Caregiver Programs Available to You in Texas

Texas has more caregiver support programs than most families realize. If you're caring for an aging parent or spouse, there are programs that can pay you for your work, give you a break through respite care, connect you with other caregivers, and help you figure out the benefits your loved one qualifies for.1 You don't have to do this alone, and you don't have to pay for everything out of pocket.

This guide covers every major caregiver program in Texas, from Medicaid-funded options that pay family members to free support groups and training. We'll point you to the right program based on your situation.

In This Guide

• Key Takeaways
• Texas Caregiver Programs at a Glance
• Texas Programs That Pay Family Caregivers
• Respite Care Programs
• Support Groups and Counseling
• Your Local Area Agency on Aging
• Other Caregiver Resources
• Key Phone Numbers and Contacts
• Frequently Asked Questions
• Next Steps

Texas Caregiver Programs at a Glance

Here is how the major Texas caregiver programs compare on what they offer, who qualifies, and what they cost.2,6,7,8,3,1,4,9

Texas Programs That Pay Family Caregivers

If you're already providing daily care for a family member, several Texas programs can pay you for that work. Here's a quick overview of each option. For the full step-by-step process, pay rates, and eligibility details, see our guide to getting paid as a family caregiver in Texas.

Medicaid Consumer Directed Services (CDS)

The most common path. CDS lets your loved one become your employer through Texas Medicaid.2 They are the employer of record: they hire you, set your schedule, set your wages and benefits, direct the care they receive, and carry the employer's liability. A Financial Management Services Agency (FMSA) acts as their employer agent (the IRS term for an entity that carries out employer duties on the employer's behalf without becoming your employer). The FMSA runs payroll, pays and reports the employment taxes, approves the budget before services start, and handles background and registry checks; it does not hire, supervise, schedule, or dismiss you.10

CDS is available through three Medicaid programs:

• STAR+PLUS, the main Medicaid managed care program for seniors and adults with disabilities
• Community Attendant Services (CAS) with up to 50 hours per week of personal care11
• Community First Choice (CFC), a Medicaid state plan benefit under Section 1915(k) rather than a waiver, so it is not gated behind a waiver interest list12

CFC's own eligibility test is where families get tripped up, so it is worth being exact. Because CFC is a state plan benefit rather than a waiver, the person receiving care has to be in a state plan eligibility group, require an institutional level of care, and, in STAR+PLUS, receive SSI or SSI-related Medicaid. Members whose Medicaid is medical assistance only (MAO) are excluded, and that includes people who qualify through the higher special income limit Texas uses for institutional care and home and community-based waiver services: that limit is a waiver pathway, not a CFC one, and those members receive attendant services through the waiver instead. HHSC does say that people already sitting on a 1915(c) interest list may be able to get CFC if they meet its eligibility and coverage requirements.12

CFC is the one of those three that is not a program row of its own. CFC personal care services and CFC habilitation are self-directable inside STAR+PLUS, STAR+PLUS HCBS, STAR Health, STAR Kids, CLASS, DBMD, HCS, MDCP, and Texas Home Living. The only rows with no CFC service are CMPAS and the combined Primary Home Care, Family Care, and Community Attendant Services row, so in practice a senior reaches CFC self-direction through STAR+PLUS.2

Pay typically ranges from $10.25 to $17.00 per hour depending on your managed care plan and region.13 Adult children, grandchildren, and siblings can generally be hired. A spouse cannot be paid as the attendant under any Texas Medicaid program, and under Community Attendant Services the attendant cannot be the legal or foster parent of a minor child who receives the service.14,15,11

CMPAS (Consumer Managed Personal Attendant Services)

If your loved one doesn't qualify for Medicaid, Consumer Managed Personal Attendant Services (CMPAS) may be an option. CMPAS is a Texas non-Medicaid program for adults with physical disabilities who are able to direct their own care or have someone who can supervise the attendant for them.6 Unlike Medicaid CDS, a spouse may be employed as the paid attendant through CMPAS. Rather than a hard income cutoff, the program uses an income-based co-payment, so a family can take part regardless of income. Licensed agencies contract with Texas Health and Human Services (HHS) to run it.

