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Metrocare has been caring for people for 50 years.

1.9 million Texans live with a serious and persistent mental illness

6.4 million Texans have a mental illness and would benefit from treatment

Last year, nearly 50,000 adults received services from Metrocare

Last year, 15,000 children received care from Metrocare

70% to 80% of parents with a child with autism will get divorced

40% of children with autism do not talk at all

Autism impacts more children than childhood cancer, juvenile diabetes, Down syndrome, and cystic fibrosis combined

Early diagnosis and intervention of an individual with autism can reduce the lifetime support costs by 66%

Screening Checklist

Blank Provider Screening Checklist

Provider Name:
Address:
Phone Number:

1. What is your organization’s Mission Statement or Philosophy?

2. Why did you or your organization decide to serve individuals with Mental Retardation/ Developmental Disabilities?

3. How long have you and/or your organization been serving persons with Mental Retardation/ Developmental Disabilities?

4. How many consumers does your HCS program serve, at the present time, and what is your capacity?

5. Do you have a reference list of families that I could talk to, regarding the services your organization has provided to their family member? (Yes / No)

6. What type and/or length of experience do your staff members have serving individuals with Mental Retardation; special problems, i.e., MH, PDD, or Autism? Could you provide records of training your staff has received, specific to various disabilities and/or conditions?

7. Tell me about the level of training, experience, and credentialing for staff providing services to consumers.

8. Describe ways in which you involve the consumers/family/guardian in the development of the consumer’s program. How do you incorporate the family’s wants for their family member when they are different from what the agency wants?

9. Does your agency have more experienced and professional staff that model for new staff or provide mentoring?

10. What procedures will staff implement in a crisis situation? Does your agency train staff in PMAB or Non-Violent Crisis Intervention? Explain.

11. How does your agency develop Behavioral Support Plans? Does a Human Rights Committee or psychiatrist approve plans? If a Human Rights Committee reviews plans, is the Committee made up of outside members, professionals, parents, and consumers?

12. What are your policies regarding visitors?

13. What are your policies regarding privacy?

14. What type of leisure/recreational activities will be available? Does my family member choose their daily routine?

15. What type of transportation does your company provide?

16. How many vehicles do you have? Is there a vehicle for each home?

17. How do you accommodate non-ambulatory individuals?

18. Do you have staff that speaks other languages? If not, will you have an interpreter available?

19. How do you accommodate non-verbal individuals? Is staff trained in sign language, use of picture schedules, picture books, and augmentative communication devices, such as The Canon, The Touch Talker or The Liberator?

20. What provision will your company make for my family member to attend the religious services of their choice?

21. What is your staff to consumer ratio?

22. What are your emergency back-up procedures, when there is a crisis or the home is short-staffed?

23. Is the staff available to support my family member in additional activities in the community? (i.e., Girl Scouts, religious activities, sports teams, etc.)?

24. How and where will my family member be cared for when he or she is ill?

25. Do you have medical staff on site or on call, for medical issues? Are medical staff willing to practice/rehearse with my family member what to expect, when going to the doctor or hospital?

26. What choices will my family member have concerning day programming, vocational training, supported employment, etc.?

27. Describe how staff trains consumers in daily living skills. Please share with me documentation or how this is reflected.

28. What geographical locations do you serve?

29. Will my home be located in close proximity to my school/ day program/ place of employment?

30. How does your agency build community awareness about persons with disabilities moving into their neighborhood? How does your agency resolve concerns?

31. Describe your complaint process.

32. Do you lease or own your residential homes? Do you have short-term or long-term leases?

33. What screening do you require when staff is hired (drug screen, criminal background check, abuse/neglect)?

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