Yes.
In Texas, a family member can be paid to give care through Consumer Directed Services (CDS) option.
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Medicaid waiver
STAR+PLUS Home and Community Based Services (HCBS) program
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Who qualifies
People 21 or older who have full Medicaid financial eligibility, are U.S. citizens and Texas residents, have an approved medical necessity for a nursing facility level of care, have an unmet need for at least one program service with an individual service plan under the cost limit, and live in an appropriate living situation. The program helps members live in the community instead of a nursing facility.
You can be assessed once your name reaches the top of the STAR+PLUS HCBS program interest list. People already receiving Medicaid and enrolled with a health plan may be able to bypass the interest list through the upgrade process.
STAR+PLUS and STAR+PLUS HCBS program members who live in their own homes or the homes of family members. It is not available to members living in adult foster care homes or assisted living facilities. You, or your legally authorized representative, become the employer: you hire, train and manage your workers, and a financial management services agency handles payroll and taxes.
STAR+PLUS services available through CDS are Personal Assistance Services and Community First Choice personal assistance or habilitation. STAR+PLUS HCBS services available through CDS include in-home respite, skilled nursing, employment assistance, supported employment and several therapies.
Yes.
Yes. The member may hire eligible service providers, such as family members, friends and other people they know, in compliance with program and CDS rules. For Personal Assistance Services, the member may select a relative or legal guardian, other than a legally responsible individual, if that person meets the requirements for the service.
A designated representative who helps you with employer duties must be a volunteer and cannot be a paid service provider.
Depends.
The two current HHSC handbooks differ. The STAR+PLUS Handbook (section 6118) says the state allows a member to select a relative or legal guardian, other than a legally responsible individual, as the Personal Assistance Services provider if that person meets the requirements for the service. The Consumer Directed Services Handbook (Appendix VI, 2016) says that under CDS the court-appointed guardian of the person receiving services must not be an employee and must be the employer.
Ask the MCO service coordinator how the rule applies before a guardian is hired. The CDS Handbook appendix is at fhb.hhs.texas.gov/book/export/html/4269.
You set wages and benefits for your workers within the funds allocated for the services you self-direct. You cannot increase or decrease the hours your MCO authorized by adjusting a worker's hourly wage.
STAR+PLUS Home and Community Based Services (HCBS) program
How to apply
Ask to be placed on the STAR+PLUS HCBS program interest list by contacting the Texas Health and Human Services Commission (HHSC) Interest List Management unit, or your managed care organization (MCO) if you are already enrolled in STAR+PLUS. When you are released from the list, you confirm your interest and submit Form H1200, Application for Assistance, Your Texas Benefits.
The number HHSC intake staff give for adding yourself to the STAR+PLUS HCBS interest list. You can also add yourself at YourTexasBenefits.com. HHSC's Interest List Reduction page gives 1-877-438-5658 for adding a name to the interest lists for waiver programs.
Your MCO service coordinator must explain the CDS option when you enroll and at least once a year. You can ask your service coordinator for information or for help enrolling in CDS at any time, and the coordinator must respond within five business days. The coordinator goes over Form 1582, Consumer Directed Services Responsibilities, with you, including a self-assessment, and helps you appoint a designated representative if you need one.
