Home and Community-Based Services (HCS)
Home and Community-Based Services (HCS) is a Medicaid waiver program that provides services and supports to Texans that have an intellectual disability or a related condition in order to allow them to live in the community. HCS services are supplemental and not intended to replace other services for these individuals.
HCS providers can offer 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 receiving HCS services can receive unlimited prescriptions through Medicaid Vendor Drug Program. HCS can provide many services, which are listed below.
- Residential services
- Group home
- Host home/ companion care
- Respite services
- Day habilitation
- Employment services
- Nursing services
- Dental services
- Behavioral support
- Supported home living (transportation)
- Social work
- Occupational therapy
- Physical therapy
- Speech therapy
- Dietary services
- Audiology services
- Cognitive rehabilitation services (services for people with brain injury)
- Accessible minor home modifications
- Adaptive aids
- Transition assistance services
Home and Community-Based Services (HCS) may be available to any Texas resident not living in an institutional setting who meets the following criteria:
- 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
Clients with intellectual and developmental disabilities that meet the above criteria can be placed on the HCS waitlist. 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, Tri-County will assist with the application process, as well as coordinate the enrollment and ongoing services.
If you have any questions about HCS eligibility and the referral process, please call 936-521-6200.
Consumer Directed Services (CDS)
Consumer Directed Services allows you to take control over your program services if you are able and willing to take more responsibility for coordinating the services. The CDS option is available for this program. Individuals who live in their own home or family home can self-direct certain services such as:
- Recruit their service providers
- Conduct criminal history checks
- Determine the competency of service providers
- Hire, train, manage and fire their service providers
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 following services are available through the CDS option:
- Cognitive rehabilitation therapy
- CFC personal assistance services/habilitation
- Employment assistance
- Financial management services
- Nursing services
- Respite care (in and out-of-home)
- Supported employment
- Supported home living (transportation)
- Support consultation
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) 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 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. Individuals can also choose to hire and train their own service providers under the consumer directed services option.
I am interested in receiving services, what is the first step?
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. 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.
What is the HCS interest list?
The HCS interest list is a listing of the individuals that are interested in Home and Community Based Services. This list is for Liberty, Montgomery and Walker Counties and is maintained by Tri-County staff. The Tri-County list feeds into the statewide list of individuals that are interested in the program.
If I move out of the local area, what happens to my HCS slot?
The HCS program covers all of the state of Texas, so if you are enrolled in the program and move out of the local area, the slot moves with you. You would transfer to a provider that covers the county you are moving to. If you are on the HCS interest list, Tri-County will work with the local authority agency that covers the county you are moving to and transfer your interest list to that agency.
How do I select an HCS provider?
There are several necessary questions and steps that must be considered before selecting an HCS provider. The regional developmental disability specialist must be included to provide guidance in this process. Some of the questions that might be considered, and steps to take, are:
- Where in the state would the child like to reside?
- Contact the providers for availability.
- Conduct background checks, according to HCS policy.
- Conduct a home visit.
- Schedule a pre-placement visit.
- Set up an enrollment meeting.
What questions do I ask the HCS provider?
Any question that is important to you, you should ask the provider. Every provider is required to offer all HCS services. How they provide the service may differ. Here are a few questions that you might consider asking:
- How long have they been serving persons with intellectual and/or developmental disabilities?
- How many consumers does their HCS Program serve in the county at the present time, and what is their capacity?
- What procedures will staff implement in a crisis situation?
- What are the provider’s staff-to-consumer ratios?
- What are your policies regarding visitors?
- How do you accommodate non-ambulatory individuals?
- What type of transportation does your company provide? How many vehicles do you have? Is there a vehicle for each home?