Mrs. Lewin and Dr. Thomas began their careers as direct service professionals (DSP) in 1986. They met in 1990 when both worked at the newly acquired Home and Community-Based Services (HCS) program at Harris County MHMRA now known as The Harris Center. Mrs. Lewin was hired as the first case manager for the HCS program. Several months later, Dr. Thomas was promoted to case manager. In 1992 while working at MHMRA, Mrs. Lewin and Dr. Thomas incorporated their first company Quality Care Community Services at the urging of State Texas Department of MHMRA, now known as HHSC, auditors who admired their grasp and implementation of the complex Texas Administrative Code HCS Principles and the Medicaid Billing rules. Mrs. Lewin and Dr. Thomas went on to work with private providers as both consultants and employees, including program direction, quality assurance and case management. In 2001, Mrs. Lewin and Dr. Thomas decided to leave consultation and their work with private providers to form their own HCS program, Thomas & Lewin Associates, Inc. The company also holds an Day Activity Health Services (DAHS)- Individualized Skills and Socialization (ISS) program license.