Long Term Services & Supports

As family members we often think we can care for our children forever. But as we age, our children get bigger and may need support we can no longer provide. This is where long-term supports come in. There are a variety of long-term support services for people with disabilities and ways to access those services.

Learn More Here: Family Supports – What are they? How do I access them?

Texas Health & Human Services (HHS) is the State Agency responsible for many State/Federal Programs that help people with disabilities.

Start by calling 211 Texas or by visiting the Your Texas Benefits website (Click on the Start Tool). Here you will find out what services and supports may be available to your child or family. You will find information on Medicaid, CHIP, Family Services, Supplemental Nutrition Assistance Program (SNAP or food assistance), and Temporary Assistance for Needy Families (TANF).

HHS disability services include:

Children\’s Mental Health services include:

Child and Youth Assessment Services
Community Mental Health Services
Family Partner Support Services
Medication Training and Support Services
Mental Health Case Management Services
Mental Health Counseling Services
Residential Treatment Center Relinquishment Avoidance Project
Skills Training Services
Transition-Age Youth Services
Youth Empowerment Services Waiver (YES) – for children under age 19 with severe emotional disturbances

The main number for HHS services is 855-937-2372. You will be asked to enter your zip code and this will direct you to the closest Aging and Disability Resource Center. These centers can answer your questions.

Texas Medicaid Programs

Traditional Medicaid:

This program primarily serves low income families and children. Often the children also receive supplemental security income (SSI).

Even if your child has a disability and receives Medicaid, you will need to get your child’s name on the “interest lists” for long-term services and supports (see “Medicaid Waivers” below).

If you child is under 20, receives Medicaid and has a disability, benefits are provided through the STAR Kids managed care program (see below).

For information on Personal Care Services, call the Texas Medicaid & Healthcare Partnership (TMHP) PCS Client Line at 1-888-276-0702 (toll free).

Children’s Health Insurance Program (CHIP):

CHIP covers children in families who have too much income to qualify for Medicaid, but cannot afford to buy private insurance. Your child must be under age 19.

Medicaid Buy In:

If you make TOO much money for Medicaid or CHIP, but need health insurance for your child, the State of Texas has a Medicaid Buy In Program. If your child is under age 20 and receives Medicaid and has a disability, benefits are provided through the STAR Kids managed care program (see below).

STAR Kids:

STAR Kids is the Texas Medicaid managed care program that provides Medicaid benefits to children and adults 20 and younger who have disabilities. This program is mandatory for any child with a disability under age 20 who is on Medicaid because they receive SSI, participate in a Medicaid buy in program, or participate in a waiver program (DBMD, MDCP, YES, CLASS, HCS, or TxHL).

STAR+Plus:

This is a Texas Medicaid managed care program for individuals who are over age 21 and have disabilities. There are some exceptions. See the STAR+PLUS Client FAQs.

Community First Choice:

This is NOT a Medicaid waiver program, but an entitlement program for personal attendant/habilitation services through your Medicaid Star Plus program. Your child MUST already be Medicaid eligible. For many, this means your child is an adult and receiving SSI & Medicaid (STAR Plus) and you are waiting for a waiver slot.

For more information on seeking services through this program, please contact your Managed Care Organization (MCO). The MCO will do an initial assessment and refer you to the local Intellectual and Developmental Disability Authority (LIDDA) for a Determination of Intellectual Disability (DID), Level of Care, and Functional Assessment. The Local Authority will complete the DID and a level of care assessment and submit the level of care assessment to HHSC. HHSC will either approve or disapprove the level of care. If approved – the LIDDA will perform a functional assessment to determine the services needed and give this to the MCO. The MCO will authorize services and the LIDDA will provide service coordination (case management).

Medicaid Waivers:

Medicaid Waiver programs are a key part of long term support for people with disabilities. Waiver services are services for your child (young or old).

While the long-term services are for those who are Medicaid eligible, your child will automatically become Medicaid eligible when they receive a Waiver slot in one of the programs that do not include parent income (all except TxHL). To understand the different waivers, this Comparison of Medicaid Waiver Programs is helpful.

In Texas, there is a waiting or “interest” list to receive Medicaid waivers that is years long (7-14 years). It is important to add your child\’s name to the Medicaid Waiver interest lists as soon as possible.

For those with intellectual or developmental disabilities:

Home & Community-based Services (HCS) and
Tx Home Living (TxHL) Programs

To register for these \”Interest Lists\” (HCS, Tx Home Living, etc.), contact the local authority agency for your county.

For those with medical or physical disabilities:

Community Living Assistance and Support Services (CLASS),
Medically Dependent Children’s Program (MDCP),
Deaf Blind Multiple Disabilities (DBMD),
Community Attendant Services (CAS), and
Personal Attendant Services (CMPAS) Programs

For these programs, please contact your local Aging & Disability Resource Center. Click here to find the office nearest you – or call 1-855-937-2372.

Please note – if you move while on the interest list, please call the agency and update your information so that the agency can find you when a waiver slot becomes available.

For most of these programs, there will be an assessment for services. Remember to answer as if you were not there to do things for your child or provide the level of support you may give (Can they do something independently?). Here are links to various assessments:

Form 8510 (TxHmL, HCS, CFC PAS/HAB assessment)
Form 8578 (IDD/Related Service Condition Assessment – Assigns LOC & LON for all waivers & CFC)
Form 6516 (CLASS/DMDB Nursing Assessment)
Form 3596 (CLASS/DMDB/CFC PAS/HAB Plan to justify services)

The Long Term Care Provider Search is a searchable data base where you can find and compare providers of long-term services and supports. These include nursing facilities, home health agencies, adult day care and others. You can also see reports on specific providers and any possible violations.

Vocational Rehabilitative Services

Texas Workforce Commission (TWC) provides Vocational Rehabilitative Services for people with physical or cognitive disabilities, including blindness or visual impairment.

Other Community Service Agencies and Resources:

Centers for Independent Living – Independent living (IL) services help people with disabilities achieve greater independence in the home and community.

Community Coordination Resource Groups – Interagency groups that come together to create plans for individuals whose needs cannot be met by one group alone.

Navigate Life Texas – Resources for kids with disabilities and special health care needs.

Parent Companion: First Five Years – Information, inspiration and resources for Texas parents of children with disabilities, birth to 5 years of age.

Social Security – How to Qualify & Apply; “Blue Book” Listing of Childhood Disabilities , Listing of Adult Disabilities

Texas AgriLife Extension