in child care;
• assist an individual to participate in post-secondary education; or
• increase the individual’s independence.

Minor Home Modification – a physical modification to a consumer's home necessary to prevent institutionalization or support de-institutionalization and is necessary to ensure the health, welfare, and safety of the individual or to enable the individual to function with greater independence in his home.

Financial Management Services – services delivered by the Consumer Directed Service (CDS) agency to an individual or Legally Authorized Representative (LAR) accessing the CDS option. The CDS agency provides services such as orientation, training, support, assistance with, and approval of budgets, and processing payroll and payables on behalf of the employer. In the CDS option, an individual or LAR employs and retains service providers and directs the delivery of program services.Access and Intake Services Community Options Rev. 11-03-2011 48

Respite –provides the primary caregiver(s) temporary relief from care during times when the caregiver would normally provide the care.

Transition Assistance Services (TAS) – a one-time service provided to Medicaid eligible Texas nursing facility residents to assist in transitions from the nursing facility into the community.

* This service is available using the Consumer Directed Services (CDS) option. The CDS option allows participants who live in their own private residences or the home of a family member to choose to self-direct certain services. By choosing to self-direct these services, participants will assume and retain responsibility to:

•recruit their service providers;

•conduct criminal history checks;

•determine the competency of service providers; and

•hire, train, manage, and fire their service providers.

Consumer Eligibility

• Age: Under 21 years of age
• Residence: Live in Texas
• Citizenship: A citizen of the United States or an alien with approved status.
• Financial Eligibility: Must be Medicaid eligible as:
  • low income families with children as provided in §1931 of the Social Security Act;
  • recipients of Supplemental Security Income (SSI);
  • Medical Assistance Only (MAO); or
  • all other mandatory and optional TANF-related groups in the Texas Medicaid State Plan.

• Disability: A person meets the disability criteria if the person receives disability benefits from:
  • Supplemental Security Income;
  • federal old-age, survivors, and disability insurance; or
  • railroad retirement; or
  • has a disability determination by HHSC.

• Medical Necessity: Meet the medical necessity determination for nursing facility care.
• Approved Living Arrangements: If under age18, the individual must reside:
  • with a family member such as a parent, guardian, grandparent, or sibling; or
  • With a foster family that includes no more than four children unrelated to the individual.

• Individual Plan of Care (IPC): The IPC is developed with the consumer and the primary caregiver(s) during the initial eligibility determination and during the annual reassessment process.

Service Maximum

• Cost Limit: The cost limit is 50 percent of the reimbursement rate that would have been paid for that same individual to receive services in a nursing facility.
• RUG: The Resource Utilization Group (RUG) is calculated based on the Medical Necessity (MN) and Level of Care (LOC) assessment, and is used to determine cost limits for MDCP participants.

Provider Base

• Respite Providers
• Adjunct Support Services Providers
• Adaptive Aids Providers
• Minor Home Modification Providers
• Transition Assistance Services Providers
• Financial Management Services Providers

Service Availability
Statewide