How to Get Paid to Care for a Family Member in Texas

Texas families caring for aging parents, disabled spouses, or loved ones with chronic conditions often don’t realize that Medicaid-funded programs may pay a family member to provide that care at home. Through Consumer Directed Services — an option available under several Texas Medicaid waiver programs — qualifying families can hire and pay a relative to serve as a home care attendant.

How Texas Pays Family Members for Home Care

Texas uses a model called Consumer Directed Services (CDS) to give Medicaid home care participants control over who provides their care. Under CDS, the person receiving services (or their Legally Authorized Representative) becomes the employer of record for their attendant. This means they choose who to hire, set the schedule, direct the tasks, and manage the employment relationship.

The critical piece: that attendant can be a family member.

A Financial Management Services Agency (FMSA) handles the behind-the-scenes work — payroll processing, tax withholding, workers’ compensation, and compliance.

Programs That Offer Consumer Directed Services

STAR+PLUS Home and Community-Based Services (HCBS)

STAR+PLUS is Texas’s Medicaid managed care program for adults with disabilities and those age 65 and older. It’s the largest program through which Dallas-area families access paid home care. In the Dallas service area, STAR+PLUS is administered by MCOs including Superior HealthPlan, Molina Healthcare, Amerigroup, and UnitedHealthcare.

CLASS (Community Living Assistance and Support Services)

Serves individuals with a “related condition.” CDS available, though CLASS often has a significant waitlist.

MDCP (Medically Dependent Children Program)

Serves children and young adults up to 21. CDS is an option, but restrictions apply for parents as paid attendants for minor children.

DBMD and Texas Home Living Waiver

Both offer CDS options for their respective populations.

Who Is Eligible?

For the Person Receiving Care

Must be a Texas resident, enrolled in or eligible for Medicaid, meet functional eligibility criteria, and be able to remain safely at home with supports. For STAR+PLUS: must be 21 or older with a disability, or 65+.

For the Family Member Providing Care

Eligible relatives include adult children, siblings, parents (with restrictions), grandchildren, grandparents, aunts, uncles, nieces, nephews. Two important restrictions: spouses cannot be paid attendants under most programs, and a person cannot serve as both the CDS employer and the paid attendant.

How Much Do Paid Family Caregivers Earn in Texas?

CDS attendant rates generally range from approximately $10.60 to $15.00 per hour, varying by program, MCO, region, and approved budget. Payment flows through the FMSA.

How to Apply: Step-by-Step

Step 1: Confirm Medicaid Eligibility

Apply at YourTexasBenefits.com, at a local HHS office, or by calling 2-1-1.

Step 2: Enroll in STAR+PLUS

Choose or be assigned an MCO in the Dallas area.

Step 3: Request Functional Assessment and HCBS

Contact your MCO for an in-home assessment and service plan.

Step 4: Choose the CDS Option

Request Consumer Directed Services during care planning. Get connected with an FMSA.

Step 5: Designate Employer and Attendant

These must be two different people. Complete background checks and FMSA enrollment.

Step 6: Begin Services

Submit timesheets through FMSA and receive regular paychecks.

How CareChoice Helps Dallas Families

CareChoice helps Dallas families cut through the complexity of Texas’s Medicaid waiver system, from determining eligibility to walking through the CDS enrollment process.

Ready to learn if your family qualifies? Contact CareChoice in Dallas →

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