How to Apply for Texas HCS and TxHmL Waivers

Applying for a Medicaid waiver in Texas isn't a single application — it's a multi-step registration process through different agencies depending on which waiver you need, and the wait to actually receive services can stretch nearly two decades. Understanding exactly how to apply, and which waivers to apply for, determines whether your child has adult supports in place when school services end.

Which Waiver Fits Your Child

Texas operates several Medicaid waiver programs under Section 1915(c) of the Social Security Act. Each targets a different population and provides different levels of service.

Home and Community-based Services (HCS) is the most comprehensive waiver for individuals with IDD. Services include group home residential support, host home placement, supervised home living, day habilitation, respite, and supported employment. Eligibility requires an IDD diagnosis or a qualifying related condition, Medicaid eligibility, and meeting ICF/IID Level of Care criteria. Apply through your local LIDDA.

Texas Home Living (TxHmL) serves individuals with IDD who live in their own or family homes and have lower support needs. It provides a capped annual allocation of approximately $17,000 for services like respite, community support, employment assistance, and minor home modifications. Same eligibility criteria as HCS, but assumes the family provides the primary residential structure. Apply through your local LIDDA.

Community Living Assistance and Support Services (CLASS) serves individuals of any age with a documented "related condition" (cerebral palsy, spina bifida, epilepsy, and similar diagnoses) that began before age 22 and who meet ICF/IID Level of Care criteria. CLASS provides home modifications, specialized therapies, behavior support, and personal attendant services. Apply through HHSC directly — not the LIDDA.

Medically Dependent Children Program (MDCP) covers medically complex children and young adults under 21 who require a nursing facility level of care. MDCP provides private duty nursing, respite, and transition support. Under March 2026 amendments, HHSC added high-acuity criteria for nursing facility diversion slots.

The Application Process for HCS and TxHmL

These two waivers share the same application path through your local LIDDA.

1. Find your LIDDA. The HHSC directory at resources.hhs.texas.gov/directories/lidda covers all 254 Texas counties. Call and request a meeting to discuss long-term service options.

2. Complete Form 8648. This Identification of Preferences form documents which waiver programs interest you. Register for both HCS and TxHmL — they have separate interest lists, and qualifying for one doesn't exclude you from the other. The Date of Discussion recorded on Form 8648 anchors your position on the waitlist.

3. Provide clinical information. The LIDDA completes Form 8577, a 20-section questionnaire covering disability onset, medical conditions, caregiver status, and daily living assistance needs. They also complete Form 8591 for CSIL data entry.

4. Verify the 60-day entry deadline. HHSC rules require the LIDDA to enter your information into the Community Services Interest List (CSIL) within 60 calendar days of the Date of Discussion recorded on Form 8648. Ask for written confirmation of submission and your assigned CARE ID number.

5. Respond to biennial contacts. Every two years, the LIDDA attempts to verify your continued interest. If it cannot reach you after multiple attempts, it marks your status as "Inactive — Unable to Locate." Your list position is preserved, but you won't receive service offers until you resolve the hold.

The CLASS Application Path

CLASS registration goes through HHSC directly, not the LIDDA. Contact the CSIL hotline at 1-877-438-5658 to initiate placement on the CLASS interest list. The same general documentation requirements apply — disability onset, clinical profile, and contact information.

Because CLASS covers "related conditions" rather than intellectual disability specifically, it's relevant for families whose child has a physical or neurological condition that doesn't meet IDD criteria but still requires long-term community-based support.

Current Wait Times and Slot Releases

As of 2026, about 199,000 Texans are on HHSC waiver interest lists. The wait varies dramatically by program:

• HCS: 17–18 years average wait; approximately 15 slots released per month statewide
• CLASS: 17–18 years average wait; variable monthly releases (approximately 285 in May 2026)
• TxHmL: 663 slots released per month statewide from May through August 2026

Apply for every program your child may qualify for. The interest lists are independent, and getting an offer for one program doesn't remove you from others. Many families register for both HCS and TxHmL simultaneously — if a TxHmL slot opens first, it provides interim support while the HCS wait continues.

When Eligibility Is Actually Determined

Joining the interest list does not require proof of eligibility. You need only basic demographic information and the clinical questionnaire. Actual diagnostic and financial eligibility is evaluated only when your child's name reaches the top of the list and HHSC issues an enrollment offer.

At that point, the student must have a qualifying disability onset before age 18 (or 22 for CLASS-related conditions) and meet the applicable asset and income limits, usually including a $2,000 countable resource limit, based solely on their own income and assets — parental income is no longer counted once the student turns 18.

This means the smartest time to apply is long before your child is close to needing services. Advocacy organizations recommend registering by age 14, right when school transition planning begins.

The Texas IEP Transition to Adulthood Guide walks through waiver registration alongside every other transition milestone, with tracking worksheets for each program's forms, deadlines, and contact verification dates.

See more Texas guides →