This glossary provides definitions of key terms, programs, and services for families of individuals with intellectual and developmental disabilities in Texas.
504 Plan
A plan developed under Section 504 of the Rehabilitation Act of 1973, a federal civil rights law. The plan ensures that students with physical or mental impairments have equal access to educational opportunities through accommodation. Unlike an IEP (which provides specialized instruction), a 504 plan focuses on removing barriers to learning. There is no cost to families to obtain a 504 plan.
Achieving a Better Life Experience (ABLE) Program
The Texas ABLE Program is a tax-advantaged savings account for individuals with disabilities and their families. Funds can be used for disability-related expenses without impacting eligibility for programs like SSI. Interest income accumulates tax-free when used for qualifying expenses. To learn more and enroll, visit www.texasable.org
Adaptive Behavior Assessment
An evaluation measuring a person’s ability to perform daily living skills appropriate for their age, including communication, self-care, home living, social skills, and safety.
Admission, Review, and Dismissal (ARD) Meeting
Also called an IEP meeting in other states. This is a formal meeting where parents, teachers, specialists, and administrators develop, review, or modify a student’s Individualized Education Program (IEP). In Texas, these are called ARD meetings.
Community Living Assistance and Support Services (CLASS)
A Medicaid waiver program providing home and community-based services to people with related conditions (disabilities other than intellectual disabilities that originated before age 22, such as cerebral palsy, muscular dystrophy, spina bifida, epilepsy, or head injuries). Services are delivered in the person’s own home or family home and include specialized therapies only available on this waiver. Individuals must exhibit substantial functional limitations in at least three areas of major life activities and be eligible for SSI or Medicaid. To join the interest list, call 877-438-5658 and ask for the CLASS Waiver Program. For questions, email CLASSPolicy@HHSC.state.tx.us
Community Waiver Programs
Texas has seven Medicaid waiver programs that let the state use Medicaid funds for long-term home and community-based services. They’re called ‘waivers’ because certain Medicaid requirements (like family income) are waived. All but one waiver is based on the child’s income alone, not the family’s income. Each waiver has its own interest list. Consider adding your child to all relevant lists—you don’t know what future needs they might have. Waivers are managed by the Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS). Important: Waiver programs are NOT entitlements. The HCS waiver has an interest list of over 100,000 individuals, and some lists take up to 18 years. Families are encouraged to place their loved ones on lists during early childhood. When your name comes up, HHSC/DSHS will review eligibility. See the comparison chart at: hhs.texas.gov/sites/default/files/documents/doing-business-with-hhs/providers/resources/ltss-waivers.pdf
Continued and Coordinated Services (CCS)
A plan is developed when a student with disabilities exits special education before graduating, ensuring they continue to receive necessary supports and services.
Day Activity and Health Services (DAHS)
Licensed facilities providing health, social, and related support services during daytime hours (typically up to 10 hours per day) to individuals with chronic medical conditions. DAHS serves as an alternative to nursing home admissions and provides services to four or more unrelated people. Previously called adult day care centers, the program is administered by the Texas Department of Health & Human Services.
Deaf Blind with Multiple Disabilities (DBMD)
A Medicaid waiver program providing home and community-based services to people who are deaf/blind with multiple disabilities. The program focuses on increasing opportunities for communication and interaction with the environment. Individuals must have a diagnosis of deaf, blindness (or related condition), an additional diagnosis, meet ICF/IID level-of-care criteria, and exhibit substantial functional limitations in at least three areas of major life activities. To join the interest list, call 877-438-5658 and ask for the DBMD Waiver Program.
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
A Medicaid benefit providing comprehensive and preventive health care services for children under age 21. The program ensures preventive dental, mental health, and specialty services are provided early to prevent more complex problems later. Health checks and screenings are performed at age-appropriate intervals. If a risk is identified, diagnostic tests and treatment referrals follow. This is a federally mandated program.
Early Childhood Intervention (ECI)
A statewide program serving families with children from birth to 36 months with developmental delays or disabilities. Services can include case management, specialized skills training, deaf education, vision services, physical/occupational/speech therapy, nursing, nutrition services, and social work. Services are provided in familiar places like home, childcare centers, libraries, parks, and other community locations. Services cover every county in Texas and are provided by local agencies and organizations.
Family Medical Leave Act (FMLA)
A U.S. federal law providing eligible employees with up to 12 weeks of unpaid leave per year for certain family and medical reasons, with job protection and continued group health insurance coverage. Enacted in 1993, the FMLA allows employees to manage significant life events without sacrificing employment.
