Texas family guide

Medicaid waiver programs in Texas for children with disabilities

Texas offers several Medicaid waiver programs that can help a child with a disability get care at home, including CLASS, HCS, TxHmL, DBMD, MDCP, and YES. Most start with an interest list that runs first come, first served, so the most useful thing you can do today is make the call that puts your child's name on it.

Last verified: September 2026 against Texas HHSC sources

See the programs How to apply

The short answer

What you can do today

  • For CLASS, DBMD, or MDCP, call HHSC Interest List Management at 877-438-5658 and ask to add your child's name.
  • For HCS or TxHmL, call your local IDD authority (LIDDA). Find yours by county or ZIP code in the HHS LIDDA directory.
  • For the YES mental health waiver, call your local mental health authority's YES inquiry line, listed by county in this HHSC PDF.
  • Do not wait to be sure. Lists are first come, first served, and HHSC checks eligibility later, when a spot is offered.
  • Apply for Medicaid now if your child may qualify. HHSC says people can receive Medicaid or other community services while on the interest list, if eligible. Apply at YourTexasBenefits.com.

This guide is general information, not medical or legal advice. Please confirm details with Texas Health and Human Services (HHSC). For general help, HHSC lists 2-1-1 or 877-541-7905 on its contact page.

What a Medicaid waiver is, in one minute

Under Medicaid's 1915(c) authority, and within broad federal guidelines, states can develop home and community-based services waivers for people who prefer to get long-term services and supports at home or in the community rather than in an institution. One federal requirement is that waiver services cannot cost more than the same services in an institution (Medicaid.gov).

That is why each Texas waiver is tied to an institutional "level of care." In HHSC's comparison chart, CLASS, DBMD, HCS, and TxHmL are measured against an intermediate care facility for people with intellectual disabilities or related conditions (ICF/IID), MDCP against a nursing facility, and YES against institutions for mental diseases (IMD), with functional eligibility based on medical necessity and level of care for psychiatric inpatient admission (HHSC chart). That comparison is part of how HHSC decides who fits each program.

If you are just starting out, our Medicaid waiver state finder shows how Texas compares with other states, and the therapy and equipment cost explorer can help you see what a year of care may involve.

Programs at a glance

Six Texas waivers that serve children.

Each card uses wording from HHSC. Services listed are examples, not a promise of what your child will receive; each waiver has its own rules and cost limits.

HCSIDD

Home and Community-based Services

Who it is for
People with intellectual disabilities who live with family, in their own home, or in other community settings such as small group homes. HHSC lists it for all ages.
What it can help with
HHSC's chart lists services such as adaptive aids, behavioral support, nursing, occupational, physical, and speech therapy, respite, dental treatment, minor home modifications, and residential options like host home or companion care.
How you get on it
Interest list. Contact your local IDD authority (LIDDA).

Official page Source Source

TxHmLIDD

Texas Home Living

Who it is for
People with intellectual and developmental disabilities who live in their family home or their own home. HHSC lists it for all ages, with the same level-of-care criteria as HCS.
What it can help with
Selected essential services and supports, which HHSC's chart lists as including adaptive aids, behavioral support, nursing, therapies, respite, dental treatment, and minor home modifications. Residential services are not part of TxHmL.
How you get on it
Interest list. Contact your local IDD authority (LIDDA).

Official page Source Source

CLASSRelated condition

Community Living Assistance and Support Services

Who it is for
People with a related condition, which HHSC defines as a disability, other than an intellectual disability, that began before age 22 and affects a person's ability to function in daily life. HHSC lists it for all ages.
What it can help with
HHSC's chart lists services such as case management, behavioral support, therapies (including aquatic, music, recreational, and hippotherapy), respite, adaptive aids, dental treatment, and minor home modifications.
How you get on it
Interest list. Call HHSC Interest List Management.

Official page Source Source

MDCPMedical

Medically Dependent Children Program

Who it is for
Children and young adults age 20 and younger who need a high level of medical care. Functional eligibility is based on the medical necessity and level of care criteria for nursing facility admission.
What it can help with
Respite, flexible family support services, minor home modifications, adaptive aids, transition assistance services, employment assistance, supported employment, and financial management services. Delivered through a STAR Kids or STAR Health health plan.
How you get on it
Interest list. Call HHSC Interest List Management. A name can be added if the child is younger than 21 and lives in Texas.

Official page Source Source

DBMDDeafblind

Deaf Blind with Multiple Disabilities

Who it is for
People who are deafblind with multiple disabilities. HHSC's chart describes a related condition that results in deafblindness (or functioning as a person with deafblindness) plus an additional disability that impairs independent functioning. HHSC lists it for all ages.
What it can help with
Services that focus on increasing opportunities to communicate and interact with the environment, which HHSC's chart lists as including intervener services, orientation and mobility, speech, hearing and language services, case management, and respite.
How you get on it
Interest list. Call HHSC Interest List Management.

