Category Archives: AyS Blog

Annual Report 2014


January 22, 2015



The Texas Administrative Code requires that we conduct Satisfaction Surveys at least annually. AyS conducts these on a quarterly basis so we can identify any dissatisfaction trends early and address them immediately. Over the last year, the satisfaction surveys returned, our consumers have marked them as “Satisfied” or “Very Satisfied.” We’d like to take this opportunity to remind you that if you have a complaint, you are always welcome to reach out to us to voice that compliant, concern or suggestion.



The Texas Administrative Code requires that we evaluate the complaints lodged during the year and also evaluate the policies that have been implemented to determine if they are successfully decreasing the number of complaints. Over the past year, no formal complaints were presented.



11/14/2014 – Emotional & Verbal Abuse –The case was referred back to the provider for administrative follow up.

10/24/2014 – Neglect – The case was returned as unconfirmed.

10/21/2014 – Unknown type of abuse – The case was referred back to the provider for administrative follow up.

02/05/2014 – Medical Neglect – The case was returned as unconfirmed.


Annual Termination of Services

The Texas Administrative Code requires that we review any termination of services over the last year. Termination of services is when a client leaves the HCS or TxHmL program all together. Over the last year the following termination and reasons for termination were reported.

3 terminations due to death


Aggregate Restraint Data

The Texas Administrative Code requires that we compare aggregate restraint data with statewide data. The state data is as follows.

  • Rate of Emergency Personal Restraint – .108
  • Rate of Emergency Mechanical Restraint – .003
  • Rate of Emergency Psychoactive Medication Restraint – .069

To calculate the AyS data, we have taken the number of restraints reported and divided it by 144, the average number of clients served throughout the year. It is difficult to assess the AyS average. In January 2014, AyS was serving approximately 99 clients. By the end of 2014, we were serving 189 clients. The number 144 is a fair guess in terms of average number of people served in 2014.

The AyS data is as follows.

  • Rate of Emergency Personal Restraint – .00
  • Rate of Emergency Mechanical Restraint – .00
  • Rate of Emergency Psychoactive Medication Restraint – .38

Confessions of a teenage bride

beka2The moment I got engaged I had no idea what I was in for. So young and getting married? I had no clue so many people frowned upon what I thought was such a beautiful thing. When people found out they were shocked. People had asked me “How do you know he’s the one? You are so young & honestly, you don’t really have the ability to understand what love is yet…” or “Or “Are you sure you’re ready to spend your life with this one person… forever?” I’ve heard so many things because of this ideal life everyone has branded in their heads. First you graduate high school. Then you go to college. Once you finish college you get this amazing career and make lots of money. Then when your settled in you find the love of your life and it’s then you can have your happily ever after.

Well some have different stories. Like me for instants.17 turning 18 and already engaged. I had so much on my plate already. Why would I want to add such a big commitment like getting married? Well, I will tell you.

When Angel came in to my life I knew god had answered my prayers. He put Angel in my life when I thought life couldn’t get any worse. Angel always made my day better. No matter how crazy it was. He would drive 4hrs from Robstown and surprise me all the way in Houston… He would take me away and make me forget about everything bad in life. He treated me like a princess. No guy had ever treated me the way he did. He was such a gentleman. & from then on he stole my heart.

3 years went by and we were still together. People had always doubted us from the beginning because of our age. But we knew we were doing the right thing by being together. It just felt so right.

When we got engaged and I heard all these negative things… It crushed me. It was coming from the people who I cared for the most. Angel realized it was hurting me so he came up with this saying, “It’s us against the world, through the good and bad always know I will be here.” He made everything so much easier with his good vibes and amazing heart.

