Waiting on a Waiver

The Problem

A Medicaid Home and Community Based Services (HCBS) waiver helps people with disabilities live and work in their community. In Texas, we offer seven different waivers, six of which are specific to individuals with disabilities. Waivers are an alternative to institutions, such as a nursing facility or intermediate care facility. A waiver can cover things that are almost NEVER covered by private insurance, like an attendant that helps someone get out of bed and get dressed, supports to help someone get or keep a job, or specialized interventions to help with someone’s behaviors in particular situations.

Because the demand far outweighs the resources made available by the legislature, Texans with IDD are placed on often decade-long interest lists until an appropriate HCBS waiver slot or opening becomes available. Unfortunately, there are over 158,000 Texans were waiting on a waiver, and the Texas Legislature continues to lack the political will to do much about it.

You Can Help

Help us increase awareness of the importance and lacking availability of HCBS waivers by completing our five minute survey and helping us tell your story.

Sharing stories is one way to increase awareness and tell lawmakers and the community why all people with disabilities should have access to the services and supports when and where they need them.

HCBS Waivers

Texas has six waivers specific to people with disabilities, each one has its own interest list, eligibility requirements, and services offered.

1. Community Living Assistance and Support Services (CLASS)
   CLASS gives home and community-based supports to children and adults with related conditions. There are over 200 related conditions, like cerebral palsy and spina bifida. The related condition must have occurred before the childwas age 22.
2. Deaf Blind with Multiple Disabilities (DBMD)
   DBMD gives services for children and adults who are deaf-blind or have a related condition that leads to deaf-blindness, and who have another disability.
3. Home and Community-based Services (HCS)
   HCS gives services and supports to children and adults with an intellectual disability (ID) or a related condition who live with their families, in their own homes, or in small group homes with no more than 4 people.
4. Medically Dependent Children Program (MDCP)
   MDCP gives services to children and adults who are 20 and younger who are medically fragile as an alternative to receiving services in a nursing facility.
5. STAR+PLUS
   STAR+PLUS gives services to adults over the age of 21 to keep them in their community and not in a nursing home facility.
6. Texas Home Living (TxHmL)
   TxHmL gives services to children and adults with an intellectual disability (ID) or a related condition who live in their own home or their family’s home.