Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings: State Policy Maker and Stakeholder Views in Six States. Texas


Texas uses only the waiver program to cover services in residential care settings. In the early 1990s, Texas became interested in supporting residential care alternatives to nursing homes for individuals who met a nursing home level of care but could not be safely cared for at home. In 1994, Texas implemented an HCBS waiver program -- called Community Based Alternatives -- to provide services in private homes, in adult foster care homes, and in assisted living/residential care facilities. The state's primary goal in creating the Community Based Alternatives waiver program was to offer both home and community alternatives to institutional care and to provide an opportunity for persons in institutions to transition to the community.

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