After I graduated High school in December 2012 I had planned to move to Robstown with Angel. But one of my passions was caring for people. So I decided to stay in Houston and continue with a program to become a CNA. Months after I graduated from the program, I got to finally move in with my love!

beka1It was the most exciting, scary, heart wrenching couple of weeks of packing. April 12th 2013 was the day my parents were dreading. I was finally moving out. Angel helped and drove the U-Haul, so I could drive my car with my pup Bella. I gave my parents the biggest hug and kiss on cheek they probably ever got from me. I felt like I was finally really happy. Months past and we were getting ready for our big day. We had decided we wanted to get married December 14th 2013 at St. Anthony’s Catholic Church and the reception would be at an amazing venue on a ranch. So I got a job as a CNA. We had no clue what we were getting ourselves in to. Getting married was so much work…. And so much money!! We struggled and fought about the details of the wedding until Angel told me” I don’t want to fight over what’s supposed to be the best day of our lives, just do what you like and run it by me “ This made it so much easier on everything. We were so stressed out over this one day. We got to see sides of each other we had never seen before. And on top of all our pay checks were going straight to the wedding.

Months and Months of fighting, crying and excitement went by so fast! Before we could blink our eyes the day of our wedding was finally here. As soon as I woke up the problems started! The limo company was giving me a hard time and was late because of some issues. I got something on my dress and I was so nervous and excited I couldn’t control my emotions. The day was here and I had lost my cool!

As soon as the big church doors swooshed open and I saw my handsome soon to be husband standing at the alter waiting for me all the problems disappeared. As my parents were walking me down the aisle all the memories rushed my mind. On how hard we worked to get where we were, and of how beautiful this all turned out. Family and friends gathered in the benches with their watery eyes just smiling in joy for us. I couldn’t pull my eyes away from angel. His facial expression was priceless, I will never ever forget that moment.

The church flew by and it was such an amazing mass. We were finally husband and wife!! It was seriously the best day of my life. I walked in the church Rebeka Mayville fighter, complainer and struggling with all this craziness and then I walked out Rebeka Gonzalez kind, selfless wife of an extraordinary man. I changed my ways for my husband.

And to all the questions I didn’t answer then about “How do you know he’s the one?” And “Why would you want to get married already, you are so young?” My answers then and now that I have been married for a while. I knew angel was the one because god sent him to me and I believe in his awesome works. I also could see an amazing future with Angel. When you meet that special someone… you just know.

And to all the negativity on” I am too young to know what love is” or that” we didn’t know what we were doing” here is a nice heads up. Not everyone lives the same life. And when you see someone’s life that is different you shouldn’t bash them for it just because it’s different from yours. Love is god’s creation and we were brave enough to accept it -even when people didn’t.

beka3Everything was all so worth it. I would do this all over again because this whole experience has made me so selfless and more proud of what my husband and I have become through the most difficult times. I am happy to say that I married my best friend at 19 years old. Every morning I wake up to this amazing smile and every night I get to fall asleep in his comforting arms. My praying buddy and my world. I wouldn’t want it any other way. I can’t wait for what god has in store for us in the future. Babies? A cute little house? Who knows. But one thing I do know is that with you by my side we can get through anything. I love you my handsome husband of mine and I promise I will be the best wife I can be.

Rebeka Mayville

Down Syndrome Awareness Month

October is Down Syndrome Awareness Month

Down Syndrome is a disorder arising from a chromosome defect, ausing intellectual impairment and physical abnormailities including short stature and broad facial profile. It arises from a defect involving chromosome 21, usually an extra copy of this chromosome. Each year approximately 5,000 children are born with Down Syndrome. It affects approximately 350,00 people.

There are a number of organizations that advocate for persons diagnosed with Down Syndrome.

The National Down Syndrome Society –

The National Association for Down Syndrome –

Down Syndrome Guild of Dallas –

The Down Syndrome Association of Central Texas –

Please visit their websites for additional facts and statistics.

Since its inception, Ahora y Siempre, Inc (AyS) has had the pleasure of working for individuals with Down Syndrome. From personal experience we can say that people with Down Syndrome are some of the sweetest people you will meet. They are caring, they are smart andmost importantly they are loving.

Take time this month to show your appreciation to someone with Down Syndrome.

Because of Katie…

“Because of Katie” | Children With Severe Disabilities Can Live at Home
By Marie Myung-Ok Lee, June 6, 2012, 10:17 AM

Katie Beckett died last month at age 34. Most Americans don’t know who she is. But as a parent of a child with disabilities, her name is as familiar as my own child’s. Because of the legislation that bears her name, hundreds of thousands of children, including my own, are able to be at home with their families instead of being institutionalized.

