Texas
Consumer Directed Services (CDS)
Self-directed care programs in Texas that let you choose your own personal assistant or pay a family member as your caregiver.
Consumer Directed Services
Open - No WaitlistPA Hourly Rate
$13.00 - $16.51
per hour
Monthly Benefit
$800 - $2,800
estimated range
What You Can & Can't Do
What You Can Do
- Hire a family member (not spouse) as your paid attendant
- Serve as the employer — hire, train, schedule, and manage your own attendant
- Access CDS at any age, including children
- Use a Financial Management Services Agency for payroll
- Receive personal care, habilitation, and respite services
- Set your attendant's schedule based on your needs
What You Can't Do
- Hire your spouse as a paid attendant
- Set your own pay rates (rates are determined by HHSC)
- Use CDS funds for room, board, or medical services
- Exceed your authorized service hours
- Receive services while in a nursing facility or institution
- Bypass the FMSA for payroll and taxes
How to Apply
Apply for Texas Medicaid
Ensure Medicaid enrollment through HHSC at (877) 438-5658 or your local office.
Request program assessment
Contact HHSC or your managed care organization to request an assessment for the relevant waiver program.
Complete functional assessment
A case manager evaluates your daily living needs and determines eligibility.
Choose CDS option
Elect Consumer Directed Services as your service delivery method.
Select a FMSA
Choose a Financial Management Services Agency from the approved list to handle employer responsibilities.
Complete employer training
Complete CDS employer orientation covering your rights and responsibilities.
Hire and enroll your attendant
Recruit your attendant, who must complete enrollment with the FMSA including background check and required forms.
PA Documents & Requirements
What your personal assistant needs to get started in Texas
Government-issued photo ID
Valid Texas ID or driver's license, or passport
Social Security card
For payroll and tax purposes
W-4 tax withholding form
Federal tax withholding
I-9 Employment Eligibility
Work authorization verification
Texas DPS criminal background check
Department of Public Safety criminal history check
Employee Misconduct Registry check
Clearance from the HHSC Employee Misconduct Registry
Nurse Aide Registry check
Verification against the Texas Nurse Aide Registry
Direct deposit form
Banking information for electronic payroll
Frequently Asked Questions
What is CDS in Texas?
Consumer Directed Services is an option within several Texas Medicaid programs that lets you hire, manage, and fire your own attendant. You're the employer and control who provides your care.
Can a family member be my CDS attendant?
Yes. Family members including parents and adult children can be paid attendants. However, spouses are generally not eligible under Texas CDS.
Is there an age requirement?
No. CDS is available at any age. Children can participate with a parent or legal guardian serving as the employer of record.
What is the pay rate in Texas?
Attendant rates range from $13.00 to $16.51 per hour depending on the waiver program (STAR+PLUS, CLASS, DBMD, etc.).
What is the CDS employer's role?
As the CDS employer, you recruit, hire, train, supervise, and fire your attendants. A Financial Management Services Agency (FMSA) handles payroll and tax compliance.
Is there a waitlist?
CDS itself has no separate waitlist, but the underlying waiver programs (like CLASS or DBMD) may have waitlists. STAR+PLUS CDS is generally available.
Ready to check your eligibility?
Answer a few questions and we'll tell you if you qualify for Texas's CDS program.