Texas CDS questions, straight answers.
About getting paid to care for a family member through Texas Medicaid's Consumer Directed Services (CDS) option, and what Hometown does.
Can I get paid to care for my own parent or child?
In many cases, yes. Through Texas Medicaid's Consumer Directed Services (CDS) option, adult children, other relatives and friends can be hired as paid attendants, and so can the parent of a son or daughter who is 18 or older and not under the parent's guardianship. A parent can't be paid to care for a child under 18, and other limits vary by program. We'll help you check yours.
Can a spouse be paid to be the caregiver?
No. In every Texas Medicaid program that offers CDS, the person's husband or wife, including a common-law spouse, can't be the paid attendant. Another relative or a friend can be hired for the authorized hours instead.
How much does Hometown cost?
Nothing. Texas Medicaid pays every FMSA a monthly fee set by HHSC, which the FMSA has to accept as payment in full. Your family never gets a bill from us, and nothing is taken out of the attendant's wages beyond the usual taxes.
How much do attendants get paid?
The employer sets the wage, which must be at least the minimum wage and fit within the budget for the approved hours. Texas ended its $10.60 base wage requirement on August 31st 2025, and HHSC's current rates assume an average attendant wage of $13.00 an hour. We'll show you exactly what your budget allows before anyone commits.
Who is the actual employer, me or Hometown?
The person receiving care, or their legally authorized representative, is the employer and stays in charge of hiring, schedules and supervision. Hometown is the fiscal agent handling payroll, taxes and state paperwork on the employer's behalf.
Is the pay taxable?
Usually, Social Security and Medicare are withheld as they would be in any job. A relative who lives with the person may be able to leave the pay out of federal income tax under IRS Notice 2014-7, and some family members are exempt from Social Security taxes. A tax adviser can tell you what applies to you.
What if we don't have Medicaid yet?
Start by applying for Texas Medicaid at YourTexasBenefits.com. Some services, such as Primary Home Care and STAR+PLUS personal attendant services, don't have waiting lists, but the waiver programs keep interest lists that can run for years, so it pays to get on the right list early. Join our waitlist and we'll point you in the right direction.
How long does it take to get started?
HHSC says it can take up to three weeks for an attendant to start working once the FMSA is involved. Having the attendant's documents ready before then shortens the wait.
We already have an FMSA. Can we switch to Hometown?
Yes. Texas lets families change FMSAs at any time. Your services, budget and attendants carry over, and only the payroll partner changes. Your case manager or service coordinator arranges the transfer, and we handle our side of the paperwork.
When does Hometown open?
Soon. We're completing our enrollment and contracts with Texas HHSC and the health plans now. Waitlist members hear first and get help preparing their enrollment packet so day one is fast.
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We'll call you when enrollment opens, and answer anything the FAQs didn't.Join the waitlist and we'll call you when enrollment opens, and answer anything the FAQs didn't.
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We'll call you when enrollment opens in your program. Joining is free and doesn't commit you to anything.
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