At 5 months of age, encephalitis left Katie Beckett spending most of her early years in the hospital. When she was 3, doctors cleared her to go home with proper supports — she still needed to be on a respirator 12 hours a day. Her insurance had been exhausted, and Medicaid refused to pay for her care unless it was done in the hospital — even though treatment could be administered at home at one-sixth the cost.

Katie Beckett’s mother tirelessly advocated, and in 1981 succeeded, in bringing Katie’s plight to the attention of President Ronald Reagan. Reagan acknowledged the illogic of “hidebound regulations” and waived the rule so Katie could go home. The following year, Reagan signed what became known as the “Katie Beckett Waiver” so all disabled children could receive Medicaid supports.

For our family, with a son with autism and other complex medical issues, the Katie Beckett Waiver literally keeps our family intact. In earlier generations, children with the level of disabilities our son has were often institutionalized as a matter of course, the conventional wisdom being that they were too difficult to manage at home. It is difficult to manage — our son, at 12, is still in diapers, for example — but with the supports he receives, including home-based behavioral therapy as well as “respite” hours where he is taken care of by a trained caregiver so that my husband and I can attend to other things, we can do it.

For us, home-based care helps to create community. In his first years, our son, like Katie, was hospitalized for an acute medical condition. We became close to many of his nurses, but it was a relationship that ended abruptly when we left the hospital. But because we now bring the caregivers into our home, this setting engenders a different kind of relationship.

Our current caregiver, Kelly, has worked with our son for so long that she has not only absorbed the rhythms and routines of our family, she’s become a part of it. When my husband had a medical emergency last month, our friends were over in a flash to watch our son while I accompanied my husband in the ambulance. In my panic, I forgot to put on shoes, but the one thing I did before speeding off was try to call Kelly. I couldn’t reach her — the vagaries of mobile reception quickly disconnected us — but even receiving this incomplete call, she somehow sensed something was amiss and left her day job to rush to the house.

Our son was still screaming, hitting himself and others, traumatized by the noise and commotion, and she calmed him down. While our friends organized a rotating pool of people to stay in the house, Kelly oversaw our son’s care, directing our friends by phone until she was done with work and could come back to stay with him — for two nights. In all this, she even managed to stop by the hospital to bring me a jacket and shoes.

One of the deepest fears I have is what would happen if my husband or I become incapacitated. We don’t have family nearby, and it was heartening to see our “takes-a-village” friends pitching in — including Kelly. At that time, she acted as a friend and a quasi-mother to our son and not as a paid caregiver. But it’s because of the Katie Beckett program that she came into our son’s life and has been able to do so for so long.

In this time of rancorous partisan debate over healthcare, perhaps a minute of silence should be taken in Katie Beckett’s memory before each session of Congress to remember how she and her determined mother captured the ear of a president, one who didn’t think in terms of “Can we make such a drastic change to Medicaid?” or “Is this socialist?” and only saw the tragedy of keeping a child separated from her family and at huge cost to taxpayers — and he fixed it with a swipe of a pen. The girl who doctors had predicted wouldn’t live past 10 then lived at home to graduate college, hold a job and write a novel as well as join her mother in the fight for disability rights.

Life with a child with disabilities is still exhausting, and there are days when my husband and I wonder if we can manage. But we have our hours when Kelly or Tasha comes in for our son’s therapy or to give my husband and me a few hours to do the grocery shopping or even a dinner out. Then we can come back to our son refreshed.

We’ve spent a lot of time teaching him to ride a two-wheel bicycle, and he’s finally gotten it. In this warm weather, we’ve had some fantastic rides on the bike paths near our house. And, after years of weekly visits to my friend Anne’s farm, our son has begun to overcome a severe fear of animals and made perhaps his first friend, a water buffalo calf. Just the picture of him smiling as he makes a few silly attempts to pat the calf’s head, or watching him pedal his bike with such determination, reminds me again of my gratitude to Katie Beckett, her mother, and Ronald Reagan: because of them, we have not missed these moments. In the years since the Katie Beckett Waiver came into effect, a half a million families just like us have had the challenges and the privilege of caring for our children at home.