Texas currently has six Medicaid waivers that can serve children, and all of them are home and community based 1915(c) waivers. Five of these six waivers are based only on child income without regard to parent income. See this information on Long Term Care or this page comparing the various programs. An independent site, Texas Medicaid Waivers Explained, also gives general information about the waiver process in Texas. Texas also has a Medicaid Buy-In Program for children.

Texas has shifted children in most waiver programs into managed care through an 1115 demonstration program called STAR Kids. In addition, Texas began implementing the Community First Choice Option in 2015, which means it can no longer have waiting lists for attendant care for individuals who qualify for Medicaid. It appears that Texas is allowing some individuals on waiting lists for waivers to access this benefit.

Texas Advocacy Organizations:

Last updated 10/30/23

Programs in Texas

  • Target Population: Children who are medically fragile or technology dependent.
  • Ages: 0-20
  • Levels of Care: Nursing Facility; Hospital
  • Income Waiver: The waiver is based on the child’s income only. Parent income is not counted.
  • Waiver Type: 1915(c)
  • Spots: 6796
  • Expiration Date: 8/31/2027
  • Description from medicaid.gov: Provides respite, supported employment, financial management services, adaptive aids, employment assistance, flexible family support services, minor home modifications, and transition assistance services to individuals who are medically fragile ages 0-20 years who meet a hospital or nursing facility level of care.  This waiver operates with a concurrent 1915(a)(1)(a) and 1115 authority.
  • Online State Information: Medically Dependent Children Program
  • Official Federal Information
  • How to Apply: Call 1-877-438-5658 to be placed on the waiting list.
  • Waiting List: There are 311,532 people with developmental disabilities, 22,609 people with physical disabilities, and 8374 children who are medically fragile on Texas’ waiting list.
  • Advocacy/Support Group: Protect TX Fragile Kids
  • Target Population: Children and adults who are both deaf and blind and have multiple disabilities.
  • Ages: all ages
  • Levels of Care: Intermediate Care Facility
  • Income Waiver: The waiver is based on the child’s income only. Parent income is not counted.
  • Waiver Type: 1915(c)
  • Spots: 381
  • Expiration Date: 2/28/2023; renewal pending
  • Description from medicaid.gov: Provides case management, day habilitation, residential habilitation, respite, supported employment, prescribed drugs, financial management services, support consultation, adaptive aids and medical supplies, assisted living, audiology services, behavioral support services, chore service, dental treatment, dietary services, employment assistance, intervener, minor home modifications, nursing, occupational therapy services, orientation and mobility, physical therapy services, speech, hearing, and language therapy services, transition assistance services for individuals with DD, ages 0 – no max age.
  • Online State Information: Deaf Blind with Multiple Disabilities Program
  • Official Federal Information
  • How to Apply: Call 877-438-5658 or contact your local office.
  • Waiting List: There are 311,532 people with developmental disabilities, 22,609 people with physical disabilities, and 8374 children who are medically fragile on Texas’ waiting list.
  • Advocacy/Support Group: Protect TX Fragile Kids
  • Target Population: Children and adults who have developmental disabilities.
  • Ages: all ages
  • Levels of Care: Intermediate Care Facility
  • Income Waiver: The waiver is based on the child’s income only. Parent income is not counted.
  • Waiver Type: 1915(c)
  • Spots: 5878
  • Expiration Date: 8/31/2024
  • Description from medicaid.gov: Provides case management, prevocational services, residential habilitation, respite (in-home and out-of-home), supported employment, adaptive aids, dental treatment, dietary, nursing, occupational therapy, physical therapy, prescribed drugs, speech and language pathology, financial management services, support consultation, auditory integration training/auditory enhancement training, behavioral support, cognitive rehabilitation therapy, continued family services, employment assistance, minor home modifications, specialized therapies, support family services, transition assistance services to individuals with DD, ages 0 – no max age.
  • Online State Information: CLASS Program
  • Official Federal Information
  • How to Apply: Call 877-438-5658 or contact your local office.
  • Waiting List: There are 311,532 people with developmental disabilities, 22,609 people with physical disabilities, and 8374 children who are medically fragile on Texas’ waiting list.
  • Target Population: Children and adults with developmental or intellectual disabilities.
  • Ages: all ages
  • Levels of Care: Intermediate Care Facility
  • Income Waiver: none
  • Waiver Type: 1915(c)
  • Spots: 5393
  • Expiration Date: 2/28/2027
  • Description from medicaid.gov: Provides day habilitation, respite, supported employment, prescription medications, financial management services, support consultation, adaptive aids, audiology services, behavioral support, community support, dental treatment, dietary services, employment assistance, minor home modifications, nursing, occupational therapy services, physical therapy services, and speech-language pathology services for individuals with intellectual disabilities and developmental disabilities ages 0 to no max age.
  • Online State Information: Home Living Program
  • Official Federal Information
  • How to Apply: Call 877-438-5658 or contact your local office.
  • Waiting List: There are 311,532 people with developmental disabilities, 22,609 people with physical disabilities, and 8374 children who are medically fragile on Texas’ waiting list.
  • Target Population: Children and adults who have developmental or intellectual disabilities.
  • Ages: all ages
  • Levels of Care: Intermediate Care Facility
  • Income Waiver: The waiver is based on the child’s income only. Parent income is not counted.
  • Waiver Type: 1915(c)
  • Spots: 27,689
  • Expiration Date: 8/31/2023; renewal pending
  • Description from medicaid.gov: Provides day habilitation, respite, supported employment, adaptive aids, audiology, occupational therapy, physical therapy, prescribed drugs, speech and language pathology, financial management services, support consultation, behavioral support, cognitive rehabilitation therapy, dental treatment, dietary services, employment assistance, minor home modifications, nursing, residential assistance (host home/companion care, supervised living, residential support services), social work, supported home living, transition assistance services for individuals with ID/DD, ages 0 – no max age.
  • Online State Information: Home and Community Based Services
  • Official Federal Information
  • How to Apply: Contact your local office.
  • Waiting List: There are 311,532 people with developmental disabilities, 22,609 people with physical disabilities, and 8374 children who are medically fragile on Texas’ waiting list.
  • Target Population: Children who have a serious emotional disturbance.
  • Ages: 3-18
  • Levels of Care: Hospital
  • Income Waiver: The waiver is based on the child’s income only. Parent income is not counted.
  • Waiver Type: 1915(c)
  • Spots: 3591
  • Expiration Date: 3/31/2028
  • Description from medicaid.gov: Provides respite, supported employment, adaptive aids and supports, community living supports, employment assistance, family supports, minor home modifications, non-medical transportation, paraprofessional services, specialized therapies, supportive family-based alternatives, and transitional services to individuals with serious emotional disturbance ages 3-18 years who meet a hospital level of care.
  • Online State Information: Youth Empowerment Services
  • Official Federal Information
  • How to Apply: Contact your County Local Mental Health Authority.
  • Waiting List: There are 311,532 people with developmental disabilities, 22,609 people with physical disabilities, and 8374 children who are medically fragile on Texas’ waiting list.

Additional Information

  • In the CLASS waiver, parents/guardians of minors may be paid to provide non self-directed services, including residential habilitation, respite, minor home modifications, and nursing.