Texas doesn't have a single simple statewide caregiver-pay program — instead, family caregivers get paid through Consumer Directed Services (CDS), an option available inside several Texas Medicaid programs, most commonly STAR+PLUS.
What Consumer Directed Services is
CDS isn't a standalone program — it's a service delivery model available within Texas Medicaid programs like STAR+PLUS and Community First Choice. Under CDS, the person receiving care (or their legally authorized representative) becomes the employer of record for their caregiver.
Who qualifies — the care recipient
- Must be a Texas resident, generally 21+ with a disability or 65+
- Must meet a nursing-facility level of care requirement
- Must meet Medicaid income and asset limits ($2,000 asset limit for an individual as of 2026; a Qualified Income Trust can help if income exceeds the limit)
- The STAR+PLUS HCBS waiver has a capped number of slots and may involve an interest list wait
Who qualifies — the caregiver
- Adult children, siblings, grandchildren, and other relatives can generally qualify
- Spouses and legal guardians are excluded from CDS, with only a narrow, limited exception (CMPAS) that isn't the main path for most families
- Must be 18 or older and pass a background check
How pay works
Pay rates through CDS typically range from about $10 to $17 per hour, depending on the managed care organization and region.
How to apply
- Call 211 or visit YourTexasBenefits.com to get on the interest list if not already enrolled
- Apply for Medicaid if the care recipient isn't already enrolled
- Complete a medical/functional assessment
- Choose a managed care organization
- Work with a service coordinator to create a care plan and select Consumer Directed Services
- A Financial Management Services Agency (FMSA) handles payroll, taxes, and workers' compensation
The full process typically takes 30–90 days, and wait times for the STAR+PLUS waiver vary significantly by region.
What you'll need to keep track of once approved
- Approved care plan and authorized hours
- Payroll/employment records through the FMSA
- Ongoing eligibility documentation
Keeping this organized
Once approved, staying on top of your care plan and hour documentation is an ongoing task. FeatherKeep organizes this automatically as you go.
Check our Medicaid Structured Family Caregiving checklist →
Check what else you may qualify for →
Related guides
Disclaimer
General information only, not legal or financial advice. Program details, wait times, and pay rates change — confirm current details with Texas Health and Human Services or your managed care organization before applying.