Waivers
What are Texas's HCBS waivers?
- Home and Community-based Services (HCS)
- Texas's main IDD waiver: services for people with an intellectual disability or related condition living in their own home, a family home, or small group homes of up to four residents — adaptive aids, respite, day programs, nursing, specialized therapies, supported employment, and supported home living.
- Texas Home Living (TxHmL)
- A capped, lower-cost IDD waiver for people living with their families or in their own homes — behavior support, respite, community support, day programs, employment help, and therapies, with limits on how much the state pays per person.
- Community Living Assistance and Support Services (CLASS)
- Home-and-community services for people with 'related conditions' — disabilities other than an intellectual disability that originated before age 22 and affect daily functioning — as a cost-effective alternative to an intermediate-care facility.
- Deaf Blind with Multiple Disabilities (DBMD)
- Services for people who are deafblind with multiple disabilities, focused on increasing opportunities to communicate and interact with their environment, as an alternative to institutional care.
- Texas runs 'interest lists,' first-come first-served by sign-up date, with enrollment driven by appropriations — the state itself posts monthly interest-list counts by years-on-list (latest posted data: May 2026). Families join the HCS/TxHmL lists through their Local IDD Authority; other waiver lists via 877-438-5658.
- The scale is the nation's largest: KFF's 2025 survey data shows 328,593 people with IDD on Texas interest lists. Texas is one of six states that don't screen for waiver eligibility before listing — KFF notes people with IDD in non-screening states wait longer on average (about 49 months versus 32 in screening states), and interest-list membership is not an eligibility determination.
Agencies
Who runs services in Texas?
- Texas Health and Human Services Commission (HHSC)
- Administers Texas Medicaid and all four IDD waivers, manages the interest lists, and publishes the monthly interest-list data.
- Local Intellectual and Developmental Disability Authorities (LIDDAs)
- The point of entry for publicly funded IDD programs — LIDDAs determine eligibility, add people to the HCS/TxHmL interest lists, and handle enrollment.
- Texas Education Agency (TEA)
- The state education agency for special education, including the ARD/IEP process and the SPEDTex family information center.
School
What's specific about IEPs in Texas?
- Texas calls the IEP team the ARD committee — Admission, Review, and Dismissal — the group responsible for decisions about a child's special-education program.
- Schools must respond to a parent's written evaluation request within 15 school days and complete the evaluation report no later than 45 school days after receiving written consent (Texas Education Code §26.0081, per TEA's parent handbook statement).
Common questions
Common questions about care in Texas
- How long are the Texas IDD interest lists?
- The largest in the country: KFF's 2025 survey data counted 328,593 people with IDD on Texas interest lists. Texas is one of six states that do not screen for waiver eligibility before listing, and KFF finds people in non-screening states wait longer on average — about 49 months against 32.
- How do I get on a Texas waiver interest list?
- For HCS and Texas Home Living, through your Local IDD Authority, which determines eligibility and handles enrollment. For the other waiver lists, call 877-438-5658.
- Does being on a Texas interest list mean my child is eligible?
- No. Texas does not screen for waiver eligibility before adding someone to a list, so interest-list membership is not an eligibility determination — eligibility is decided when a slot is offered. Enrollment from the lists is driven by state appropriations, and HHSC posts monthly interest-list counts by years-on-list.
- How fast must a Texas school respond to an evaluation request?
- Within 15 school days of a parent's written request, with the evaluation report due no later than 45 school days after the school receives written consent (Texas Education Code §26.0081, per TEA's parent handbook statement).
Sources: HHSC IDD long-term care programs (as of 2026-07) · HHSC interest-list reduction (monthly data) (as of 2026-07) · HHSC Local IDD Authorities (as of 2026-07) · KFF HCBS waiting-list state indicator (TX) (as of 2026-07) · TEA evaluation-timeline handbook statement (as of 2026-07). General information, not legal or benefits advice.