Home & Community-Based Services (HCS)

Service Description
The HCS Program provides individualized services and supports to individuals with diagnoses of mental retardation or a related condition who live in their family home, their own homes, or other community settings such as small group homes where no more than four persons live.

Funding Sources
Title XIX Medicaid 1915(c) Home and Community-Based Services Waiver and State Funds

Covered Services
Services include:

• Adaptive aids
• Minor home modifications
• Specialized therapies (includes audiology, speech/language pathology, occupational therapy, physical therapy, dietary services, social work and behavioral support)
• Dental treatment
• Nursing
• Supported home living
• Residential assistance o Foster/companion care
• Supervised living
• Residential support
• Respite
• Day habilitation
• Supported employment

The local MR Authority provides service coordination to all individuals enrolled in HCS.

Consumer Eligibility

• Age: No limit
• Income and Resources: An applicant is financially eligible if he or she:
  • is eligible for supplemental security income (SSI);
  • is eligible for Medical Assistance Only (MAO) protected status; or
  • have a monthly income that is within 300% of the SSI monthly income limit and meets the resource requirements for Medicaid benefits in an ICF/MR. ($2,022/month with resources of $2,000 for an individual. Spousal impoverishment provisions apply.);
  • is a disabled child who would be eligible for Medicaid if institutionalized and if parental income is not deemed to the child;
  • is under 20 years of age, financially the responsibility of TDFPS in whole or in part and is being cared for in a foster home or group home licensed or certified and supervised by TDFPS in which a foster parent is the primary caregiver residing in the home; or
  • is a member of a family who receives full Medicaid benefits as a result of qualifying for Temporary Aid to Needy Families.

Additional Criteria
Individuals must also:

• qualify for an ICF/MR Level of Care (LOC) I;
• have a determination of MR made in accordance with state law or have been diagnosed by a physician as having a related condition;
• have an Individual Plan of Care (IPC) that does not exceed 200% of the reimbursement rate that would have been paid for that same individual to receive services in an ICF/MR, or 200% of the estimated annualized per capita cost for ICF/MR services as of August 31, 2010, whichever is greater;
• have made a choice of the HCS Program over the ICF/MR Program; and
• not be enrolled in another 1915(c) waiver program. 

Provider Base
Public and private entities. Individuals electing to direct their own employees may choose a Consumer Directed Services Agency (CDSA) to assist with payroll for respite or supported home living.

Service Availability
Statewide