Home and Community-Based Services (HCS)
The largest and most comprehensive community waiver. HCS services include residential options (three or four-bed group homes and host home/companion care), support in a person’s own home or community, transportation, Individualized Skills and Socialization, employment services, and more. HCS is intended to supplement, not replace, services from other programs. To join the interest list, contact your Local Intellectual and Developmental Disability Authority (LIDDA). For Bexar County: Alamo Area Council of Governments (AACOG) – Intake: 210-832-5020, Main: 210-362-5200, Website: https://aacog.gov/IDDServices
Inclusion Rate
The percentage of time a student with disabilities spends in general education classrooms with non-disabled peers. Higher inclusion rates indicate more time in mainstream classroom settings.
Individualized Education Program (IEP)
A written education plan for students ages 3-21 who qualify for special education services. The IEP outlines specific learning goals, accommodations, modifications, and services the student will receive.
Individual Service Plan (ISP)
For individuals enrolled in Home & Community Services (HCS), an Individual Service Plan (ISP) is created and reviewed annually to determine supports such as adaptive aids, caregiver respite, dental treatment, nursing services, specialized therapies, supported employment, and supported home living.
Individualized Skills and Socialization (ISS)
Formerly called day habilitation, ISS is a service in the HCS, TxHmL, and DBMD waivers designed to provide person-centered care. Unlike traditional day habilitation, ISS focuses on developing and enhancing skills, promoting community integration and socialization, and increasing community access. ISS emphasizes skill-building and can be delivered individually or in small groups in the community or in the individual’s home, rather than in a facility.
Intellectual or Developmental Disability (IDD)
Lifelong conditions that uniquely affect an individual’s physical, intellectual, and/or emotional development, requiring services and support across the lifespan. Common examples include autism spectrum disorders (ASD), Down Syndrome, and Cerebral Palsy. About one-third of individuals with IDD also have a mental health condition.
Intermediate Care Facilities (ICF-IIDs)
A state entitlement program providing 24-hour care to individuals with IDD living in a facility. There are no interest lists for entitlement programs—they’re available statewide to anyone meeting eligibility requirements (diagnosis of intellectual or developmental disability). Community-based ICF-IIDs can be public or privately owned and may be small (up to 8 beds), medium (9-13 beds), or large (14+ beds). The majority are small.
Inventory for Client and Agency Planning (ICAP)
A comprehensive assessment tool used to evaluate adaptive behaviors and identify support needs for individuals with IDD in Texas. It guides resource planning and service allocation, ensuring individuals receive appropriate support based on their unique needs. The ICAP is essential for establishing consistent levels of need and reimbursement rates for services, including the ICF/IID program.
Level of Care (LOC) Assessment
An evaluation to determine the intensity of services and supports an individual needs, used to determine eligibility for waiver programs. The assessment is based on primary diagnosis, IQ score, and adaptive behavior level. Both LOC and Level of Need (LON) are essential for ensuring individuals receive appropriate support to promote their health, safety, independence, and quality of life.
Level of Need (LON)
An assessment for individuals with IDD in Texas to determine the appropriate level of support and reimbursement rate for certain HCS program services. Individuals are categorized into five levels (LON 1, 5, 8, 6, and 9) based on adaptive skills and problem behavior.
- LON 1 (Intermittent) requires minimal support with very independent living skills.
- LON 5 (Limited) requires reminders to 24-hour guidance.
- LON 8 (Extensive) requires hands-on personal care assistance.
- LON 6 (Pervasive) requires significant behavioral intervention and may need 1:1 supervision.
- LON 9 (Pervasive Plus) requires 1:1 supervision for at least 16 hours per day due to dangerous behaviors.
This assessment is crucial for HCS eligibility.
Local Intellectual and Developmental Disability Authority (LIDDA)
LIDDAs serve as the point of entry for publicly funded IDD programs. They provide or contract services, enroll eligible individuals into Medicaid programs (ICF/IID, HCS, TxHmL), and handle Permanency Planning for individuals under 22 in residential settings. For Bexar County: Alamo Area Council of Governments (AACOG) – Intake: 210-832-5020, Main: 210-362-5200, Crisis: 210-832-5022, Website: https://aacog.gov/IDDServices, Address: 2700 NE Loop 410, Suite 101, San Antonio, TX 78217
Medically Dependent Children Program (MDCP)
Services supporting families caring for medically dependent children and young adults aged 20 and younger, encouraging de-institutionalization. MDCP provides respite, flexible family support, minor home modifications, adaptive aids, transition assistance, employment assistance, supported employment, and financial management services through STAR Kids or STAR Health managed care. HHSC oversees this program: 877-438-5658.
Natural Supports
Unpaid assistance provided by family members, friends, neighbors, coworkers, or community members—as opposed to paid professional services.
Occupational Therapy (OT)
Therapy focused on fine motor skills, self-care activities, sensory processing, and daily living skills. OT helps with dressing, eating, bathing, handwriting, play skills, and managing sensory sensitivities, enabling individuals to participate more fully in everyday activities at home, school, and in the community.
