2003 Research and Demonstration Grants — Money Follows the Person Rebalancing Initiative

TEXAS

Grant Information

Name of Grantee
Texas Department of Human Services
Title of Grant
Promoting Independence
Type of Grant
Money Follows the Person Rebalancing Initiative
Amount of Grant
$730,422
Year Original Funding Received
2003

Contact Information

Cindy Kenneally, Director
512–438–4151
cindy.kenneally@dhs.state.tx.us

Lily Vela, Project Coordinator
Community Care Provider Services
701 West 51st Street
PO Box 149030, Mailcode W-521
Austin, TX 78714
512–438–2489
lilia.vela@dhs.state.tx.us


Subcontractor(s)

To be determined by an RFP process in first year of the grant.

Target Population(s)

Individuals of all ages residing in nursing homes who want to live in the community.

Goals

Activities

Abstract

The purpose of this grant is to create a local system in each community that will allow the Texas Department of Human Services (DHS) to more efficiently and effectively help clients transition from nursing homes to the community.

The DHS San Antonio Region has established a voluntary workgroup of caseworkers, advocates, other agency personnel, local government employees, profit and nonprofit organizations, home health providers, housing authority representatives, and others to look at each individual requesting transition from the nursing facility to the community. The workgroup looks at individual needs, establishes transition plans based upon those needs, offers technical assistance to group members and clients, secures resources, and transitions individuals to the community.

A first step in replicating this model throughout the state is to educate DHS staff, consumers, advocates, and other stakeholders about the range of community care options available through DHS. Greater knowledge of the options available to enable people to live in the community will help transition individuals from nursing homes. The second step is to establish workgroups in the other 10 regions of the state.

Measurable outcomes include increased knowledge of community long-term care options available thorough DHS, community care coordination workgroups at the local level, and increased local resources to ensure a smooth transition and continued community supports.