Texas Medicaid Waivers: What Texas Health Steps Providers Need to Know

Texas Medicaid waiver programs for children with disabilities

The tabs shown below provide information about the Texas Medicaid waiver programs for children, including an overview of services and eligibility, contact information and a link to the HHSC website.

  • Community Living Assistance and Support Services (CLASS) Waiver

    Community Living Assistance and Support Services (CLASS) Waiver

    • CLASS supports individuals with an intellectual disability OR a related condition. A related condition is a disability, other than an intellectual disability, that originated before age 22 and that affects a person's ability to function in daily life.
    • More than 200 related conditions are listed on the Texas Approved Diagnostic Codes for Persons with Related Conditions, including cerebral palsy, spina bifida, muscular dystrophy, epilepsy and head injuries.
    • To be eligible for the CLASS waiver, individuals also must have substantial functional limitation in at least three of the following fields:
      • Learning
      • Mobility
      • Self-care
      • Language
      • Self-direction (age 10 and older)
      • Independent living (age 10 and older)
    • Services include adaptive aids; auditory enhancement/auditory integration training; behavior support; case management; cognitive rehabilitation therapy; dental services; dietary services; employment services; minor home modifications; nursing; occupational and physical therapy; personal assistance services; respite; speech and language therapy; transition assistance services and transportation. Services that are unique to the CLASS waiver include continued family services, support family services and many of the specialized therapies. If at least one CLASS program service is delivered through the consumer directed services (CDS) option, financial management services (FMS) and support consultation are also provided.
    • Individuals must live in their own home or their family’s home.
    • Eligibility is based on the child’s income.
    • Individuals receiving CLASS waiver services can remain on other waiver interest lists but cannot be enrolled in another Medicaid waiver unless they give up their CLASS waiver.
    • Request to be added to the CLASS waiver interest list by calling 877-438-5658 toll-free and asking for the CLASS waiver program.
  • Deaf Blind with Multiple Disabilities (DBMD) Waiver

    Deaf Blind with Multiple Disabilities (DBMD) Waiver

    • The DMBD program provides home and community-based services to individuals who are deafblind or function as a person with deafblindness with an additional disability as a cost-effective alternative to placement in an institution such as a nursing home or hospital. Deafblindness also includes those who have a related condition that leads to deafblindness.
    • Provides home and community-based services to individuals who are deafblind or function as a person with deafblindness with an additional disability as a cost-effective alternative to placement in an institution such as a nursing home or hospital. Deafblindness also includes those who have a related condition that leads to deafblindness.
    • Deafblind individuals must have another diagnosis to qualify—including but not limited to an intellectual disability—that originated when the individual was 22 years of age or younger. The disability must affect the individual's ability to function in daily life. The waiver refers to these disabilities as “related conditions.”
    • More than 200 related conditions are listed on the Texas Approved Diagnostic Codes for Persons with Related Conditions, including cerebral palsy, spina bifida, muscular dystrophy, epilepsy and head injuries.
    • To be eligible for the DBMD waiver, individuals also must have substantial functional limitation in at least three of the following fields:
      • Learning
      • Mobility
      • Self-care
      • Language
      • Self-direction (age 10 years and older)
      • Independent living (age 10 years and older)
    • Services include adaptive aids and medical supplies; assisted living; audiology; behavioral support services; case management; day habilitation; dental services; dietary services; employment services; minor home modifications; nursing; occupational and physical therapy; respite; and speech, hearing and language therapy services. Chore services, orientation and mobility services and intervener services, which are unique to DBMD, also may be provided. If at least one DBMD program service is delivered through the CDS option, FMS and support consultation are also provided.
    • Eligibility is based on the child’s income.
    • Individuals receiving DBMD waiver services can remain on other waiver interest lists but cannot be enrolled in another Medicaid waiver unless they give up DBMD waiver services.
    • Request to be added to the DBMD waiver interest list by calling 877-438-5658 toll-free and asking for the DBMD waiver program.
  • Home and Community-based Services (HCS) Waiver

    Home and Community-based Services (HCS) Waiver

    • The HCS program provides individualized services and supports to persons with intellectual disabilities who are living with their family, in their own home or in other community settings, such as small group homes.
    • Services include transition assistance services (TAS); physical therapy, including a pre-enrollment minor home modifications assessment; occupational therapy, including a pre-enrollment minor home modifications assessment; speech and language pathology; audiology; social work; behavioral support; dietary services; cognitive rehabilitation therapy; nursing provided by an RN or LVN; host home/companion care; supervised living; residential support; supported home living; respite; day habilitation; employment assistance; supported employment; adaptive aids; minor home modifications, including pre-enrollment minor home modifications; and dental treatment. If at least one HCS program service is delivered through the CDS option, FMS and support consultation are also provided.
    • Eligibility is based on the child’s income.
    • Individuals receiving HCS waiver services can remain on other waiver interest lists but cannot be enrolled in another Medicaid waiver.
    • Families can call 2-1-1 for information about eligibility or contact the Local Intellectual and Developmental Disability Authority (LIDDA). See the Appendix for LIDDA contact information.
  • Medically Dependent Children Program (MDCP) Waiver

