Texas Medicaid Waivers & Home and Community Based Programs Overview
- Waiver Policy Analyst
- Sep 30, 2024
- 2 min read
Texas, known as The Lone Star State, has a robust Medicaid Waiver and Home and Community-Based Services (HCBS) system designed to provide long-term care alternatives for seniors, individuals with disabilities, and those with chronic health conditions.
Administered by the Texas Health and Human Services Commission (HHSC) in coordination with Texas Medicaid & Healthcare Partnership (TMHP) and Local Intellectual and Developmental Disability Authorities (LIDDAs), the state’s Medicaid waiver programs allow eligible individuals to receive services in their homes or community settings rather than institutional care.
Key waiver programs include the STAR+PLUS Home and Community-Based Services (HCBS) Waiver, which provides personal care, respite, and home modifications for seniors and adults with physical disabilities, and the Home and Community-Based Services (HCS) Waiver, which offers residential, employment, and behavioral health support for individuals with intellectual and developmental disabilities (IDD).
Other major programs include the Community Living Assistance and Support Services (CLASS) Waiver, the Deaf-Blind with Multiple Disabilities (DBMD) Waiver, the Texas Home Living (TxHmL) Waiver, and the Medically Dependent Children’s Program (MDCP) Waiver, all of which provide specialized, person-centered services. Texas also offers Consumer-Directed Services (CDS), allowing waiver participants more flexibility in choosing and managing their caregivers.
Regulatory oversight in Texas is managed through HHSC, TMHP, and LIDDAs, with additional provider licensing and compliance enforcement handled by the Texas Department of State Health Services (DSHS) and the Regulatory Services Division of HHSC. The state operates under a Managed Care model, with HCBS services integrated through Texas Medicaid’s STAR+PLUS Managed Care Organizations (MCOs) to enhance service coordination and cost-effectiveness.
Texas has also implemented Electronic Visit Verification (EVV) for personal care services, ensuring greater accountability in home-based care programs. Providers must navigate Medicaid enrollment, waiver-specific service authorizations, and stringent quality assurance measures to participate successfully in the state’s HCBS programs.
With a strong emphasis on self-determination, rural healthcare access, and person-centered service delivery, Texas’ Medicaid waiver system ensures that individuals receive high-quality, sustainable long-term care while maintaining independence, dignity, and full participation in their communities.
Explore Policy and Procedure manual for licensing and certification for your state Medicaid Waiver and HCBS programs here.
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