Video: Waivers and Wait Lists
Texas Medicaid waivers are a gateway to getting services for your child. We don’t want to tell you what to do, but we strongly suggest that you consider adding your child to the waiver interest list(s), which many parents call “waiting lists,” if you haven’t already done so.
Even if you hope your child will never need those services, it is important that they be added to the interest list for any program(s) that might meet their needs. Your child might have to wait a long time to get services through the waiver. You can always decline the services once your child moves to the top of the list.
Many parents say they wish they had signed up for the waiver interest lists when their child was born or first diagnosed. Some of the interest lists have more than a 15-year wait time.
We know this page has a lot of information for you to take in. It’s okay if you don’t absorb everything here in one visit. Take a deep breath and come back as much as you want or need to.
What Are Waivers and How Do They Work?
- Waivers let states use Medicaid funds for long-term home and community-based services for people with disabilities or special health-care needs in order to help them live in the community.
- Before the creation of waiver programs, people had to live in hospitals, nursing homes, or other institutions like State Supported Living Centers or Residential Treatment Centers so Medicaid would pay for long-term services.
- Some of the services you can get with a waiver are:
- Personal care for help with things like bathing or dressing
- Nursing care
- Home modifications like ramps
- Car modifications
- Respite care
- Certain therapies
- They are named “waivers” because certain Medicaid requirements are waived (meaning they don’t apply). For example, family income. All but one waiver are based on just the child’s income alone. Your child’s income means any money that they personally have earned or are paid—not your whole family’s income.
- Besides getting these additional services, people who receive waiver long-term services and supports also get full Medicaid health-care benefits. This is a huge help for children and adults who have complicated medical needs and no other health insurance.
- Texas has seven waivers. Each one has its own interest list. Consider adding your child to all the interest lists based on their identified diagnosis and current needs. You don’t know what future needs your child might have. You might want to place them on as many of the lists as possible.
- Waivers are managed by the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS).
- When there is room for your child or young adult on one of the waiver programs, they will come off of the interest list for the program with the opening. You may choose to continue to leave your child’s name on interest lists for other waiver programs. This is when HHSC and/or DSHS will review diagnostic and other information to decide if your child meets the waiver requirements. Depending on the waiver, you might be asked for information about their medical, psychological, and developmental history, as well as financial and income eligibility. The eligibility information that is needed changes based on the waiver. The comparison of Texas Medicaid waiver programs chart gives you more details about what is needed for each of the waivers.
How to Add Your Child to Interest Lists
You do not have to prove your child is eligible before adding them to the waiver interest lists. Your child will go through this process once they move to the top of the list. Only then is the eligibility information reviewed and used to decide if your child can enroll.
- Call 1-877-438-5658 for information about putting your child on an interest list for long-term services. This is for the CLASS, DBMD, and MDCP waivers. See the section below for details about each of these waiver programs.
- Call your Local Mental Health Authority about the Youth Empowerment Services (YES) waiver program. Go to the DSHS website to find the Local Mental Health Authority in your area.
- Call your Local Intellectual and Developmental Disability Authority (LIDDA) to get your name on the interest list for the HCS and Texas Home Living Waiver programs. You can search for your LIDDA’s telephone number.
Texas Medicaid Waivers
Click on the links below for more information:
- Community Living Assistance and Support Services (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 child was age 22.
- Deaf Blind with Multiple Disabilities (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.
- Home and Community-based Services (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.
- Medically Dependent Children Program (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.
- STAR+PLUS Home and Community-based Services (HCBS): gives services to adults over the age of 21 to keep them in their community and not in a nursing home facility.
- Texas Home Living (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.
- Youth Empowerment Services (YES): gives home and community-based services to children under the age of 19 who otherwise would need psychiatric inpatient care or whose parents would turn to state custody for care.
Important Tips About Interest (Waiting) Lists
- Consider adding your child to as many waiver interest lists as possible when your child is first diagnosed with a disability or special health-care needs. You should also think about adding your child to the lists even if they aren’t diagnosed but have reason to believe that your child will have a long-term disability or special health-care needs. If your child no longer needs the service when they come off the interest list, you can tell them you do not want the waiver. If you refuse a waiver slot offer for your child once they are at the top of the interest list, your child’s name will be placed at the bottom of the interest list again.
- Ask for an email confirmation or a mailed letter when you add your child to the Medicaid waiver interest lists. Keep this in a safe place.
- It is very important to keep your address and contact phone numbers updated. If your child moves to the top of the interest list and they can’t reach you, your child will be dropped from the list. They might also call you or send you a letter to see if your child still needs services. If they can’t reach you, they might take your child off the list.
- At least once a year, call to update your contact information. Most parents remember by calling around their child’s birthday. During these calls, you can also find out where your child is on the list. Write it down in a safe place, like your care notebook, so you can keep track of how far your child moves up the list each year. See our Organizing Medical Records page for more information about care notebooks.
- Once your child moves to the top of an interest list, a service coordinator, case manager, or nurse will schedule a home visit. This will start the process of determining if your child is able to enroll in one of the waiver programs. You can also research the waiver program beforehand to learn what it takes for your child to get services.
- Your child can remain on other waiver interest lists while receiving waiver services. They just can’t receive services from more than one waiver program at the same time. For example, your child is receiving MDCP services. They move to the top of the CLASS interest list and are approved for CLASS services, you will have to pick between the two programs. You might want to connect with other parents who have done this before.
- If you have other health insurance through an employer and your child is enrolled in a waiver program, you might be reimbursed for health insurance premiums through the Health Insurance Premium Payment (HIPP) program. Once your child starts receiving waiver services, call your local utility company about possible discounts on electricity, water, and wastewater bills, if your child lives in your home. Depending on income, your family might also be able to receive food stamps (SNAP benefits).
- Most of the waivers offer the Consumer Directed Services (CDS) choice for at least some, if not all, of the program’s services. Also known as “self-directed services,” this gives you more personal control over how your child’s services are delivered, and many parents prefer it. For example, parents who pick the CDS choice serve as the employer for their child’s attendants. They are able to interview, hire / fire, and train them. It can take up a lot of your time. You might want to check out our connecting with other parents page to learn from other parents.
- If your child has an intellectual disability or a condition related to an ID, and is in a crisis or has high medical needs, call your LIDDA to ask about diversion slots. You can search for your LIDDA’s telephone number on the HHSC website. These slots are for extreme cases only, such as a critical health crisis that puts the family at risk of placing the child in a state-supported living center. If approved, your child moves to the top of the HCS interest list.
Quotes from Parents
“Our son has been receiving MDCP services for 4 years, and we don’t know what we would do without this waiver program. It has allowed us to care for him at home and provides services we wouldn’t otherwise be able to afford.”
“We are still waiting. We started on the CLASS list at number 50,000 and now we are down to number 8,000. We've been waiting for 9 years. I should have done it sooner.”