    Medically Dependent Children Program (MDCP) Waiver

    • Provides services to support families caring for children and young adults ages 20 and younger who are medically dependent and to encourage de-institutionalization of children and young adults who reside in nursing facilities.
    • Services include adaptive aids; employment assistance; financial management services; flexible family support services; minor home modifications; respite; supported employment and transition assistance services through a STAR Kids or STAR Health managed care organization. If at least one MDCP program service is delivered through the CDS option, FMS and support consultation are also provided.
    • Eligibility is based on the child’s income.
    • Individuals receiving MDCP waiver services can remain on other waiver interest lists but cannot be enrolled in another Medicaid waiver.
    • Request to be added to the MDCP waiver interest list by calling 877-438-5658 toll-free and asking for the MDCP waiver program.
  • STAR+PLUS Home and Community Based Services (HCBS) Waiver

    STAR+PLUS Home and Community Based Services (HCBS) Waiver

    • A managed care model that provides services for adults 21 and older who are medically eligible for nursing home care but who want to live in their community. It is sometimes called the STAR+PLUS waiver.
    • Services include personal assistance services; respite care; home nursing services; home-delivered meals; minor home modifications; adaptive aids; medical equipment and supplies; adult foster care; assisted living; cognitive rehabilitation; and occupational, physical and speech-language therapy.
    • Individuals receiving STAR+PLUS HCBS waiver services can remain on other waiver interest lists but cannot be enrolled in another Medicaid waiver.
    • Call 877-782-6440 toll-free for information about eligibility. 
    • Request to be added to the STAR+PLUS HCBS waiver interest list by calling 800-964-2777 toll-free and asking for the MDCP waiver program.
  • Texas Home Living (TxHmL) Waiver

    Texas Home Living (TxHmL) Waiver

    • TxHmL provides selected essential services and supports to people with intellectual and developmental disabilities who live in their family homes or their own homes.
    • Services include day habilitation; respite; supported employment; adaptive aids; behavioral support; community support; employment assistance; minor home modifications; nursing; dental treatment; occupational therapy; physical therapy; and speech/language pathology services; audiology services; and dietary services. If at least one TxHmL program service is delivered through the CDS option, FMS and support consultation are provided.
    • Parents’ income is considered in determining a child’s eligibility, as well as the child’s income. The family must be eligible for Texas Medicaid for the child to be considered for the waiver program.
    • Individuals receiving TxHmL waiver services can remain on other waiver interest lists but cannot be enrolled in another Medicaid waiver.
    • Families can 2-1-1 for information about eligibility or contact the Local Intellectual and Developmental Disability Authority (LIDDA). See the Appendix for LIDDA contact information.
  • Youth Empowerment Services (YES) Waiver

    Youth Empowerment Services (YES) Waiver

    • Provides home and community services to children ages 3 through 18 years who otherwise would need psychiatric inpatient care or whose parents would turn to state custody for care.
    • Services include adaptive aids and supports; community living supports (CLS); employment assistance; family supports; respite; supported employment; non-medical transportation; paraprofessional services and specialized therapies.
    • Nontraditional services provide alternative and creative forms of therapy to help improve the youth’s health, welfare and functioning in their community:
      • Animal-assisted therapy
      • Art therapy
      • Music therapy
      • Recreational therapy
      • Nutritional counseling
    • Services are provided within a team planning process called wraparound. Wraparound builds on family and community support and uses YES services to help build the family’s natural support network and connection with their community.
    • YES is not a first stop for meeting serious mental, emotional and behavioral health needs. Eligibility requires that children have tried less intensive mental health services.
    • Average length of time in the YES waiver is 11 to 18 months. A child’s needs determine program duration.
    • YES Waiver does not have a statewide interest list at this time. Slots are allocated based on data indicating need for each geographic area.
    • Eligibility is based on the child’s income.
    • For eligibility information, call the YES waiver inquiry line at your Local Mental Health Authority (LMHA) or Local Behavioral Health Authority (LBHA). Each LMHA and LBHA has a designated phone number for inquiries about YES enrollment. See link in the Appendix.

Note: See the Appendix of Resources for Health-Care Providers at the end of this course for links to fact sheets about some of these Texas Medicaid waiver programs.