While some people want to stay in their own homes, others may want or need to live in a place where they can get 24-hour help. These places are called residential settings.

Assisted Living Facility

If you choose to live in assisted living facility, you will usually have your own room or apartment. You can bring your things with you to make it feel like home. You will usually eat with others. Services might include:

  • Help bathing or getting dressed.
  • Someone to make sure you get your medicine.
  • Employees checking on you to make sure you are doing OK.

How do People Pay for This?

Two HHSC programs may pay for assisted living — Community Based Alternatives (CBA) and Deaf Blind with Multiple Disabilities (DBMD). Not all facilities offer CBA and DBMD services.

People who don't qualify for one of those programs will need to use their own money or possibly long-term care insurance to pay for assisted living. You can learn more about long-term care insurance at LongTermCare.gov.

Who Monitors Assisted Living?

HHSC licenses assisted living facilities and inspects them once a year. The agency also looks into complaints made about facilities.

Many times residents have access to a volunteer long-term care ombudsman who can help resolve issues. Ask the facility staff who your ombudsman is.

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Community ICF/IIDs

Community ICF/IIDs come in many shapes and sizes. You can live in a home with a few other people or you can live in a facility with many people. At both, employees are there to help you 24 hours a day.

You get to help decide on the types of services you get. This is called your individual service plan. This plan is reviewed once a year. The plan can be changed as needed.

You will have help with managing things, such as:

  • Taking medicine
  • Dressing, cooking or bathing
  • Managing your behaviors

Who Monitors ICF/IIDs?

DADS certifies ICF/IIDs and inspects each facility once a year. The state looks into complaints against facilities.

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Your Rights

People who live in an ICF/IID have the same rights as everyone else. These brochures will help you understand your rights.

Home and Community-based Services Group Homes

People who get services from the Home and Community-based Services (HCS) program can live in a small group home. If you live in an HCS group home, you will share a home with up to four people who also have IDD. People will help you take medicine, get dressed or bathe, cook, and manage your behaviors.

Interest List

Because there are more people who want HCS services than the state can pay for, your name would be placed on a interest list. You will be contacted when you can start getting services.

Service Planning

You get to help decide on the types of services you get. This is called your individual service plan. This plan is reviewed once a year to see if it still works for you. The plan can be changed as needed.

People in HCS may get:

  • Adaptive aids
  • Caregiver respite
  • Daytime programs
  • Dental treatment
  • Nursing services
  • Specialized therapies
  • Supported employment
  • Supported home living

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Your Rights

People in the HCS program have the same rights as everyone else. These brochures will help you understand your rights.

Nursing Home

If your doctor says you need full-time care from a nurse, a nursing home may be right for you. Nursing homes are the highest level of care most people will receive outside of a hospital. This type of care is sometimes called custodial care. In additional to a high level of medical care, residents get help getting into and out of bed and with feeding, bathing and dressing and other activities.

The cost of a nursing home in Texas ranges from $3,000 to $4,000 a month (University of Texas). If you do not have much income or other resources, Medicaid may pay for a nursing home. You can talk to a HHSC worker about Medicaid. You will have to live in a nursing home for 30 consecutive days before you can apply for HHSC services.

Will Medicare Pay for a nursing home?

Many people think that Medicare will pay their nursing home expenses. That is not always true. Medicare pays for up to 100 days in a skilled nursing facility following a hospital stay. Skilled care includes physical and other types of therapy. The goal is to help you return home as soon as possible and keep you from being readmitted to the hospital.

Who Monitors Nursing Homes?

HHSC licenses and certifies nursing homes, and the agency inspects them once a year. The state also looks into complaints against nursing homes.

Many times residents have access to a volunteer long-term care ombudsman who can help resolve issues. Ask the facility staff who your ombudsman is.

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State Supported Living Centers

Texas has 13 state supported living centers. They are in all parts of the state. They specialize in helping people who have medical and behavioral problems. Visit the living center website to learn more.

Service Planning

If you choose to call a living center home, you will help plan the types of assistance you get. This is called your individual service plan. This plan will be reviewed§ once a year. The plan can be changed as needed.

You will have help with managing things, such as:

  • Taking medicine
  • Dressing, cooking or bathing
  • Managing your behaviors

Who Monitors Living Centers?

HHSC certifies the state supported living centers and inspects them once a year. The state also looks into complaints.

Each living center has a full-time ombudsman to help residents, family members, staff and others who have concerns about the centers.

To Learn More

Your Rights

Living center residents have the same rights as everyone else. These brochures will help you understand your rights.

Where Do I Call to Get These Services?

Please click here to find your local intake office, area agency on aging, local authority, or aging and disability resource center. You can search by city, county or ZIP code.

What You Need to Know

Click here to find out other things you need to know about getting help from HHSC, including the application process, your rights and interest lists.