That first sentence is doing more work than it looks like, and it is the part to read twice. Under 26 TAC 275.25, a person may not receive CMPAS if they are Medicaid eligible and live in a managed care service area, unless their spouse was already employed as their attendant and they chose to remain in CMPAS when the managed care service area expanded to include where they live. STAR+PLUS covers all 13 service delivery areas. So for a Medicaid-eligible Texan, the spouse route through CMPAS is a grandfathered arrangement rather than a door that is still open, and CMPAS is available only in the areas where it is actually offered.6

Where it is open, an applicant must be 18 or older, be assessed as needing help with at least one personal care task and an allowable service for at least five hours a week, live in an area CMPAS serves, and have a service plan of no more than 52 hours a week.6

VA Caregiver Programs

For families of veterans, the VA offers two programs:

Program of Comprehensive Assistance for Family Caregivers (PCAFC): Pays a monthly stipend built from the OPM GS-4 step-1 annual rate for the veteran's locality pay area, divided by 12. Houston's 2026 GS-4 step-1 annual rate of $41,989 gives a monthly base of about $3,499, and 38 CFR 71.40(c)(4)(i) then applies one of four multipliers to that base:7

• Current program (veteran meeting 38 CFR 71.20(a)): 0.625, about $2,187/mo, or 1.00, about $3,499/mo, if VA determines the veteran is unable to self-sustain in the community.7
• Legacy participant or legacy applicant (38 CFR 71.20(b) or (c)): the multiplier comes from the sum of the veteran's 2019 clinical ratings, and no unable-to-self-sustain determination is required on this route. A sum of 21 or higher pays 1.00 (about $3,499/mo), 13 to 20 pays 0.625 (about $2,187/mo), and 1 to 12 pays 0.25 (about $875/mo).7

A veteran who meets both the current and the legacy requirements is paid whichever amount is higher, and a legacy participant's stipend cannot fall below what the caregiver was eligible to receive the day before October 1, 2020 while the veteran stays at the address VA has on record. The legacy schedule runs for the eight years beginning October 1, 2020 and lapses October 1, 2028.7 The veteran must have a service-connected disability rated at 70% or higher. Spouses can qualify. Primary caregivers also receive CHAMPVA health insurance, mental health counseling, and at least 30 days of respite care per year.

Veteran Directed Care (VDC): Gives veterans a flexible budget to hire their own caregivers, including family members and spouses.8 A financial management services provider handles payroll. In Texas, VDC is available through organizations like REACH, Inc. and the North Central Texas Council of Governments.

Call the VA Caregiver Support Line at 1-855-260-3274 for more information about either program.5

Respite Care Programs

Every caregiver needs a break. Respite care gives you time off while someone else cares for your loved one, even if it's just for a few hours.

Texas Lifespan Respite Care Program (Take Time Texas)

The state's main respite program provides vouchers of $800 to $1,000 per eligible family through your local Area Agency on Aging.3 The voucher covers in-home or facility-based respite care and can be used all at once or spread over a three-month period. This program doesn't pay you as the caregiver. It pays for a substitute so you can rest.

To find a respite provider near you, visit Take Time Texas or call your local AAA at 1-800-252-9240.16

Medicaid-Funded Respite

If your loved one is on the STAR+PLUS HCBS waiver, respite care is a covered benefit. The waiver provides in-home and facility-based respite so family caregivers can take a break. Community First Choice, the state plan attendant benefit that sits alongside it, is not a respite program: what it covers is personal assistance with daily activities, habilitation, emergency response services, and support management.12

NFCSP Respite Through Your AAA

Your local Area Agency on Aging may also offer respite care directly through the National Family Caregiver Support Program.1 Availability varies by region and funding, so call your AAA to ask what's available in your area.

Support Groups and Counseling

Caregiving can be isolating. Talking with people who understand your situation makes a real difference.

Alzheimer's Association Texas Chapters

The Alzheimer's Association runs six chapters across Texas with free support groups, educational programs, and care consultations.4 You don't have to be caring for someone with Alzheimer's to use many of these resources.

The six Texas chapters are:

• Houston & Southeast Texas (alz.org/texas)
• Dallas & Northeast Texas (alz.org/dallasnetexas)
• San Antonio & South Texas (alz.org/sanantonio)
• Capital of Texas / Austin (alz.org/texascapital)
• North Central Texas (alz.org/northcentraltexas)
• West Texas, serving Amarillo, El Paso, Lubbock, the Permian Basin, and San Angelo (alz.org/westtexas)

Chapters run both in-person and virtual support groups and education programs. The Association also offers free care consultations with a Care Consultant, a master's-level dementia expert.

Alzheimer's Texas (txalz.org), a separate Central Texas nonprofit, also offers caregiver education and support services.

The Association's national 24/7 Helpline, 800-272-3900, is one line for the whole country rather than a chapter number, and it provides confidential support, crisis assistance, and referrals to local resources in over 200 languages.4 Calling at 2 AM because you're overwhelmed is exactly what it's there for.