Person-Centered Planning (PCP)
A planning process that puts the individual with disabilities at the center of all decisions about their life, focusing on their strengths, preferences, and goals rather than limitations.
Physical Therapy (PT)
Therapy focused on gross motor skills, mobility, strength, balance, and coordination. PT helps improve movement patterns, build strength, and increase independence with walking, standing, sitting, and other physical activities. Particularly important for children with conditions affecting muscle tone, movement, or physical development.
Representative Payee
A person or organization appointed by Social Security to receive and manage SSI or SSDI benefits on behalf of someone who cannot manage their own benefits. Parents can apply to become representative payees for their adult children when they turn 18 without requiring guardianship.
Respite Care
Temporary relief care provided to caregivers of individuals with disabilities, giving family members a break from caregiving responsibilities.
Social Security Disability Insurance (SSDI)
A federal program providing monthly payments to people with disabilities. Minor children (age 17 and younger) can qualify based on their parents’ income. Adult children (18+) can qualify based on their own employment record or by collecting children’s benefits through their parent’s Social Security retirement/disability earnings. After receiving SSDI for 24 months, individuals can get Medicare health insurance. SSDI and SSI are different programs with different rules—getting one may affect the other. Some people can get SSI, SSDI, and Medicaid simultaneously. Check with Social Security Administration before applying if your child already gets another benefit.
Speech-Language Therapy (Speech Therapy/SLP)
Therapy addressing communication skills (speaking, understanding language, using communication devices), feeding and swallowing difficulties, and social communication. Speech-language pathologists help with articulation, language development, augmentative and alternative communication (AAC) devices, social pragmatics, and oral motor skills needed for safe eating and drinking.
STAR Kids
A Texas Medicaid managed care program providing benefits to children and youth 20 and younger who have disabilities. Participation is required for those covered by Medicaid who get SSI, get Medicaid and Medicare, live in a community-based ICF/IID or nursing facility, or receive services through MDCP, YES, CLASS, DBMD, HCS, or TxHmL waivers. At age 15, transition planning begins to migrate to STAR+PLUS by age 21.
State Supported Living Centers (SSLCs)
A state entitlement program providing 24-hour care to individuals with IDD in large, state-owned and operated institutional facilities. There are no interest lists—services are available statewide to anyone meeting eligibility requirements (diagnosis of intellectual or developmental disability).
Supplemental Nutrition Assistance Program (SNAP)
Provides food benefits to individuals and families to supplement their grocery budget. Formerly known as food stamps, SNAP benefits are provided through an Electronic Benefits Transfer (EBT) card, which can be used at authorized retailers. Overseen by the U.S. Department of Agriculture (USDA).
Supplemental Security Income (SSI)
Often called ‘disability benefits,’ SSI is a federal program providing monthly payments to help cover basic needs like medical care, food, clothing, and shelter. The amount depends on living situation and income. If the individual is 17 or younger, the family might receive SSI to help with the child’s needs. Adult children with disabilities might get SSI themselves. The child may qualify for Medicaid health insurance if receiving SSI. SSI and SSDI are completely different benefits.
Texas Health Steps (THSteps)
Texas’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program for Medicaid recipients under age 21. THSteps provides comprehensive healthcare services including regular medical checkups, dental care, vision care, hearing tests, immunizations, and therapy services (PT, OT, speech). Services are provided at no cost and are in addition to services received through school or ECI. Valuable for children needing more therapy hours than ECI or schools provide.
Texas Home Living (TxHmL)
A Medicaid waiver program delivering services in a person’s own home or family home, including Individualized Skills and Socialization, employment services, and transportation. This is the ONLY waiver considering family income for eligibility. TxHmL supplements (doesn’t replace) services from other programs like Texas Health Steps or natural supports. To join the interest list, contact your LIDDA. For Bexar County: AACOG at 210-832-5020.
Youth Empowerment Services (YES) Waiver Program
A Medicaid program helping children and youth (ages 3-18) with serious mental, emotional, and behavioral difficulties. YES provides intensive services through a strengths-based Wraparound process. A facilitator meets weekly with youth and family to create a Wraparound Plan with help from a Child and Family Team. The child must have a qualifying mental health diagnosis, be at risk of out-of-home placement, meet psychiatric hospital criteria, and be Medicaid eligible (parent’s income doesn’t apply). Average program length is 11-18 months. Contact your Local Mental Health Authority (LMHA) to be added to the inquiry list. For Bexar County: Center for Health Care Services at 210-261-CHCS (2427).
Credits & Sources
“What is IDD?” Providers Alliance for Community Services of Texas
Various state of Texas websites were also utilized to produce this glossary.
Navigate Life Texas – https://www.navigatelifetexas.org/en/insurance-financial-help/texas-medicaid-waiver-programs-for-children-with-disabilities
