Home and Community-based Services (HCS)

A brief description

Home and Community-based Services (HCS) is a Medicaid Waiver Program that provides community-based services and supports to eligible persons as an alternative to the Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) program.

Services are available to persons living in their own home or living with their family or paid companion. Services may also be provided to persons living in small group homes where no more than four persons may live.

The HCS Program is operated by the Texas Health and Human Services (HHS).

Who is eligible for HCS?

A person is eligible for the HCS Program if he or she:

  1. Has a diagnosis of intellectual and developmental disabilities or a related condition
  2. Is eligible for Supplemental Security Income (SSI) or eligible for Medicaid
  3. Is not enrolled in another Medicaid waiver program (if they are enrolled in another Medicaid waiver program, they must choose one)
  4. Chooses to participate in the HCS program instead of the ICF/IID Program.

Who provides HCS services?

HCS Program providers are privately owned entities. HHS certifies all HCS Program providers and monitors the services they provide.
You or your representative choose the HCS Program provider that will provide your services.  You or your representative can choose a different program provider at any time. Your services will be transferred to the HCS Program provider you choose and your service coordinator will help you transfer your services.

What services are available?

Residential Assistance

comprises supports needed for an individual to live in the community. It comes in three different levels of assistance type:

  1. HCS Host / Foster / Companion Care (care in a private residence by a provider who lives in the residence)
  2. Supervised Living / Residential Support (group home with shift staff)
  3. Supported Home Living (support provided in your own home or your family home)
Support services:
  • Respite (short term relief for unpaid care takers)
  • Day Habilitation (working on self-help, socialization, and adaptive skills)
  • Employment Assistance (help in finding paid employment)
  • Supported Employment  (help to maintain paid work by the individual, including supervision and training)
Specialized supports:
  • Nursing
  • Counseling and Therapy provided by a licensed therapist and can include:
    • Audiology
    • Dietary
    • Occupational Therapy
    • Physical Therapy
    • Psychology
    • Speech/Language Pathology
Reimbursed Services:
  • Dental Treatment may be provided up to a maximum amount of $1,000 per IPC year.
  • Adaptive Aids (mobility aids, control switches, medically necessary supplies, and communication aids).
  • Minor Home Modifications (physical adaptations to the individual’s home that are necessary to ensure access).

Comparison of HCS and TxHmL:

Home and Community-based Services Program compared to Texas Home Living Program