Texas has seven Medicaid waiver programs that provide home and community-based services for individuals with IDD. These programs are NOT entitlements—funding is limited, and demand far exceeds availability. The Home and Community-based Services (HCS) waiver, the largest program, has an interest list of over 100,000 individuals.
The Most Important Thing to Know
- GET ON THE LISTS EARLY. You can be added to interest lists during early childhood—you don’t need to wait for formal diagnoses or eligibility determinations. Some lists take up to 18 years before your name is reached. Your position is based on the DATE you were added to the list. Eligibility is determined later, when funding becomes available and your name comes up.
⚠️ CRITICAL ACTION: Join waitlists as soon as possible. Some families wait 10-18 years. The earlier you join, the sooner services become available.
How to Get on the Waitlists
- For IDD waivers (HCS, TxHmL, CLASS, DBMD): Call the general waitlist number at 877-438-5658, or contact your Local Intellectual and Developmental Disability Authority (LIDDA).
- For Bexar County (San Antonio area): Contact Alamo Area Council of Governments (AACOG) – Intake Phone: 210-832-5020, Main Phone: 210-362-5200, Website: https://aacog.gov/IDDServices
- For YES Waiver (mental health): Contact your Local Mental Health Authority (LMHA). For Bexar County: Center for Health Care Services at 210-261-CHCS (2427).
Which Waitlists Should You Join?
- Consider joining ALL relevant lists. Each waiver has its own interest list and eligibility criteria. Join all lists based on your child’s diagnosis and needs—you don’t know what future needs they might have. See the Community Waiver Programs section in the glossary for details on each waiver.
What You Need to Provide NOW
- Basic information only. You need basic contact information and a request to be added to specific waiver interest list(s). That’s it.
What You Do NOT Need NOW
- No formal documentation required yet. You do NOT need: formal eligibility determination, complete diagnostic documentation, or financial eligibility verification. These come later when your name comes up on the list.
Important Maintenance
- Keep your contact information current with HHSC. Notify them immediately of any address or phone number changes. Failure to maintain current contact information could affect your position on the list.
⚠️ CRITICAL MAINTENANCE: Update your contact information immediately when it changes. Missing contact from HHSC could mean losing your place on the waitlist.
What Happens When Your Name Comes Up
- HHSC and/or DSHS will contact you. They will review diagnostic, medical, psychological, and developmental history. Financial and income eligibility will be assessed (requirements vary by waiver).
- You will be offered services if eligible. When you receive an offer for one waiver, you come off that interest list, but can remain on others.
Additional Resources
See the Definitions/Glossary section for detailed information about each waiver program.
For comprehensive waiver information and assistance navigating the system, visit www.sacrd.org/IDD, connect with a case manager or social worker at various organizations or contact Morgan’s Multi-Assistance Center and their team of Navigators.
Remember: Getting on the waitlists early is one of the most important steps you can take for your child’s future. Don’t wait for a formal diagnosis—join the lists now.
