Home & Community-based Services

Ahora y Siempre, Inc.(AyS) is contracted by Texas HHS to provide HCS services. HHS regularly monitors AyS to ensure quality of services. When enrolling in the HCS program, applicants choose their provider from a list of available providers ini their area. Individuals are able to change providers at any time, even if they move to another area of Texas. AyS is contracted to provided services in all parts of Texas. Individuals can also choose to hire and train their own service providers under the consumer directed services option.

The Home and Community-based Services (HCS) program is a Medicaid waiver program that supplies services and supports to Texans with an intellectual disability (ID) or a related condition so that they can live in the community. HCS are intended to supplement rather than replace services from other programs, such as Texas Health Steps, or from natural supports, including families, neighbors or community organizations.

HCS may be available to any Texas resident not living in an institutional setting who:

  • has an IQ of 69 or below or has an approved relation condition with an IQ of 75 or below.
  • has mild to sever deficits in adaptive behavior.
  • is eligible for Medicaid benefits.
  • is not enrolled in any other Medicaid waiver program.

The following services are available in the HCS program.


Residential Services Dental Services Dietary Services
     Group Home Behavioral Support Audiology Services
     Host Home Supported Home Living Cognitive Rehab
Respite Services Social Work Minor Home Modifications
Day Habilitation Occupational Therapy Adaptive Aids
Employment Services Physical Therapy Transition Assistance Services
Nursing Services Speech Therapy

The HCS provider can also provide personal assistance services, habilitation or emergency response services through the Community first Choice (CFC) program to individuals who live int heir own home or family home. Individuals can also receive unlimited prescriptions through the Medicaid Vendor Drug Program.

The Consumer Directed Services (CDS) option is available for this program. Through CDS, individuals who live in their own home or family home can self-direct certain services and will assume and retain responsibility to:

  • recruit their service providers.
  • conduct criminal history checks.
  • determine the competency of service providers.
  • hire,train, manager and fire their service providers.

The following services are available through the CDS option:

Employment Assistance Respite Care Supported Employment
Financial Mgmt Services Supported Home Living Cognitive Rehab Therapy
Nursing Services Support Consultation CFC/PAS/Hab

Individuals who use the CDS option must select a financial management services agency (FMSA) that will provide training, pay the service providers, pay federal and state employer taxes, and conduct criminal history checks.

Individuals interested in receiving HCS services are placed on an interest list by the local intellectual and development disability authority (LIDDA) until funding becomes available. An offer of the HCS program depends on individual need and one’s date of placement on the interest list.

Please contact our office for help determining you LIDDA.