Medicaid Waivers and "Interest Lists"
What is a Medicaid Waiver?
A Medicaid waiver will allow the state to be more flexible in how it spends money to *some long-term services to people with disabilities or elderly citizens who are eligible for Medicaid. In the past, people had to be in nursing homes/facilities or other large institutions for Medicaid to pay for long-term care services.
Waivers override certain rules for how Medicaid funding can be used. If they meet the eligibility requirements, people can get the services they need in their own homes or other community settings, instead of having to go into a nursing facility or institution.
In Texas, there are several different waiver programs that offer a broad range of home and community-based services to people with disabilities and elderly citizens. There are different rules and funding amounts for each of the different waivers. In general, though, they all help people get the supports they need in the community.
Who can get services in Texas?
- You must qualify for care in an intermediate care facility for individuals with an intellectual disability or related conditions.
- You must have a determination of an intellectual disability in accordance with state law or have a diagnosis of a related condition with an IQ of 75 or below.
- You cannot be enrolled in another waiver program.
- Your income and resources may not exceed specified limits.
How old do you have to be to start receiving services in Texas?
You can be of any age and get waiver services. Your age will help determine which waiver you go on.
What assistance is available while you wait for waiver services in Texas?
If you are looking for disability services, start by calling 2-1-1. This is a free service, and you can speak to knowledgeable staff 7 days a week 24 hours a day.
What are Interest Lists?
The Department of Health and Human Services maintains an "Interest List" (also known as the "Waiting List") for individuals with disabilities and their families who are requesting Medicaid waiver services. Due to a variety of reasons, the interest lists move at a different pace for each of the waivers. Some waivers are available immediately, while others have wait time of up to 13 years at the current time. This function was previously maintained by DADS - Texas Department of Aging and Disability Services.
- Sign up for all interest lists that you and your family member may be eligible for or are interested in, even if you are not sure you will qualify.
- Always get the name and contact information of the person who records your information and keep it with your records. You should receive a letter of confirmation with the following information: Waiver, Agency, Name and Contact Information
- If you receive a letter or phone call from the agency regarding the interest list ALWAYS respond. Your name may be "scrubbed" from the list if there is no response.
- Ask: How many people are on the list?
- Is it organized by state or county?
- When and how will they contact you?
- If you change your address or phone number, make sure that you call the Health and Human Services (HHS) office to give them the correct information. Also, call at least one time a year to verify that your name is still on the list and that your contact information is still correct.
Agency Contacts to Get on the Interest List
What do the specific waivers help with?
- CLASS Community Living Assistance and Support Services - adaptive aids, Case Management, Dietary/Nutrition, Habilitation Attendant/Habitation Training
- DBMB Deaf Blind with Multiple Disabilities - adaptive aids, assisted living, behavior communication specialist, chore services, day habitation, dietary/nutrition, intervenor
- HCS Home and Community Services - adaptive aids, audiology, case management, day habitation, dental, dietary/nutrition, Foster/Companion Care
- MDCP Medically Dependent Children Program - adaptive aids, Adjunct Support Services, Case Management
- STAR+PLUS HCBS Home and Community Based Service - personal assistance services, respite care, home nursing services, home-delivered meals, minor home modifications, adaptive aids, medical equipment and supplies, adult foster care, assisted living, cognitive rehabilitation, and occupational, physical and speech-language therapy.
- TxHmL Texas Home Living Waiver - adaptive aids, Audiology, Behavioral Support, Community Support, Day Habitation, Dental, Dietary/Nutrition, Employment Assistance, dental
- YES Youth Empowerment Services - adaptive aids, community living supports (CLS), employment assistance, family supports, respite, supported employment, non-medical transportation, paraprofessional services and specialized therapies
WAIVERS IN TEXAS:
- Request to be added to the CLASS waiver interest list by calling 877-438-5658 toll-free and asking for the CLASS waiver program.
- Request to be added to the DBMD waiver interest list by calling 877-438-5658 toll-free and asking for the DBMD waiver program
- Families can call 2-1-1 for information about HCS eligibility or contact the Local Intellectual and Developmental Disability Authority (LIDDA)
- Request to be added to the MDCP waiver interest list by calling 877-438-5658 toll-free and asking for the MDCP waiver program.
- Request to be added to the STAR+PLUS HCBS waiver interest list by calling 800-964-2777 toll-free and asking for the MDCP waiver program.
- Call 877-782-6440 toll-free for information about eligibility. Request to be added to the STAR+PLUS HCBS waiver interest list by calling 800-964-2777 toll-free and asking for the MDCP waiver program.
- For eligibility information, call the YES waiver inquiry line at your Local Mental Health Authority (LMHA) or Local Behavioral Health Authority (LBHA). Each LMHA and LBHA has a designated phone number for inquiries about YES enrollment.