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​Over the past two years, the Texas Home and Community-based Services (HCS) program has undergone several significant changes aimed at enhancing service delivery, compliance, and provider operations. This blog post outlines the key updates implemented between 2023 and 2025.​

1. Implementation of Individualized Skills and Socialization Services

Effective January 1, 2023, the HCS program introduced Individualized Skills and Socialization services, replacing the previous day habilitation services. This transition aimed to align with federal Home and Community-Based Services (HCBS) settings requirements, emphasizing personalized skill development and community integration. During the interim period from January 1 to February 28, 2023, both day habilitation and the new services were available. However, as of March 1, 2023, day habilitation ceased to be a Medicaid-billable service in the HCS program. ​pfd.hhs.texas.gov+3Twogether Consulting+3Texas Legislature Online+3Texas Health and Human Services+1Texas Legislature Online+1

2. Adoption of New HCS Program Rules

On March 1, 2023, the Texas Health and Human Services Commission (HHSC) adopted new rules for the HCS program. These rules implemented the federal HCBS settings requirements and relocated the HCS program regulations from Title 40 to Title 26 of the Texas Administrative Code. This reorganization aimed to streamline regulatory oversight and improve clarity for providers and stakeholders. ​Texas Health and Human Services+1Texas Legislature Online+1

3. Medicaid Enrollment Revalidation Requirements

As of June 1, 2024, HCS program providers are required to disclose and maintain all practice locations in the Provider Enrollment Management System (PEMS) during their Medicaid enrollment revalidation process. This measure enhances transparency and ensures accurate provider information within the Medicaid system. ​TMHP+1Texas Health and Human Services+1

4. Introduction of Employment Readiness Services

In December 2024, HHSC amended its rules to incorporate employment readiness into the array of HCS program services. This addition aims to support individuals in developing skills necessary for integrated employment, reflecting the state’s commitment to promoting workforce participation among HCS beneficiaries. ​Twogether Consulting+7Texas Health Law Section+7Texas Legislature Online+7Houston Chronicle

5. Training Initiatives for Providers

Throughout 2024, HHSC emphasized provider education by offering in-person training sessions on writing acceptable Plans of Correction for HCS and Texas Home Living (TxHmL) providers. These interactive sessions covered essential components of corrective action plans and the Informal Dispute Resolution process, fostering compliance and quality improvement within the provider community. ​TMHP+8Texas Health and Human Services+8Texas Health and Human Services+8

6. Proposed Revisions to Billing Requirements

In December 2024, HHSC sought stakeholder feedback on proposed revisions to the HCS and TxHmL billing requirements. This initiative aimed to refine billing processes and ensure they accurately reflect service delivery, enhancing the efficiency and accountability of program operations. ​Texas Health and Human Services+1TMHP+1

7. Rate Enhancement for Individualized Skills and Socialization

Beginning in the state fiscal year 2024, HHSC transitioned the rate enhancement participation category from day habilitation services to Individualized Skills and Socialization services. Providers interested in participating were required to complete an Enrollment Contract Amendment during the enrollment period starting July 1, 2023. This change aimed to align financial incentives with the updated service model. ​Twogether Consulting+3pfd.hhs.texas.gov+3pfd.hhs.texas.gov+3pfd.hhs.texas.gov

8. Legislative Developments: House Bill 4169

In May 2023, House Bill 4169 was introduced to require HHSC to seek federal authorization to include prevocational services within the Individualized Skills and Socialization offerings under Medicaid waiver programs. This legislative effort underscores the state’s commitment to expanding employment-related services for individuals with disabilities. ​

These developments reflect Texas’s ongoing efforts to enhance the HCS program, ensuring compliance with federal standards, promoting individualized services, and supporting providers through education and regulatory clarity.