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STAR+PLUS HCBS for In-Home Care, Explained

The same STAR+PLUS HCBS waiver that funds assisted-living-style care also funds in-home services for Fort Worth-area seniors who want to stay in their own home.

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Home›State Rules›STAR+PLUS HCBS for In-Home Care, Explained
Short answer

STAR+PLUS HCBS also functions as Texas's primary in-home-services Medicaid waiver, delivering the same core services -- personal assistance, respite, home-delivered meals, emergency response, minor home modifications -- at the member's residence instead of inside a facility.

What it does not cover

Rent, mortgage, utilities and food are not covered -- only the care services themselves.

Who helps locally

In Tarrant County, the Area Agency on Aging of Tarrant County (817-258-8000) coordinates local help with applying. Outside Tarrant County -- Parker, Johnson, Denton and Wise counties -- the North Central Texas Council of Governments Aging and Disability Resource Center (800-272-3921) covers this instead.

Questions families ask

Is independent living licensed the same way as assisted living in Texas?

No. Independent living is generally unlicensed housing in Texas because no personal care is provided -- residents are fully able to manage their own daily activities. Assisted living requires an HHSC Type A or Type B license because personal care services are part of what's provided.

How is memory care different from standard assisted living in Fort Worth?

Texas requires any facility marketing memory care to file a specific Alzheimer's/dementia disclosure statement covering staffing, training and physical design -- standard assisted living carries no such requirement. Physically, memory care units typically add secured egress, and there's no published cost median for memory care the way there is for standard assisted living.

When does in-home care make more financial sense than assisted living in the Fort Worth area?

Using Texas's CareScout median home health aide rate of roughly $28/hour, in-home care tends to cost less than assisted living's $5,250 statewide median up to roughly 40 hours a week of care -- beyond that, a licensed community frequently becomes the less expensive option.

What's the real difference between a nursing home and assisted living in Texas?

Nursing homes are licensed under a separate Texas rule chapter from assisted living and provide 24-hour licensed nursing care for higher medical acuity. Nursing homes also carry federal CMS star ratings through Medicare's Care Compare tool; assisted living facilities are not rated by that system at all.

Should a Fort Worth family consider a CCRC instead of standalone assisted living?

A Continuing Care Retirement Community (CCRC) keeps a couple together across changing care levels on one campus, typically through an entry-fee structure. Standalone assisted living is usually simpler to enter and less expensive upfront, without a large entry fee.

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