State Medicaid Waiver Directory

Texas has not adopted the Katie Beckett/TEFRA state plan option, so there is no child-only income route that ignores parental income. Children qualify for Medicaid through SSI-linked eligibility and standard Medicaid rules, and receive managed care services through STAR Kids — STAR Kids delivers services once a child is Medicaid-eligible but does not itself disregard parental income. Contact Texas HHSC about STAR Kids enrollment immediately, then separately apply for the HCS interest list for waiver-based IDD supports.

Texas operates six Medicaid HCBS waivers: HCS (Home and Community-based Services), TxHmL (Texas Home Living), CLASS (Community Living Assistance and Support Services), DBMD (Deaf Blind with Multiple Disabilities), MDCP (Medically Dependent Children Program), and STAR+PLUS HCBS. HCS and TxHmL — the primary waivers for individuals with intellectual and developmental disabilities — have interest lists with reported waits of 10 to 20 or more years. The Arc of Texas cites up to 16 years for some waivers. As of early 2026, over 180,000 people are on the combined interest lists. Texas has historically underfunded these programs compared to population need. For adults with physical disabilities, STAR+PLUS is the primary managed care program and does not have a waitlist — eligible adults can enroll directly.

The Home and Community-based Services (HCS) waiver is the primary support program for Texans with intellectual and developmental disabilities. As of 2025–2026, over 100,000 people are on the HCS interest list alone. Reported wait times range from 10 to 20+ years depending on when you applied. Apply immediately through your local LIDDA — you do not need to prove eligibility to be added, and your place is based on when you applied.

If a person with IDD is at imminent risk of institutionalization, they may qualify for a Crisis Diversion slot, which bypasses the general interest list. Contact your local LIDDA and explain the situation. The LIDDA will complete Form 1058 and submit documentation. This is the primary pathway for getting services without waiting years on the interest list.

STAR Kids is Texas's Medicaid managed care program for children under 21 with disabilities. It provides comprehensive Medicaid-covered services including therapies, behavioral health, medical supplies, and some HCBS. STAR Kids does not require a waitlist and disregards parental income. This is the first step for any Texas family with a child with a disability. Enroll through Texas HHSC.

STAR+PLUS is the primary Medicaid managed care program for Texas adults with physical disabilities and those 65+. It integrates acute and long-term services and supports and has no waitlist for eligible adults. It covers personal care, home health, adult day, and HCBS supports. Contact Texas HHSC to enroll.

Local Intellectual and Developmental Disability Authorities (LIDDAs) are the entry point for all IDD waiver services in Texas. LIDDAs handle interest list enrollment, eligibility assessments, crisis diversion requests, and service coordination. Find your local LIDDA at hhs.texas.gov or call HHSC at 1-877-438-5658.

Texas VR (twc.texas.gov/programs/vocational-rehabilitation), part of the Texas Workforce Commission, helps people with disabilities prepare for, find, and keep employment. Services include vocational evaluation, job training, assistive technology, job placement and coaching, and supported employment. Services are free and available statewide. VR also serves transition-age youth (ages 14+).

TTAP (ttap.disabilitystudies.utexas.edu) provides free assistive technology services including device demonstrations, short-term equipment loans, device reuse programs, and information on AT funding sources. Available statewide to all Texans with disabilities.

ECI (hhs.texas.gov) provides free early intervention services to infants and toddlers birth through 36 months with developmental delays, disabilities, or at-risk conditions. Services are provided in homes and communities and are family-focused. Families can self-refer. Call 1-800-HELP-5-4-U (1-800-435-7548).

Texas Parent to Parent (txp2p.org) connects families of children with disabilities through peer support and advocacy. Navigate Life for Texas (navigatelifetexas.org) is a comprehensive website for families of children with disabilities or special health care needs, providing information on disability services, advocacy, and community resources statewide.

The Arc of Texas (thearcoftexas.org) is one of the best resources for navigating Texas's Medicaid waiver system. Their Medicaid waivers page includes guidance on which waitlists to join, how to check your place in line, and how to access crisis diversion services. They also run policy advocacy to address the chronic underfunding of Texas IDD services.

DRTx is the state's Protection and Advocacy agency, providing free legal services, advocacy, and information on disability rights, education rights, employment issues, assistive technology access, and abuse/neglect across Texas.

Texas does not currently have a state-mandated paid family leave program. Workers rely on federal FMLA for unpaid leave (up to 12 weeks annually). Some employers in Texas offer voluntary Short-Term Disability or paid parental leave benefits — check with your employer for availability.

Respite is a covered service under several Texas waivers (TxHmL includes caregiver respite, and the CLASS waiver covers respite for families of minors), so waiver participants can use it without the long interest list wait once enrolled. Outside waivers, the Texas Lifespan Respite Care Program (through the Coastal Bend ADRC) helps caregivers of someone of any age with a chronic condition or disability. See the Provider Directory for Texas respite and community programs.

Adaptive Training Foundation (Carrollton) trains people with physical disabilities, and Special Strong runs adaptive fitness locations across Dallas-Fort Worth, Houston, and Texas City. Ability Connection in Dallas hosts adaptive sports, games, and day activities. Texas Foundation of Hope in San Antonio runs a weekday adult program. See the Provider Directory for details.