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Medicaid Waivers and Assisted Living

Texas's STAR+PLUS HCBS waiver pays for care services inside a participating assisted living facility -- not room and board.

HomeCosts & PayingMedicaid Waivers and Assisted Living
Short answer

Texas runs one primary Medicaid HCBS waiver relevant to assisted living: STAR+PLUS HCBS, delivered through the STAR+PLUS Medicaid managed care program. It pays for care services inside a participating facility. It does not cover room and board.

What STAR+PLUS HCBS covers

  • Personal assistance with daily activities, in-home nursing, respite care, and emergency response systems.
  • Placement in an assisted living facility or adult foster care home that holds a current HCBS provider agreement.
  • Home-delivered meals, minor home modifications and adaptive equipment.

What it does not cover

Room and board at the facility remains the resident's own responsibility, typically funded from the resident's income up to Texas's applied-income rules. A community can hold a provider agreement and still have limited or no waiver capacity available -- ask directly how many current residents actually use it.

How families pay for care. STAR+PLUS HCBS pays for care services inside a participating facility, not room and board. VA Aid and Attendance adds up to $2,874/month for a veteran with a dependent. Read the full explanation →

Questions families ask

What happens at an ombudsman-attended care conference?

An ombudsman advocate can sit in alongside the resident and family during a facility care plan meeting, help the family understand what's being proposed, and advocate for the resident's stated preferences if there's a disagreement with the facility's plan.

How do I report suspected abuse or neglect in a Fort Worth-area facility?

Call the Texas Abuse Hotline at 1-800-252-5400, available 24 hours a day statewide, to report suspected abuse, neglect or exploitation of an older adult. If someone is in immediate danger, call 911 first.

What's the difference between reporting to APS and reporting to HHSC in Texas?

Adult Protective Services (1-800-252-5400) investigates concerns about a specific person's safety, including self-neglect. HHSC's Complaint and Incident Intake line (1-800-458-9858) investigates a licensed facility's regulatory compliance -- staffing, physical conditions, and whether the facility followed required procedures.

Is Texas Adult Protective Services a single statewide hotline or run by county?

Texas APS runs one statewide 24-hour hotline (1-800-252-5400) rather than separate county offices with separate numbers. This is the same number whether you're calling from Fort Worth, Arlington, Burleson, or anywhere else in Tarrant, Parker, Johnson, Denton or Wise County.

Can I report a concern anonymously in Texas?

Yes. Texas Adult Protective Services accepts anonymous reports through the statewide hotline at 1-800-252-5400 or online at the Texas Department of Family and Protective Services' reporting portal.

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