Official page Source Source

YESMental health

Youth Empowerment Services

Who it is for
Children and youth 3 through 18 with serious mental, emotional and behavioral difficulties, a qualifying mental health diagnosis, and risk of placement outside the home, who meet criteria for a psychiatric hospital and live at home with a legal guardian (or on their own if legally emancipated). The child must be eligible for Medicaid; HHSC says parent's income does not apply.
What it can help with
HHSC lists services such as art, music, and animal-assisted therapy, nutritional counseling, community living supports, family supports, respite, paraprofessional services, nonmedical transportation, adaptive aids, and minor home modifications.
How you get on it
Inquiry list. A parent, guardian, or managing conservator contacts the local mental health authority.

Official page Source Source

Where STAR Kids fits

STAR Kids is not a waiver, and it is not one of the programs HHSC lists as having an interest list. It is a Texas Medicaid managed care program for children and young adults with disabilities age 20 or younger. HHSC lists groups such as children who qualify for SSI or SSI-related Medicaid, and children enrolled in MDCP, CLASS, DBMD, HCS, TxHmL, or YES (HHSC STAR Kids page). HHSC says STAR Kids services are provided by health plans, and MDCP services are delivered through a STAR Kids or STAR Health managed care organization (HHSC MDCP page). For MDCP or DBMD problems that need escalation, HHSC lists the MDCP/DBMD Escalation Helpline at 1-844-999-9543.

For adults, HHSC's chart lists STAR+PLUS Home and Community Based Services for age 21 and older, which also has an interest list (HHSC).

A starting point

Which program should I ask about?

Answer a few questions and the matching cards above will be highlighted. This is only a starting point for your call. HHSC and its local partners make every eligibility determination, and you can ask about any list, even one this tool does not highlight.

How to apply, step by step

Your first calls, in order.

  1. Call to get on the right list

    For CLASS, DBMD, and MDCP, call HHSC Interest List Management at 877-438-5658. For HCS and TxHmL, contact your LIDDA (directory by county or ZIP). For YES, call the local mental health authority's inquiry line (inquiry lines by county, or find your local mental health authority). Write down the date you called.

  2. Ask about more than one program

    A child can fit more than one description. HHSC's LIDDA handbook notes that a person can be on the HCS and TxHmL interest lists at the same time (handbook). Ask each office what other lists your child could join.

  3. Apply for Medicaid, or confirm current coverage

    Apply, check status, or renew at YourTexasBenefits.com. The site also has a prescreening tool for benefits and support services. For help with Your Texas Benefits, HHSC lists 2-1-1 or 877-541-7905 (select your language, then Option 2) on its contact page.

  4. Keep your contact information current

    For HCS and TxHmL, the LIDDA handbook says it is the family's responsibility to tell the LIDDA about contact changes, and LIDDAs check in every two years to confirm continued interest (handbook). If repeated attempts to reach the family fail, the handbook says the LIDDA checks an "Inactive-Unable to Contact" box on the record, so update your address and phone number whenever they change.

  5. When your name comes up, respond quickly

    For MDCP, HHSC's handbook says individuals are released from the interest list in the order of the request date, and that the STAR Kids health plan then completes assessments and verifies eligibility (handbook). Have your child's records ready for that step.

  6. Get help while you wait

    If something goes wrong, the HHS Office of the Ombudsman is listed at 877-787-8999 (Relay Texas: 7-1-1 or 800-735-2989) (HHSC contact page). Teagan's Crown also helps families directly: you can apply for help here.

The waiting list, honestly

How the Texas interest list actually works

HHSC explains that demand for community-based services often outweighs available resources, so names may be placed on an interest list until services are available. Applicants are placed on the lists on a first-come, first-served basis, and the people who have been on the lists the longest are enrolled first (HHSC Interest List Reduction). HHSC lists interest lists for CLASS, DBMD, HCS, TxHmL, MDCP, and STAR+PLUS HCBS on that page. YES uses its own inquiry list through local mental health authorities (HHSC YES page).

For MDCP, HHSC's handbook says names are placed on the list according to the date and time of the request, regardless of the program's enrollment status (handbook). In other words, the clock starts when you call, not when you feel ready.

We are not going to guess at a wait time. The HHSC pages we used do not give a single number a family can plan around, and HHSC posts its own interest list data on its Interest List Reduction page. If you want a current picture, ask the person you speak with, and check that page.

Why sign up now, even if you are unsure

Being on a list is not an eligibility decision. For HCS and TxHmL, HHSC determines eligibility only when the person is offered the chance to enroll (handbook). Meanwhile, HHSC says people can receive Medicaid or other community services while they are on the interest list, if they are eligible (HHSC).