AAA Caregiver Counseling and Training

Through the National Family Caregiver Support Program, your local AAA offers individual counseling, caregiver training, and help organizing support groups. These services are free, and they reach further than most families assume: caregivers of adults 60 and older, caregivers of a person of any age with Alzheimer's disease or a related disorder, older relatives who are not parents and are 55 or older caring for a child under 18, and older relatives, including parents, who are 55 or older caring for an adult aged 18 to 59 with a disability. Texas AAA services are targeted to those with the greatest economic and social need.1

Your Local Area Agency on Aging

Texas's 28 Area Agencies on Aging are often the single best starting point for caregivers.1 They're federally funded through the Older Americans Act and deliver five categories of services through the National Family Caregiver Support Program:

1. Information about available services in your area
2. Help accessing services. They'll walk you through applications and connect you to programs
3. Counseling, support groups, and training. One-on-one counseling, organized support groups, and caregiver training
4. Respite care. Temporary relief from caregiving duties
5. Supplemental services, on a limited basis

Most families who call their AAA for the first time are surprised by how much help is available. The staff know every program in your area and can point you to resources you wouldn't find on your own.

Call 1-800-252-9240 to reach your local AAA.5

Other Caregiver Resources

Aging and Disability Resource Centers (ADRCs)

ADRCs cover all 254 Texas counties and serve as one-stop shops for long-term care information.5 They help caregivers and seniors find services, understand Medicaid options, and connect with local programs. Call 1-855-937-2372 (855-YES-ADRC).

2-1-1 Texas

Dial 2-1-1 or visit 211texas.org for 24/7 referrals to community services.5 Operators can connect you to local food assistance, utility help, transportation, and other support services that reduce the financial burden of caregiving.

PACE (Program of All-Inclusive Care for the Elderly)

PACE bundles primary and specialty medical care, prescriptions, day health care, in-home services, hospital and skilled nursing care, transportation, and meals into one program run by a single care team.9 Qualifying takes six things, not three: you must be 55 or older, have chronic medical problems and functional impairments, meet nursing facility medical necessity criteria, live in a designated PACE service area, choose PACE, and be eligible for Supplemental Security Income (SSI) or Medicaid under the institutional special income limit.9 That last one is the test families miss: meeting the medical bar is not enough if the financial bar isn't met too.

Texas has three PACE sites, and that is the whole list: Bienvivir Senior Health Services in El Paso, (915) 562-3444; The Basics at Jan Werner serving Amarillo and Canyon, (806) 374-5516; and Silver Star Health Network in Lubbock, (806) 740-1500.9 If your loved one lives outside those three areas, PACE is not available to them. And because PACE is all-inclusive, it is mutually exclusive with STAR+PLUS and every other HHSC program, so enrolling means leaving those behind.9

Electronic Visit Verification (EVV)

If you become a paid Medicaid caregiver through CDS, you'll need to know about EVV. Texas has required electronic visit verification for all Medicaid personal care services, including services delivered through CDS, since January 1, 2021. You clock in and out on one of three HHSC-approved methods: a downloadable application for use on a smartphone or device with internet connectivity, a home phone landline, or an alternative device. The mobile method is the only approved one when a visit begins or ends out in the community.17

Then there's the deadline nobody mentions until it costs someone money. If a clock-in gets missed, the visit has to be corrected through visit maintenance within 95 calendar days of the date of service. After that the EVV system locks the transaction, and fixing it requires the payer to approve a Visit Maintenance Unlock Request. Your FMSA will help you set the system up, and on Form 1722 the CDS employer chooses whether they or the FMSA handles visit maintenance.17

Key Phone Numbers and Contacts

Keep these Texas caregiver helplines and resources within reach.5,18

Next Steps

Finding the right caregiver program depends on your family's specific situation. Here's where to start:

• If your loved one is on Medicaid (or might qualify), ask about CDS through their service coordinator, or read our guide to getting paid as a family caregiver in Texas.
• If your loved one is a veteran, call the VA Caregiver Support Line at 1-855-260-3274.5
• If you need a break, contact your local AAA at 1-800-252-9240 about respite vouchers.
• If you need someone to talk to, call the Alzheimer's Association 24/7 Helpline at 800-272-3900.
• If you're not sure where to start, call the ADRC at 1-855-937-2372 or chat with Brevy to get personalized guidance on which programs fit your family.

For a deeper look at Texas Medicaid options, see our guides to Texas Medicaid programs, STAR+PLUS, and HCBS waivers.

Learn More

Find personalized help connecting with Texas caregiver programs at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.