How does the Texas Home and Community-Based Services (HCS) Program work?

Texas HCS is a Medicaid waiver program that provides long-term, community-based support for individuals with intellectual and developmental disabilities. Services are coordinated through a local authority and require Medicaid eligibility and a qualifying diagnosis.

The Texas Home and Community-Based Services program funds care for individuals who need ongoing support but want to receive that care in home or community settings rather than institutions. It is administered by the Texas Health and Human Services Commission and coordinated locally through Intellectual and Developmental Disability Authorities (LIDDAs).

Covered services can include residential support, day habilitation, supported employment, behavioral services, nursing care, and home modifications. The exact services depend on individual needs and the care plan developed after assessment.

To get started, families contact their local LIDDA, complete an eligibility and functional assessment, and, if qualified, are placed on the HCS interest list until a slot becomes available.

HCS and ABA therapy are separate but complementary. A child with autism may receive long-term support through HCS while also accessing ABA therapy through Medicaid. To understand how therapy fits in, see Alpaca’s guides on Texas Medicaid coverage for ABA therapy and autism resources in Texas.

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Is there a waiting list for the Texas HCS program?

Yes. Texas HCS has one of the longest Medicaid waiver waitlists in the country, with wait times that can exceed a decade. Families are encouraged to apply as early as possible.

How does the Colorado Home and Community-Based Services (HCS) Program work?

Colorado’s HCBS program provides Medicaid-funded support that allows individuals with disabilities to receive care at home or in the community instead of institutional settings. Services are delivered through waiver programs under Health First Colorado, and eligibility depends on Medicaid enrollment and functional need.

Do IEPs or 504 Plans include ABA therapy in Texas?

IEPs and 504 Plans are school-based supports and typically do not include ABA therapy, which is usually provided through insurance or Medicaid outside of school.

Which plan (IEP or 504) is right for my child in Texas?

A 504 Plan is best if your child needs classroom accommodations, while an IEP is better if your child needs specialized instruction or services.

IEP vs. 504 Plan in Texas - Key Differences

The main difference is that IEPs provide specialized instruction and services, while 504 Plans provide accommodations only.

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