What to say when you call

A simple script, and a checklist.

These are suggestions written by our team, not an official HHSC script. Use your own words; the goal is to leave the call with your child's name on a list and a note of the date.

Suggested call script

"Hi, my name is ____. I am calling about my child, ____, who is ____ years old and lives in ____ County, Texas."

"My child has ____ and needs help with ____. I would like to add my child's name to the interest list for ____."

"Are there any other waiver lists my child could be added to? Can you confirm the date of my request, and what happens next?"

"What is the best way to update my address or phone number if it changes? And is there anything my child may be able to get now, while we wait?"

Before you hang up, write down the date, the time, and the name of the person you spoke with.

Have these nearby

Checkboxes are for your own use and are not saved.

Condition guides that may help you describe your child's needs: cerebral palsy, autism spectrum disorder, and Down syndrome. These guides do not decide program eligibility; HHSC does.

Questions families ask

Answers, with sources.

How do I get my child on a Texas Medicaid waiver interest list?

HHSC says to contact your Local Intellectual and Developmental Disability Authority (LIDDA) for HCS and TxHmL, and to call 877-438-5658 for the other waiver programs, which include CLASS, DBMD, and MDCP (source). For the YES waiver, a parent, guardian, or managing conservator contacts the local mental health authority to join its inquiry list (source).

Does being on the interest list mean my child is eligible?

No. HHSC's LIDDA handbook says eligibility for HCS and TxHmL is determined by HHSC only at the time the person is offered the opportunity to enroll (source). Being on a list holds your place; the eligibility check comes later.

Can my child get Medicaid services while waiting on the interest list?

Yes, if eligible. HHSC states that people can receive Medicaid or other community services while they are on the interest list, if they are eligible (source).

Does my family's income count for these waivers?

HHSC's waiver comparison chart (revised 09/05/2025) marks consideration of parental income for a minor as No for CLASS, DBMD, HCS, MDCP, and YES, and Yes for TxHmL (source). The YES waiver page also says parent's income does not apply (source). Confirm your child's situation with HHSC, because other financial rules still apply.

What is STAR Kids, and is it a waiver?

STAR Kids is a Texas Medicaid managed care program that provides health coverage for children and young adults with disabilities age 20 or younger. It is not one of the waivers on the interest list. Children who qualify for SSI or SSI-related Medicaid, or who are enrolled in waivers such as MDCP, CLASS, DBMD, HCS, TxHmL, or YES, are among the groups HHSC lists for STAR Kids (source). MDCP services are delivered through a STAR Kids or STAR Health managed care organization (source).

How long is the wait?

The HHSC pages we reviewed do not give a single wait time you can plan around. What HHSC does say is that lists are first come, first served, and the people who have been on the lists the longest are enrolled first (source). That is why the date you call matters.

What if my child is too old for MDCP or YES?

HHSC lists MDCP for ages 0 through 20 and YES for ages 3 through 18. CLASS, DBMD, HCS, and TxHmL are listed for all ages, and STAR+PLUS Home and Community Based Services is listed for age 21 and older (source).

Sources

Official pages we used

Every program fact on this page comes from these pages. Rules change, so treat the agency as the final word. Teagan's Crown is not affiliated with these agencies. More guides live in our resource library.

  1. HHSC: Interest List Reduction accessed September 2026
  2. HHSC: Texas Long-Term Service and Supports (LTSS) Waiver Programs chart (PDF, revised 09/05/2025) accessed September 2026
  3. HHSC: Community Living Assistance and Support Services (CLASS) accessed September 2026
  4. HHSC: Home and Community-based Services (HCS) accessed September 2026
  5. HHSC: Texas Home Living (TxHmL) accessed September 2026
  6. HHSC: Deaf Blind with Multiple Disabilities (DBMD) accessed September 2026
  7. HHSC: Medically Dependent Children Program (MDCP) accessed September 2026
  8. HHSC STAR Kids Handbook, 2000: MDCP Intake and Initial Application accessed September 2026
  9. HHSC: YES Waiver accessed September 2026
  10. HHSC: YES Waiver Local Mental/Behavioral Health Authority Inquiry Line by County (PDF) accessed September 2026
  11. HHSC: Find Your Local Mental Health or Behavioral Health Authority accessed September 2026
  12. HHSC: STAR Kids accessed September 2026
  13. HHSC LIDDA Handbook, 7000: HCS and TxHmL Interest Lists accessed September 2026
  14. HHS Resources: Local Intellectual and Developmental Disability Authorities directory accessed September 2026
  15. HHSC: Contact Us accessed September 2026
  16. Your Texas Benefits accessed September 2026
  17. Medicaid.gov: Home and Community-Based Services 1915(c) accessed September 2026

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Also useful: Medicaid waiver finder, what a year of care costs, and the full resource library.

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