Hear from The Arc of Texas staff and Texans who have received Medicaid Home and Community Based Services about the reality of waiting on a waiver in Texas.
A Medicaid Home and Community Based Services (HCBS) waiver helps people with disabilities live and work in their community. In Texas, we offer 7 different waivers. 6 of these waivers are specific to individuals with disabilities. Waivers are an alternative to institutions, such as a nursing facility or intermediate care facility. A waiver can cover things that are almost NEVER covered by private insurance, like an attendant that helps someone get out of bed and get dressed, supports to help someone get or keep a job, or specialized interventions to help with someone’s behaviors in particular situations.
Because the demand far outweighs the resources made available by the legislature, Texans with IDD are placed on often decade-long interest lists until an appropriate HCBS waiver slot or opening becomes available. As of January 31, 2022, 170,000 Texans waiting on a waiver, and the Texas Legislature continues to lack the political will to do much about it.
What are HCBS Waivers?
Medicaid home and community-based services (HCBS) provide opportunities for people to receive cost-effective, long-term services and supports in their own home, rather than in an institutional setting, allowing them to live and work in their community.
HCBS waiver services can include, but are not limited to:
- personal assistance services
- in-home or out-of-home respite care
- home nursing services
- medical equipment and supplies
- assisted living
- employment supports
- cognitive rehabilitation
- occupational, physical and speech therapies
You Can Help
Investigative reporters at the Austin American Statesman are looking to connect with individuals who have been, or currently are, waiting on a waiver. Help us increase awareness of the importance and lacking availability of HCBS waivers by completing our 5 minute survey and helping us tell your story.
Sharing stories is one way to increase awareness and tell lawmakers and the community why all people with disabilities should have access to the services and supports when and where they need them.
Interest List: How To Apply
If you or your loved one would like to receive services and supports, you should start by contacting your Local IDD Authority (LIDDA). They can help you understand your options based on your individual circumstances and needs. Income, age, disability and urgency may all impact options.
You may go to https://www.yourtexasbenefits.com/Learn/Home
to apply for benefits of all kinds and determine what you may be eligible for (the LIDDA can assist you in filling out the form).
- To be added to MDCP MDCP, CLASS, and DBMD interest list: Call: 1-877-438-5658
- To be added to the HCS and TxHmL interest contact your LIDDA. To find out your local authority, visit: https://apps.hhs.texas.gov/contact/search.cfm
- To be added to STAR+PLUS interest list: Call: 877-782-6440
Please note that you must contact all of the above to be added to all of the lists. THERE IS NO ONE NUMBER TO CALL!
Texas has six waivers specific to people with disabilities, each one has its own interest list, eligibility requirements, and services offered.
- Community Living Assistance and Support Services (CLASS)
- Deaf Blind with Multiple Disabilities (DBMD)
- Home and Community-based Services (HCS)
- Medically Dependent Children Program (MDCP)
- Texas Home Living (TxHmL)
CLASS gives home and community-based supports to children and adults with related conditions. There are over 200 related conditions, like cerebral palsy and spina bifida. The related condition must have occurred before the child was age 22.
DBMD gives services for children and adults who are deaf-blind or have a related condition that leads to deaf-blindness, and who have another disability.
HCS gives services and supports to children and adults with an intellectual disability (ID) or a related condition who live with their families, in their own homes, or in small group homes with no more than 4 people.
MDCP gives services to children and adults who are 20 and younger who are medically fragile as an alternative to receiving services in a nursing facility.
STAR+PLUS gives services to adults over the age of 21 to keep them in their community and not in a nursing home facility.
TxHmL gives services to children and adults with an intellectual disability (ID) or a related condition who live in their own home or their family’s home.
Comprehensive Information On Each Waiver
What Are Waivers and How Do They Work?
Options for Receiving Texas Medicaid for an Individual with a Disability