A&A HCS Inc. supports Texans with intellectual and developmental disabilities in their own homes and communities — residential support, nursing, day habilitation, and the service coordination that holds it all together.
Which program fits depends on where someone lives, what they're eligible for, and how long they've been waiting. We'll tell you plainly which one applies — and say so if it's none of them.
HCS
Home & Community-based Services
The largest of the Texas IDD waivers, and the broadest programme we offer. It serves people of any age living in their family home, their own home, a host home, or a small group home.
Medicaid waiver
Host home & group home residential support
Registered nursing
Day habilitation & supported employment
Respite, adaptive aids, minor home modifications
To qualify: an IDD diagnosis, Medicaid eligibility, and an ICF/IID level of care. HHSC determines eligibility at the point a slot is offered.
General Revenue
State funded · not a Medicaid waiver
Paid from state rather than federal funds, so there is no interest list of the kind the waiver has. It often covers people who are not currently eligible for HCS — and it is the shortest route to some help.
Not a waiver
Respite
Service coordination
Screening & eligibility determination
Note: each LIDDA decides which optional GR services it offers locally. Only screening, eligibility determination, respite and service coordination are required of every LIDDA, so availability varies by county.
Approach
The whole person, not the paperwork
A service plan is a document. A life is not. We staff for the three things that actually decide whether someone thrives at home.
Same team, long enough to notice
The programs differ in what the state will fund. They don't differ in how we intend to show up — we keep the same people around someone long enough to notice when something changes.
01
Emotional
The same faces, week after week. Continuity isn't a nicety in this work — it is the service.
02
Physical
Nursing oversight, medication management, personal care, and the equipment that makes a home workable.
03
Independence
Cooking, transit, budgeting, a job. Support that gets smaller as someone gets more capable is support that worked.
Care circle
Who's around the table
HCS involves more people than any one family should have to chase. This is the group we convene, and the part we take responsibility for coordinating.
The individual and family are at the centre
Every role below exists to serve one plan — the person's own. Where those roles disagree, the plan is what settles it.
That's us
A & A HCS Inc.
We deliver the day-to-day services written into the plan — residential support, nursing, day habilitation, respite — and we employ and train the staff who provide them.
You choose us
Once HHSC offers a slot, not before
Switching
Allowed without rejoining the interest list
Where you start
Local IDD Authority
The LIDDA for the county you live in. It holds the interest list, carries out screening and eligibility determination, and assigns the service coordinator who oversees your plan across every provider involved.
Your Medicaid health plan. It covers acute and routine health care — doctors, hospital, pharmacy — which sits alongside the waiver rather than inside it. The two are funded and authorised separately.
Covers
Acute health care under Medicaid
Does not cover
The waiver services in your plan
Clinical
Registered nurse
Reviews health needs, manages medication and delegates specific tasks to trained support staff — then keeps checking that the delegation still holds as needs change. This is why a change in health need not mean a change of home.
Reviews
Medication, health, staff competency
Frequency
Set by the plan and level of need
Oversight
Residential monitor
Visits the home itself. Checks its safety and condition, and whether the support actually being delivered matches what the plan says. This is the check that catches the gap between a good plan and an ordinary week.
Looks at
The home, staffing, the daily routine
Reports to
The service coordinator and HHSC
The person's voice
Advocate or guardian
The legally authorised representative, family member or advocate who speaks for the individual where they cannot speak for themselves — and who holds everyone else, including us, to what was agreed.
Role
Consent, decisions, and challenge
Involved in
Every planning meeting
Enrolling
How people get in
You don't enrol through a provider — you choose a provider once the state has offered you a slot. Here's the actual order of events.
Step 01
Join the interest list
Call the LIDDA for the county you live in — every local authority in Texas is listed in the state HHS directory. Join as early as you can.
Step 02
Wait, and keep details current
Slots are released in the order people joined the list, so the longest wait is served first. Keep your contact details up to date — an unreachable family can lose a slot.
Step 03
Eligibility is determined
HHSC determines waiver eligibility only once you have been offered the chance to enrol — not while you are waiting. Diagnosis, level of care and Medicaid are confirmed here.
Step 04
Choose a provider, then plan
You choose from the program providers serving your area — this is where you can name us. We then write the plan with you, your service coordinator and the nurse.
Before a slot is offered
Be realistic about the wait.
The HCS interest list in Texas commonly runs well over a decade. Being on the list is not a guaranteed slot — it is a place in a queue. If you need support sooner, ask your LIDDA about General Revenue services and Community First Choice, which do not work the same way.
Already with a provider
Already with another provider and want to transfer?
You may change program provider without going back to the interest list. We will coordinate the paperwork with your service coordinator.
The team
The people you'll actually meet
The staff at our Pastor Bailey Drive office — the people who answer the phone, coordinate the plan and visit the home.
Miguel Perez
Arnulfo Gonzalez
Adriana Rosas
Amy Mendoza
Anita Perez
Carmen Vasquez
Christian Perez
Ester Williams
Juana Cerda
Careers
Work with us
We take applications from direct support professionals, host home providers, LVNs and RNs.
