Texas Medicaid Recipients Can Self-Direct Long-Term Care Services
Summary
Texas Medicaid recipients can self-direct long-term care services through the Consumer Directed Services (CDS) option, which allows them to hire and manage their own service providers. The CDS option originated as a 1997 pilot authorized by the 75th Texas Legislature and was later codified by Senate Bill 1586, 76th Legislature, into Texas Administrative Code, Chapter 264. Multiple Medicaid programs including Community Living Assistance and Support Services, Home and Community-based Services, STAR Kids, and STAR+PLUS now participate in the CDS option, offering services such as personal care, nursing, therapy, employment assistance, and respite.
“Consumer Directed Services (CDS) allows people who receive services from Texas Medicaid to hire and manage the people who provide their services.”
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What changed
This informational page describes the Texas Medicaid Consumer Directed Services (CDS) option, which enables recipients to hire and manage their own long-term care service providers. The CDS option was established by the 75th Texas Legislature in 1997 as a pilot and later codified by Senate Bill 1586, 76th Legislature, into Texas Administrative Code, Chapter 264. Multiple Medicaid programs are listed as eligible to participate in the CDS option.
Affected parties — Texas Medicaid recipients and contracted service providers — should review the listed programs and services to determine eligibility for self-directed care arrangements. Financial Management Services agencies contracting with HHS can access CDS webinars and utilization reports through the resources provided.
Archived snapshot
Apr 22, 2026GovPing captured this document from the original source. If the source has since changed or been removed, this is the text as it existed at that time.
Consumer Directed Services (CDS)
Consumer Directed Services (CDS) allows people who receive services from Texas Medicaid to hire and manage the people who provide their services.
The CDS option was introduced as a pilot for two attendant services programs as authorized by the 75th Texas Legislature in 1997. The pilot proved successful, and Senate Bill 1586, 76th Legislature, authorized the CDS option, now codified in Texas Administrative Code, Chapter 264.
Since 2001 long-term services and support programs and services have been added to the CDS option. Programs and services that can be self-directed are listed in the table below.
Services That Can Be Self-Directed
| Program Name | Type of Service |
|---|---|
| Community Living Assistance and Support Services | - Cognitive rehabilitation therapy |
- Community First Choice Personal Care Services (CFC-PCS)
- Community First Choice Habilitation (CFC-HAB)
- Employment assistance
- Nursing
- Occupational, physical, hearing, speech, and language therapies
- Respite
- Support consultation
- Supported employment
- Transportation (habilitation) | | Consumer Managed Personal Attendant Services | - Personal attendant services | | Deaf-Blind with Multiple Disabilities | - Community First Choice Personal Care Services (CFC-PCS)
- Community First Choice Habilitation (CFC-HAB)
- Employment assistance
- Intervener
- Respite
- Support consultation
- Supported employment
- Transportation (habilitation) | | Home and Community-based Services | - Cognitive rehabilitation therapy
- Community First Choice Personal Care Services (CFC-PCS)
- Community First Choice Habilitation (CFC-HAB)
- Employment assistance
- Nursing
- Respite
- Support consultation
- Supported employment
- Transportation (supported home living) | | Medically Dependent Children Program (MDCP) | - Adaptive aids
- Community First Choice Personal Care Services (CFC-PCS)
- Community First Choice Habilitation (CFC-HAB)
- Employment assistance
- Flexible family support
- Minor home modifications
- Personal care services
- Respite
- Support consultation
- Supported employment | | Primary Home Care, Family Care, Community Attendant Services | - Personal assistance services
- Support consultation | | STAR Health | - Community First Choice Personal Care Services (CFC-PCS)
- Community First Choice Habilitation (CFC-HAB)
- Personal care services (PCS) | | STAR Kids | - Community First Choice Personal Care Services (CFC-PCS)
- Community First Choice Habilitation (CFC-HAB)
- Personal care services (PCS) | | STAR+PLUS | - Community First Choice Personal Care Services (CFC-PCS)
- Community First Choice Habilitation (CFC-HAB)
- Personal assistance services | | STAR+PLUS HCBS | - Cognitive rehabilitation therapy
- Community First Choice Personal Care Services (CFC-PCS)
- Community First Choice Habilitation (CFC-HAB)
- Employment assistance
- Nursing
- Occupational, physical, speech and language therapies
- Personal assistance services
- Protective supervision
- Respite
- Supported employment | | Texas Home Living | - Adaptive aids
- Audiology
- Behavioral support
- Community First Choice Personal Care Services (CFC-PCS)
- Community First Choice Habilitation (CFC-HAB)
- Dental
- Dietary services
- Employment assistance
- Employment readiness
- Individual skills and socialization
- Minor home modifications
- Nursing
- Occupational, physical therapies
- Respite
- Speech-language pathology services
- Support consultation
- Supported employment
- Transportation (community supports) |
CDS Option Webinars
All webinars and resources on this page are solely for agencies that contract with HHS to provide Financial Management Services (FMS) to people who use the Consumer Directed Services (CDS) option and those people who use the CDS option.
- Nov.14, 2025 - Recording
- June 27, 2025 - Recording | Questions & Answers (PDF)
- Nov. 22, 2024 - Recording | Questions & Answers (PDF)
- April 2, 2024 - Recording | Questions & Answers (PDF)
CDS Utilization Reports
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