TX Home Living Program

Published on
July 19, 2023
Last updated
February 29, 2024
Written by
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Katie Wilkinson
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Discover TxHmL, a Medicaid waiver program offering essential services to Texans with intellectual disabilities, and the potential for caregiver compensation through the Consumer Directed Services (CDS) option.
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The Texas Home and Community-Based Services and Texas Home Living (TxHmL) Medicaid waiver program is designed to promote inclusivity and independence. This program ensures individuals can continue to live fulfilling lives within their communities. While TxHmL is not intended to replace existing services from other programs or natural supports, it is crucial in supplementing and enhancing the quality of care provided.

Overview of TxHmL Medicaid Waiver Program

The Texas Home and Community-Based Services and Texas Home Living (TxHmL) Medicaid waiver program is a lifeline for Texans with intellectual disabilities (ID) or related conditions, striving to ensure they can lead meaningful lives within their communities. Established with a compassionate and inclusive approach, TxHmL offers a comprehensive array of essential services and supports to enable eligible individuals to remain in their homes and avoid institutionalization.

To be eligible for TxHmL, individuals must meet specific criteria related to intellectual disability or related conditions, age, and citizenship status. The program targets a diverse population, including children and adults with ID, autism spectrum disorder, and other related developmental disabilities.

The overarching goal of TxHmL is to enhance its participants' quality of life and independence. By providing a wide range of services, such as personal assistance, respite care, and adaptive aids, TxHmL empowers individuals to engage in community activities, improve their skills, and foster a sense of belonging.

Additionally, the program aims to alleviate the burden on family caregivers by supplementing their efforts and fostering a supportive environment that acknowledges their indispensable role in the care continuum.

Eligibility Requirements for TxHmL Medicaid Waiver Program

To qualify for the Texas Home and Community-Based Services and Texas Home Living (TxHmL) Medicaid waiver program, individuals must meet specific eligibility criteria, ensuring that those with intellectual disabilities (ID) or related conditions receive the necessary support to live in their homes or family settings.

Eligible applicants must meet one of the following criteria:

  1. Intellectual Disability (ID): Individuals with an IQ of 69 or below can apply for TxHmL. Alternatively, those with an approved related condition can qualify with an IQ of 75 or below.
  2. Deficits in Adaptive Behavior: The program requires applicants to demonstrate mild to severe deficits in adaptive behavior. Adaptive behavior refers to an individual's ability to carry out everyday tasks necessary for independent functioning.
  3. Medicaid Eligibility: To be considered for TxHmL, applicants must be eligible for Medicaid benefits, which involve meeting specific income and asset requirements set by the state.
  4. Non-Enrollment in Other Medicaid Waiver Programs: Applicants cannot be enrolled in any other Medicaid waiver program while seeking eligibility for TxHmL.

By adhering to these requirements, the TxHmL Medicaid waiver program ensures that the proper support reaches those who need it most, enabling them to live fulfilling lives within their communities and fostering a compassionate and inclusive society.


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Services and Supports Available under TxHmL Medicaid Waiver Program

The Texas Home and Community-Based Services and Texas Home Living (TxHmL) Medicaid waiver program offers a comprehensive range of services and supports tailored to meet the unique needs of individuals with intellectual disabilities (ID) or related conditions, allowing them to thrive within their communities.

  1. Day Habilitation: This service fosters skill development, socialization, and community integration through meaningful activities.
  2. Respite Services: Caregivers can take temporary breaks from their responsibilities while their loved ones receive temporary care and support.
  3. Employment Services: Individuals are offered assistance in finding and maintaining employment suited to their abilities and preferences.
  4. Nursing Services: Qualified nurses provide specialized medical care and support based on individual health needs.
  5. Dental Services: Access to dental care is facilitated to maintain oral health and well-being.
  6. Behavioral Support: Behavioral specialists offer interventions and strategies to address challenging behaviors effectively.
  7. Community Support (Transportation): Transportation services enable individuals to participate in community activities and events.
  8. Occupational Therapy: Occupational therapists help individuals develop the skills necessary for daily living and increased independence.
  9. Physical Therapy: Physical therapists work on improving mobility, strength, and coordination.
  10. Speech Therapy: Speech therapists assist with communication challenges, promoting practical language skills.
  11. Audiology Services: Hearing-related assessments and support are provided for those with hearing impairments.
  12. Dietary Services: Nutrition planning and dietary support are available to promote overall health.
  13. Minor Home Modifications: Adaptations are made to homes to enhance accessibility and safety.
  14. Adaptive Aid: Devices and aids are provided to facilitate daily activities and promote independence.

The TxHmL program allows individuals to receive personal assistance services, habilitation, or emergency response services through the Community First Choice (CFC) program. Moreover, participants can access unlimited prescriptions through the Medicaid Vendor Drug Program, ensuring their medical needs are adequately addressed.


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Compensation for Caregivers

The TX Home Living Program does not have a self-direction option, meaning the individual or their representative cannot choose and manage their service providers.

Self-direction is only available for specific services in other programs, such as the Community Living Assistance and Support Services (CLASS) Waiver, the Deaf Blind with Multiple Disabilities (DBMD) Waiver, the Home and Community-Based Services Program Waiver, and the Medically Dependent Children Program (MDCP) Waiver. In these programs, the individual or their representative can hire, train, manage, and fire their service providers, including family members or friends, as long as they are not their spouse. They can also manage their service budget and have more flexibility and control over their services.

The TX Home Living Program does not have a self-direction option because it is a state plan service, not a waiver service. State plan services are mandatory services that Texas must provide to all eligible Medicaid recipients. In contrast, waiver services are optional services that Texas can deliver to a limited number of eligible Medicaid recipients.

Waiver services allow Texas to waive specific federal rules and regulations that apply to state plan services, such as income limits, service limits, and provider qualifications. This gives Texas more freedom and flexibility to design and implement waiver programs that meet different populations' specific needs and preferences.
Suppose you want to get paid as a caregiver for an individual with intellectual or developmental disabilities who lives in their own or family's home. In that case, consider applying for one of the waiver programs in Texas with a self-direction option.

Learn more about Medicaid consumer-directed care >>

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