What is HCS?

HCS stands for Home and Community-Based Services, a program that helps people with intellectual disabilities or related conditions live in their community instead of in an institution. It’s a Medicaid program, which means it’s funded by the government to provide these supports for free or at a low cost.

Who is it for?

• Texans with intellectual disabilities or related conditions.
• People who want to live in their own homes or with family, rather than in a group home or care facility.

What does it do?

The program provides extra help (called supplemental services) to meet needs that other programs might not fully cover. It works alongside other services the individual might already have.

What services does HCS provide?

The program offers a long list of services, including:

• Housing help: Residential services, group homes, or living with a companion caregiver.
• Daily support: Help with things like bathing, cooking, and getting around.
• Specialized services: Nursing care, therapy (like speech or physical therapy), and help managing behavior.
• Job help: Employment training and Individual Skills and Socialization program (day habilitation).
• Tools for independence: Adaptive aids (special equipment), home modifications (like wheelchair ramps), and support with medications.
• Health and social care: Dental services, social work, and dietary help.
• Community Support Services: Assistance with daily activities to help individuals live independently in their homes or communities.

How does it help?

These services are designed to help people live more independently, take part in their community, and improve their quality of life.

Consumer Directed Services (CDS)

Consumer Directed Services (CDS) gives you the ability to manage your own services if you’re able to. It’s available to individual’s living in their own home or with family. With CDS, you can:

• Choose the people who will help you
• Make sure they have a clean background
• Decide if they are good at their job
• Hire, train, and let go of helpers when needed

If you choose CDS, you will work with an agency that helps with:

• Paying your helpers
• Handling taxes and background checks
• Training you to manage the process

You can use CDS for services like:

• Therapy to help with thinking and memory
• Help with personal care (like bathing or dressing)
• Help with finding a job
• Financial help
• Nursing care
• Respite care (care while you take a break)
• Help with transportation
• Advice and support

CDS gives you more control over the services you receive while making sure you get the help you need.

Additional IDD Services

For information about additional IDD services, please click here.

Frequently Asked Questions

Who provides Home and Community-Based Services (HCS)?

The Texas Health and Human Services Commission (HHSC) works with both public and private organizations to provide HCS services. HHSC checks these providers regularly to make sure the services are good. When you apply for HCS, you can choose a provider from a list of available ones in your area. You can also switch providers at any time, even if you move to a different part of Texas. If you prefer, you can hire and train your own service providers through a special program called consumer-directed services.

I am interested in receiving services, what is the first step?

To start getting HCS services, you need to contact your local authority for intellectual and developmental disability services (LIDDA). They will put you on the interest list. Find the LIDDA in your area. Whether you can get services depends on your needs, when you joined the list, and if funding is available. Once you are approved, the LIDDA will help you with your application and set up your services.

What is the HCS interest list?

The HCS interest list is a list of people who want to receive Home and Community-Based Services. In Liberty, Montgomery, and Walker counties, Tri-County staff keeps the list. This list is part of the statewide list for people interested in the program.

If I move out of the local area, what happens to my HCS slot?

HCS is available all over Texas, so if you are already enrolled and move to a new area, your slot moves with you. You will just switch to a provider in your new area. If you are still on the interest list, Tri-County will help transfer your information to the new local authority in your new area.

How do I select an HCS provider?

Choosing an HCS provider involves asking important questions and getting help from a regional developmental disability specialist. Some things you will need to consider include:

• Where do you want to live in Texas?
• Contact providers to see if they have availability.
• Do background checks on the providers.
• Visit the provider’s homes and schedule a pre-placement meeting.
• Set up an enrollment meeting.

What questions do I ask the HCS provider?

You should ask any questions that are important to you. All providers offer the same services, but they may deliver them differently. Here are some questions you may want to ask:

• How long have you been helping people with intellectual and developmental disabilities?
• How many people are currently in your HCS program, and how many can you serve?
• What do you do in a crisis situation?
• How many staff members are there for each person in the program?
• What are your rules about visitors?
• How do you help individuals who can’t walk or need special support?
• What transportation do you provide, and how many vehicles do you have? Does each home have its own vehicle?