Community Based Services

Local Intellectual and Developmental Disability Authorities (LIDDAs)

Local intellectual and developmental disability authorities (LIDDAs) serve as the single point of entry for certain publicly funded intellectual and developmental disability (IDD) services and supports for persons residing within the LIDDAs service area.

LIDDA Services include:

  • Diagnostic testing and evaluation for eligibility of publicly funded programs.
  • State funded services to persons with IDD.
  • Placement of persons on the HCS and TxHmL interest list.
  • Service coordination for waiver programs.
  • Preadmission Screening and Resident Review (PASRR) evaluations for persons in a nursing facility who are suspected of having IDD.
  • Planning for the local service area.
  • Permanency planning for certain persons under 22 years of age
  • Protecting the rights of persons
  • Performing enrollment activities for HCS and TxHmL waiver programs
  • Providing support through:
    • Crisis intervention specialists (CIS);
    • Crisis respite (CR);
    • Enhanced community coordination (ECC); and
    • Transition support teams (TST).

Some services and supports have interest lists because they do not have immediate openings available. Persons who want particular services or supports should add their names to the appropriate interest list as soon as possible. Persons who are now receiving particular services or supports may add their names to the interest list for other services and supports.

For more information about services and supports, including a list of providers in your area, please contact your local IDD authority (LIDDA). You can find your LIDDA’s contact information at https://apps.hhs.texas.gov/contact/search.cfm.

Non-Waiver Community First Choice (CFC) Services

Non-waiver CFC provides basic attendant and habilitation services for persons with disabilities and are available to Medicaid recipients who meet an intermediate care facility for persons with intellectual disabilities (ICF/IID) level of care.

CFC enables Texas Medicaid to provide the most cost effective approach to basic attendant and habilitation service delivery. The services available in CFC are:

  • Personal assistance services
  • Habilitation services
  • Emergency response services
  • Support management

To be eligible for Community First Choice services a person must:

  • Be eligible for Medicaid.
  • Need help with activities of daily living, such as dressing, bathing and eating.
  • Meet an institutional level of care.

Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions Program (ICF/IID)

The ICF/IID program provides residential and habilitation services to people with intellectual disabilities or a related condition.

Community-based ICF/IIDs provide 24-hour residential services for people with intellectual disabilities or related conditions. Residents have access to comprehensive and individualized services and supports in their local communities including:

  • Primary and specialty medical care
  • Behavioral support
  • Clinical therapies
  • Nursing
  • Dental treatment
  • Vocational and employment services, skills training and habilitation services
  • Adaptive aids
  • Specialized diets
  • Planned activities

To search for your nearest ICF, use the ICF Search page.

For more information about ICF, visit the ICF/IID page from the Texas Health and Human Services website.

Home & Community-based Services (HCS)

HCS is a Medicaid waiver program that provides individualized services and supports to Texans with an intellectual disability or a related condition so that they can live in the community. Individualized services and supports may be provided to persons living in their own home, family home, or other community settings, such as small group homes.

HCS services are intended to supplement rather than replace services received from other programs, such as Texas Health Steps, or from natural supports, including families, neighbors or community organizations.

HCS may be available to any Texas resident not living in an institutional setting who:

  • Has an IQ of 69 or below or has an approved related condition with an IQ of 75 or below; or
  • Has a primary diagnosis by a licensed physician of a related condition that is included on the list of diagnostic codes for persons with related conditions approved by HHSC [available here]; and
  • Has mild to extreme deficits in adaptive behavior.
  • Is eligible for Medicaid benefits.
  • Is not enrolled in any other Medicaid waiver program.

HCS services may include the following services:

  • Residential services
  • Group home
  • Host home/companion care
  • Respite services
  • Day habilitation
  • Employment services
  • Nursing services
  • Dental services
  • Behavioral support
  • Community support (transportation)
  • Social Work
  • Occupational therapy
  • Physical therapy
  • Speech therapy
  • Audiology services
  • Dietary services
  • Minor home modifications
  • Adaptive aids
  • Transition assistance services

For more information about HCS, visit the HCS page from the Texas Health and Human Services website.

Texas Home Living (TxHmL)

TxHmL is a Medicaid waiver program that provides essential services and supports to Texans with an intellectual disability or a related condition so they can continue to live in their own home or family’s home.

TxHmL services are intended to supplement rather than replace services received from other programs, such as Texas Health Steps, or from natural supports, including families, neighbors or community organizations.

This program may be available to any Texas resident not living in an institutional setting who:

  • Develop and monitor the implementation of a five-year statewide behavioral health strategic plan
  • Develop annual coordinated statewide behavioral health expenditure proposals
  • Annually publish an updated inventory of behavioral health programs and services that are funded by the state

TxHmL can provide the following services:

  • Day habilitation
  • Respite services
  • Employment services
  • Nursing services
  • Dental services
  • Behavioral support
  • Community support (transportation)
  • Occupational therapy
  • Physical therapy
  • Speech therapy
  • Audiology services
  • Dietary services
  • Minor home modifications
  • Adaptive aid

For more information about TxHmL, visit the TxHmL page from the Texas Health and Human Services website.

Community Living Assistance and Support Services (CLASS) provides home and community-based services to individuals with related conditions as a cost-effective alternative to an intermediate care facility for individuals with an intellectual disability or related conditions (ICF/IID).

CLASS services are available to Texas residents not living in an institutional setting who:

  • Have been diagnosed with a related condition prior to age 22 as described in the Texas Approved Diagnostic Codes for Persons with Related Conditions.
  • Have a qualifying adaptive behavior level.
  • Meet the level-of-care criteria for placement in an ICF/IID.
  • Do not exceed specified income and resource limits.
  • Are not enrolled in any other Medicaid waiver program.
  • Demonstrate need for one or more services monthly.

For more information about CLASS, visit the CLASS information handout from HHSC.

Deaf Blind with Multiple Disabilities (DBMD) provides home and community-based services to individuals with deafblindness and another disability as a cost-effective alternative to an intermediate care facility for individuals with an intellectual disability or related conditions (ICF/IID).

DBMD services are available to Texas residents not living in an institutional setting who:

  • Have a diagnosis of deafblindness (or a related condition that will result in deafblindness) as well as an additional diagnosis
  • Have a related condition that was displayed before age 22
  • Meet the level-of-care criteria for placement in an ICF/IID
  • Do not exceed specified income and resource limits
  • Are not enrolled in any other Medicaid waiver program
  • Demonstrate need for one or more services on a monthly basis

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