Deaf Blind with Multiple Disabilities (DBMD)

Care Crusaders provide specialized home and community-based services as a cost-effective alternative to institutional care. Managed by the Texas Health and Human Services Commission (HHSC),  DBMD program is designed for individuals of all ages who are deaf-blind and have at least one other disability that impairs their ability to function independently. 

 

Key Services Provided

The DBMD program offers a wide range of supports tailored to help individuals remain in their own homes or small group settings: 

 

Specialized Support: Intervener services for communication and environmental access, orientation and mobility training, and behavioral support.

 

Direct Care: Nursing services, personal assistance, and respite care for family caregivers.

 

Therapies: Occupational, physical, speech, hearing, and language therapy.

 

Home & Equipment: Minor home modifications for accessibility, adaptive aids, and medical supplies.

Community Integration: Day habilitation, employment assistance, and supported employment. 

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Community Living Assistance and Support Services (CLASS) 

Care Crusaders Service work to ensure that individuals with disabilities have the resources and support they need to live independently. Our goal is to provide an alternative to institutionalization by fostering autonomy within your home and your local neighborhood.

Here is how we fulfill that mission:

 

We Support Our Clients

1. Promoting Daily Independence

Personal Assistance: We help with bathing, dressing, and grooming to maintain health and dignity.

• Habilitation: We don't just "do" for our clients; we teach. We assist with meal preparation, housekeeping, and money management to build independent living skills.

• Community Integration: We go beyond the front door, helping our clients navigate grocery stores, banks, and social gatherings so they remain active members of society.

 

2. Delivering Professional & Clinical Care

We coordinate and provide specialized services tailored to each person’s unique functional needs.

• Therapeutic Support: We facilitate physical, occupational, and speech therapies to help clients maintain or regain their mobility and communication skills.

• Nursing & Health Oversight: We manage medical needs that require professional clinical attention, ensuring our clients stay healthy at home.

• Behavioral Support: We develop and implement strategies to help individuals navigate emotional or behavioral challenges.

 

3. Managing the Environment

We ensure that a client's physical space and tools are working for them, not against them.

• Adaptive Aids: We provide and maintain the technology and equipment—like wheelchairs or specialized communication devices—that our clients rely on.

• Home Modifications: We oversee the installation of ramps, grab bars, and other modifications to make living spaces fully accessible.

We serve as the primary link between the individual and the complex healthcare system.

• Care Planning: We develop and constantly update the Individual Plan of Care (IPC) to ensure that as a client’s life changes, our services evolve with them.

• Caregiver Support: We provide Respite Care, stepping in to give family members a necessary break, which helps keep the primary support system strong.

• Advocacy: We stand by our clients to ensure their rights are protected and their voices are heard in every decision regarding their lives.

Ultimately, we believe that every individual deserves the right to self-determination. We provide the scaffolding that allows our clients to build a life of their own choosing.

As providers within the Texas Health and Human Services (HHS) ecosystem, we offer several specific programs designed to keep individuals in their homes rather than in nursing facilities. While these programs (PCS, PHC, CAS, and FC) share many of the same "allowable tasks," they differ primarily based on age, Medicaid eligibility, and medical necessity.

 

Personal Care Services (PCS)

This program is specifically for children and young adults (birth through age 20) who have a physical, cognitive, or behavioral limitation.

 

• The Focus: Assistance with ADLs, IADLs, and Health Maintenance Activities (HMAs).

• Core Services: Help with bathing, dressing, eating, and toileting. We also provide "cueing" or supervision for those who can physically do a task but need a reminder or guidance due to a cognitive condition.

• Settings: Unlike adult programs, we can provide PCS in various settings, including the home, school, or daycare.

 

Primary Home Care (PHC)

This is a Medicaid entitlement program for adults (21+) who already have full Medicaid coverage (usually through SSI).

 

• The Focus: Non-technical, medically related personal attendant services.

• Core Services:

  • Personal Care: Bathing, grooming, dressing, and assistance with self-administration of medication.

  • Home Management: Housecleaning, laundry, meal preparation, and grocery shopping.

  • Escort Services: Accompanying clients to medical appointments.

• The Medical Hook: To provide PHC, we require a Practitioner's Statement of Medical Need (PSMN) from a doctor.

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Community Attendant Services (CAS)

CAS provides almost identical services to PHC, but it is designed for individuals who do not automatically qualify for Medicaid through SSI.

 

• The Focus: Non-medical personal care for people who meet higher income/asset limits but still have a functional disability.

• Core Services: Exactly the same as PHC (Personal Care, Home Management, and Escort Services).

• Key Difference: We use this program to help those who are "Medicaid-eligible" based on their high medical costs or disability status but who aren't on standard welfare-based Medicaid.

 

Family Care (FC)

Family Care is our "non-Medicaid" option. It is funded by the state for individuals who have a functional need but do not qualify for Medicaid at all.

 

• The Focus: Non-skilled, non-technical attendant care for those with limited income who fall outside the Medicaid umbrella.

• Core Services: Attendant Care: Help with ADLs like bathing and dressing.

  • Housekeeping: Cleaning and laundry specifically for the client's living area.

  • Meal Prep: Cooking and feeding assistance.