Medicaid Waiver Programs

Texas Medicaid Waiver Programs & Other Long-Term Supports & Services (LTSS)

Sweeping change is coming! 

SB 7 – a Medicaid LTSS reform bill was signed into law on June 14, 2013 changes how Texas manages and pays for medical and LTSS services for people with and IDD in CLASS, DBMD, HCS and TxHmL Medicaid Waiver programs. It also effects medical and LTSS in the MDCP program.

SB7 Board Timeline & Acute Care Carve-In Timeline here.

Medicaid Managed Care Initiatives. This site was developed to keep you informed of LTSS changes in Texas. Click here for more information. Visit often to stay informed!

Community-Based Supports and Services: What we know

DADS Long-Term Services and Supports provide daily health care and living needs to qualified individuals (of all ages) who have a disability or long-term illness in the community or in an institutional setting.

LTSS programs include but are NOT limited to Medicaid Waiver programs, groups homes and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID).

LTSS program eligibility is determined when services are offered. Each LTSS program has different eligibility requirements, rules, funding amounts, service rates and service options. Some do NOT consider family income.

Some LTSS programs are entitlement programs and others are offered on a first come first served basis. Comparison charts were created to describe the similarities and differences among DADS LTSS waiver and entitlement programs.

LTSS entitlement programs
LTSS waiver programs
Home and Community-based Services in Texas: Which Program Does What? July 2013 Guide in English and Spanish

The “interest list” for Medicaid Waiver programs is lengthy and can be as long as 10+ years. To view the interest list reduction summary click here.

The Texas Department of Aging and Disability Services (DADS) administers several LTSS programs that include, among others, Texas Medicaid Waiver programs.

Texas Medicaid Waiver programs administered through DADS include:

  • Community Living Assistance and Support Services (CLASS)
  • Deaf Blind with Multiple Disabilities (DBMD)
  • Home and Community-based Services (HCS)
  • Medically Dependent Children’s Program (MDCP)
  • TxHml Texas Home Living Waiver (TxHmL

For a detailed list of all LTSS programs administered by DADS visit the DADS website.

STAR+PLUS  is a Medicaid Waiver managed care program administered through the Texas Health and Human Services Commission (HHSC).

Youth Empowerment Services (YES Waiver) is a Medicaid Waiver program administered through the Texas Department of State Health Services (DSHS) for individuals who have a Serious Emotional Disturbance (SED).


83rd Legislature

DADS Legislative Presentation Charge #5 (July 2012)

82nd Legislature

Cuts to community-based LTSS occurred during the 82nd Legislature. Click on the presentations below for detailed information.

Service Cuts in Medicaid Waiver Programs
Who will be affected, how will cuts be implemented & what are your rights?

How to Explain Your Service Needs

TEXAS CAN DO BETTER! There is room for improvement 

The Annual Case for Inclusion Reports ranks all 50 States and the District of Columbia on how well they are providing community-based supports to Americans with intellectual and developmental disabilities being served by Medicaid. Texas ranks 50th in the latest report released in July 2015.

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