FFASN Texas support programs, 08/27/2009 


Medicaid was established in 1967 under the Social Security Act. It provides medical assistance for lowincome
families and many individuals with disabilities, including children. Approximately 60% of those
on Medicaid in Texas are children. Medicaid is an “entitlement program,” meaning that if you meet the
eligibility requirements, the state must provide certain services within federal guidelines.
The Texas Medicaid program is administered through the Health and Human Services
Commission. Information on eligibility criteria and the application process can be obtained on-line at
http://www.hhsc.state.tx.us/help/index.html, by calling 211, or by contacting your local Department of
Aging and Disability Services Office (formerly Department of Human Services Office). To find the office
nearest you, visit http://www.dads.state.tx.us/services/contact.cfm
Medicaid offers two types of facility entitlement service, Nursing Facility(NF) and Intermediate Care
Facilities for Persons with Mental Retardation(ICF/MR)
Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR) Program
This program provides residential and habilitation services to people with mental retardation and/or a
related condition. A related condition is a disability, other than mental retardation, that originated before
age 22 and that affects the ability to function in daily life.
To apply for services, contact your local mental retardation authority.
To learn more, visit the following web site:



The Medicaid program is an enormously important source of money to pay for services and supports for
people with developmental disabilities. About $3 of every $4 that states spend for developmental
disabilities services comes by way of Medicaid. Once, Medicaid dollars only paid for institutional
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services. Today, Medicaid allows more diverse services and supports for individuals in the community,
by "waiving" the need to get those same services in an institution.
Texas currently has seven different Medicaid funded waiver programs designed to allow Medicaid funds
to be available to provide individuals with disabilities the opportunity to receive supports and services in
their community as an alternative to institutional care. These waivers are administered through the Texas
Department of Aging and Disability Services (DADS). Medicaid waiver services can be especially
helpful to families caring for children with disabilities. Services can include nursing care, attendant care,
respite, home modifications, medical equipment and supplies, therapies, service coordination, prevocational
services, community living supports, assistive technology, and more. In addition to the
services provided through the waiver program, a child who is in a Medicaid funded waiver program also
has access to Medicaid healthcare benefits.
Medicaid funded waivers, however, are not entitlements. This means that the number of individuals that
can receive Medicaid funded waiver services depends on the willingness of the state legislature to fund
these services. When the Texas Legislature meets every two years, they appropriate funding for a certain
number of waiver “slots.” The “slots” appropriated translate into the number of people who will receive
services. The number of “slots” funded, historically, has been well under the number of individuals and
families requesting those services. Consequently, waiver waiting/interest lists are used to provide services
as they become available on a first-come, first-serve basis. To be eligible for Medicaid funded waiver
services, children and adults must meet both financial eligibility requirements as well as functional
eligibility requirements. In all but one of the eight waiver programs (Texas Home Living Waiver),
financial eligibility for children is based on the child’s income rather than the family income, making it
possible for many struggling families to obtain services that enable them to keep their child at home and
prevent institutionalization.
Due to the existence of extensive waiting/interest lists for Medicaid waiver services, it is important for
families to place their child’s name on the waiting lists for all programs for which their child may be
eligible as soon as possible. Eligibility assessments will not be done until a waiver slot becomes available,
which may be several years. As it is often impossible to know what children may need in the future, it is
better to have your child’s name on the list(s) so the option for services in the future remains available.
Putting your child’s name on a waiver waiting list does not obligate you to accept those services in the
future. It simply makes the option of supports and services available in the future. The following is a list
of Texas Medicaid funded waiver programs. Additional information can be obtained by visiting the web
site listed under each program.
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Medicaid Funded Waiver Description
1. Home and Community-based Services Program (HCS)
HCS provides individualized services and supports to persons with mental retardation who are living with
their family, in their own home or in other community settings, such as small group homes.
To learn more, visit the following web site:
2. Community Living and Support Services (CLASS) waiver
CLASS provides home- and community-based services to people with related conditions as a costeffective
alternative to placement in an intermediate care facility for persons with mental retardation or a
related condition (ICF-MR/RC).
To apply for services, call toll-free to 1-877-438-5658 to have a person placed on the interest list. To
learn more, visit the following web site:
3. Medically Dependent Children’s Program (MDCP)
MDCP provides services to support families caring for children and young adults who are medically
dependent and to encourage de-institutionalization of children in nursing facilities.
To apply for services, call 1-877-438-5658 to have the child's or young adult's name placed on the MDCP
interest list. To learn more, visit the following web site:
4. Community Based Alternatives (CBA)
CBA provides home- and community-based services to people who are elderly and to adults with
disabilities as a cost-effective alternative to living in a nursing home.
To learn more, visit the following web site:
5. Deaf-Blind Multiple Disabilities Program (DB/MD)
DB-MD provides home and community-based services to people who are deaf-blind with multiple
disabilities as a cost-effective alternative to institutional placement. The program focuses on increasing
opportunities for consumers to communicate and interact with their environment.
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To learn more, visit the following web site:
6. Texas Home Living (TxHmL)
This program provides selected essential services and supports to people with mental retardation who live
in their family homes or their own homes.
To learn more, visit the following web site:
7. Consolidated Waiver Program (CWP)
This is a Bexar County Pilot Program serving individuals of all ages, with varying disabilities; no specific
waiting list exists as referrals for these slots come from the HCS, CLASS, MDCP, DBMD, and CBA
waiting lists.
To learn more, visit the following web site:



Community MHMR Centers are designated as local Mental Retardation Authorities (MRAs). The MRA
serves as the point of entry for publicly funded mental retardation programs whether publicly or privately
operated. In addition, MRAs provide or contract to provide an array of services for persons in the mental
retardation priority population with general revenue funds.
For services and eligibility requirement, please visit the following web site:
Note: For FY 2012-2013, funding for MR community services has been reduced 27%. The
amount is used to obtain more federal matching fund for Texas Home Living Waiver. For FY
2012-2013, funding for Texas Home Living Waiver has been increased 511%.
In addition to Medicaid and Medicaid waiver programs, there are other state programs that offer services
to children with disabilities. These programs are typically funded through state dollars or, like Medicaid
programs, through a combination of state and federal dollars. These programs are referred to as
“community care” programs and are intended to help individuals with disabilities remain in families and
in their communities. Some family support services are available through these various programs, but
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benefit levels and the types of services offered are generally more limited than in the Medicaid waiver
1. In-Home and Family Support Programs
This program provides limited, direct grant benefits to people with disabilities and or their families to
help them purchase services that enable them live in the community. Eligible people choose and purchase
services that help them to remain in their own homes. It is available statewide to children (and adults)
with both physical and cognitive disabilities. Currently, two separate programs exist – one serving those
with mental retardation, and the other serving individuals with physical disabilities.
Services include attendant care, respite, transportation services and others. For more information, visit the
following web site:
Note: There is no funding for IHFS for FY 2012-13. What will happen in the future regarding
IHFS is not clear.
2. Early Childhood Intervention (ECI)
ECI is a statewide program for families with children, birth to three, with disabilities and developmental
delays. ECI supports families to help their children reach their potential through developmental services.
Services are provided by a variety of local agencies and organizations across Texas.
ECI provides evaluations and assessments, at no cost to families, to determine eligibility and need for
services. Family copayment for ECI services is determined using a sliding fee scale and is based on
family size and income after allowable deductions. No child and family will be turned away because of an
inability to pay. ECI is an entitlement to eligible children, therefore no waiting lists exist.
For more information and eligibility requirement, visit the following web site:
3. Children’s Health Insurance Program (CHIP)
Texas families with uninsured children may be able to get health insurance through Children’s Medicaid
and the Children’s Health Insurance Program (CHIP). Both programs offer health care benefits, including
regular checkups and dental care.
To qualify for CHIP or Children's Medicaid, a child must be age 18 or younger, a Texas resident and a
U.S citizen or legal permanent resident. The citizenship or immigration status of the parents does not
affect the children's eligibility and is not reported on the application form. Any adult who lives with an
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uninsured child and provides care for that child can apply. This includes parents, step-parents,
grandparents, other relatives, legal guardians or adult brothers or sisters.
To apply for CHIP/Children’s Medicaid or CHIP perinatal benefits, you can apply online at
www.chipmedicaid.com or call toll-free 1-877-543-7669 (that’s 1-877-KIDS-NOW) to apply by phone.
4. Children with Special Health Care Needs (CSHCN)
This program is administered through the Texas Department of State Health Services. It is designed to
help children with special health-care needs and people of any age with cystic fibrosis.
You may apply to the CSHCN Services Program year-round, but current clients must renew their
applications every six months.
To learn more, visit the following web site:
5. Primary Home Care (PHC)
This program is a personal care service provided to adults whose health problems cause them to be
functionally limited in performing activities of daily living, according to a statement of medical need.
Covered services include escort, home management and personal care.
For more information and eligibility requirement, visit the following web site:
The information sources of the above article are obtained through Understanding Family Support and
Opening Doors to the Future and DADS web site at www.dads.state.tx.us