Home and Community-Based Services (HCS)
HCS is a Medicaid waiver program that supplies services and supports to Texans with an intellectual developmental disability (IDD) or a related condition so that they can live in the community. HCS services are intended to supplement rather than replace services received from other programs, such as Texas Health Steps, or from natural supports, including families, neighbors or community organizations.
HCS may be available to any Texas resident not living in an institutional setting who:
- Has an IQ of 69 or below or has an approved related condition with an IQ of 75 or below.
- Has mild to severe deficits in adaptive behavior.
- Is eligible for Medicaid benefits.
- Is not enrolled in any other Medicaid waiver program.
Residential services Options
- Supervised Living (Group home)
- Host home/ companion care
- Supported Home Living
- Respite services
Professional Services
- Nursing services
- Dental services
- Behavioral support
- Social work
- Occupational therapy
- Physical therapy
- Speech therapy
- Dietary services
- Audiology services
- Cognitive rehabilitation services (services for people with brain injury)
Additional Services
- Day habilitation
- Employment services
- Transportation
- Minor Home Modifications
- Adaptive aids
- Transition assistance services
- Consumer Directed Services (CDS)
Through CDS, individuals who live in their own home or family home can self-direct certain services and will assume and retain responsibility to:
- Recruit their service providers.
- Conduct criminal history checks.
- Determine the competency of service providers.
- Hire, train, manage and fire their service providers.
The following services are available through the CDS option:
- Employment assistance
- Financial management services
- Nursing services
- Respite care (in- and out- of-home)
- Supported home living (transportation)
- Support consultation
- Supported employment
- Cognitive rehabilitation therapy
- Community First Choice (CFC)/Personal Assistance Services /Habilitation
- Individuals who use the CDS option must select a financial management services agency (FMSA) that will provide training, pay the service providers, pay federal and state employer taxes, and conduct criminal history checks.
The HCS provider can provide personal assistance services, habilitation or emergency response services through the Community First Choice (CFC) program to individuals who live in their own home or family home. Individuals can also receive unlimited prescriptions through the Medicaid Vendor Drug Program.
Those interested in receiving HCS services are placed on an interest list by contacting the local intellectual and developmental disability authority (LIDDA) that serves the county in which they live. Find the LIDDA that serves your area at https://apps.hhs.texas.gov/contact/la.cfm. An offer of the HCS program depends on individual need,one’s date of placement on the interest list and the availability of funding for the program. Once HHSC approves an offer for HCS, the LIDDA serving a local service area will assist with the application process, as well as coordinate the enrollment and ongoing services.
Home and Community-Based Services-Adult Mental Health (HCBS-AMH)
The Home and Community-Based Services – Adult Mental Health (HCBS-AMH) program is designed to increase available support services for adults with Serious Mental Illness (SMI) and a history of long-term psychiatric hospitalization, frequent arrests, or frequent hospital emergency room use. HCBS-AMH uses a person- centered recovery planning approach to provide services designed to enable individuals diagnosed with SMI to live independently in the community.
- 18 or older with a diagnosis of a serious mental illness
- Not enrolled in:
– Long-term Services and Supports (LTSS);
– Community Living Assistance and Support Services (CLASS);
– Deaf Blind with Multiple Disabilities (DBMD);
– Home and Community-based Services Waiver (HCS), or
– Texas Home Living Waiver (TxHmL), or
– STAR+PLUS HCBS Waiver
- Have income that does not exceed 150% of the Federal Poverty Line
LONG-TERM PSYCH. HOSPITALIZATION
- Resided 3 or more years (cumulatively) in an inpatient psychiatric hospital
- Medicaid eligible
JAIL DIVERSION
- 4 or more arrests and 2 or more psychiatric crises during the 3 years prior to referral
- Active Medicaid benefit
EMERGENCY ROOM DIVERSION
- 15 or more Emergency Room visits and 2 or psychiatric crises during the 3 years prior to referral
- Active Medicaid benefit
Residential Options
- Host Home/Companion Care
- Supervised Living Services
- Assisted Living
- Supported Home Living
- Respite Care
Professional Services
- Registered Nursing
- HCBS-AMH Psychosocial Rehabilitation Services
- Community Psychiatric Supports and Treatment
- Substance Use Disorder Services
Additional Services
- Peer Support
- Home-Delivered Meals
- Transportation
- Supported Employment
- Employment Assistance
- Transition Assistance
- Flexible Funds
- Minor Home Modification
- Adaptive Aids
Those interested in receiving HCBS-AMH services can apply and/or enroll by contacting the local mental health authority (LMHA) that serves the county in which they live. Find the LMHA that serves your area or call the HCBS-AMH Inquiry Line (PDF) in the community to begin the application process or if you are in a state hospital, ask your social worker for more information. For more information on the referral and enrollment process, email HCBS-AMH Enrollment and Referral at HCBS-AMH-enrollmentandreferral@hhsc.state.tx.us. An offer of the HCBS-AMH program depends on individual needs, the availability of funding for the program and whether eligibility criteria is met.
The Texas Health and Human Services Commission (HHSC) contracts with public and private entities to provide HCS services. HHSC regularly monitors these providers to ensure quality of services. When enrolling in the HCS or HCBS-AMH program, applicants choose their provider from a list of available providers in their area. Individuals are able to change providers at any time, even if they move to another area of Texas.
