The Texas Medicaid waiver interest list for autism in Houston

The Texas Medicaid waiver interest list for autism in Houston is a set of separate waiting lists run by the state. Your place on each list is set by the date you sign up, so add your child to the right ones now. For Harris County you start HCS and TxHmL through The Harris Center. For CLASS, DBMD and MDCP you call HHSC at 877-438-5658. You can join several lists at once, and HHSC says eligibility is decided when a slot is offered.

This guide covers what each program pays for, who to call in Harris, Fort Bend and Montgomery counties, HHSC’s September 30, 2026 numbers, and HHSC’s proposal to end the Children’s Autism Program.

What is a Texas Medicaid waiver, and why is there an interest list?

A waiver program pays for services at home and in the community instead of in an institution. HHSC says waiver funding follows the person anywhere in Texas, so a family that moves from Houston to El Paso keeps its place in the program once enrolled.

More people qualify than the funding covers, so HHSC keeps interest lists, offers slots as funding allows, and decides eligibility when a slot is offered. HHSC says getting Medicaid or other community services while you wait does not change your spot.

What do HCS, CLASS, TxHmL, DBMD and MDCP pay for?

HHSC’s October 2026 explainer and its waiver chart describe each program like this.

Every one of these programs includes respite. HHSC defines it as short-term relief from a trained worker when the unpaid caregiver is unavailable. The published respite limits differ: HHSC’s waiver chart (revised September 5, 2025) lists 30 units for CLASS and DBMD, 300 units for HCS, 29 days for MDCP, and no set limit for TxHmL beyond need.

Two cautions. First, autism alone does not guarantee a spot in any program. CLASS and the other programs look at diagnosis and level of need when a slot is offered, and HHSC points to a code list of qualifying related conditions, so ask the intake staff how your child’s diagnosis is handled. Second, waivers do not replace ABA. ABA for children and young people through age 20 is a separate Medicaid benefit.

How does the STAR Kids and MDCP route work?

MDCP is the waiver that runs through a Medicaid managed care plan. Once enrolled, the child gets MDCP services through a STAR Kids health plan. HHSC’s handbook says the family picks a STAR Kids plan or is defaulted to one, and that plan selections are generally due within 30 days of the enrollment packet being mailed.

To get on the list, call the Interest List Management unit at 877-438-5658. HHSC’s handbook says people are placed and later released in the order of the date and time of the request, and the person must be younger than 21 and live in Texas. MDCP is meant for people who would otherwise need nursing-facility care, so ask intake staff whether it fits your child’s needs and which lists they recommend.

Who do you call in Harris, Fort Bend and Montgomery counties?

HHSC says the local IDD authority (LIDDA) where you live helps you enroll in HCS and TxHmL. HHSC’s directory lists these for the Houston area:

• Harris County: The Harris Center for Mental Health and IDD, 9401 Southwest Freeway, Houston. HHSC’s directory lists 713-970-7000 for IDD intake. The Harris Center’s IDD page lists 713-970-7799 for questions about IDD or autism services and asks you to complete an online intake packet first.
• Fort Bend County: Texana Center, 4910 Airport Ave., Building D, Rosenberg. IDD intake: 281-239-1363.
• Montgomery County: Tri-County Behavioral Healthcare, 233 Sgt Ed Holcomb Blvd. South, Conroe. To start IDD intake or ask about the HCS wait list, Tri-County says to call its main line, 936-521-6200, and ask for IDD Authority Support Staff. HHSC’s directory lists 936-521-6228 or 936-521-6203 as Tri-County’s IDD intake numbers, and Tri-County’s IDD page gives them for IDD questions.

Other counties in the metro area have their own authority. HHSC’s LIDDA directory lets you look up the one for your county. You can also apply through YourTexasBenefits.com, and the Harris Center page does not mention an interest list by name, so tell them plainly that you want your child added to the HCS and TxHmL interest lists and ask for the date they record.

Many LIDDAs also provide state-funded IDD services without a waiver. HHSC says a person can qualify for those with a diagnosis of autism spectrum disorder, although not every service is offered in every area. Ask about service coordination, respite and community supports when you call.

How long is the wait? What does HHSC’s data show?

HHSC’s file gives counts by years on the list rather than an average wait. It publishes monthly counts on its Interest List Reduction page in an Excel file, along with counts by years on the list. The table below comes from the most recent file, titled “Interest List Data with Times and Dispositions,” covering FY 2026-27 through September 30, 2026 (report generated October 20, 2026). We have not estimated anything beyond what the file says.

*“In the pipeline” means people released from a list who are still being processed and are not yet enrolled. The 5+ and 10+ columns are our sums of HHSC’s one-year buckets, with percentages of each program’s list as HHSC’s years-on-list table totals it. HHSC says people can be on more than one list, and the unduplicated count across all six lists, including STAR+PLUS HCBS for adults, is 198,819.

How to read the table:

• It shows who is waiting now. It does not predict how long a new sign-up will wait.
• HCS’s list grew from 128,110 at the end of August 2025 to 136,144, with 9,966 added and 1,957 removed since September 1, 2025.
• MDCP moves fastest. No one on its list had waited more than two years.
• Counts are statewide. HHSC’s file does not break them out for Houston.

Why sign up now, and how do you keep your place?

Because the list start date sets your order. If your child is eligible later, the date you asked is what counts, and for HCS and TxHmL HHSC’s handbook says the request date does not change if your record moves to another local authority when you move counties.

Staying on the list takes some work:

• HCS and TxHmL: the local authority must contact you at least once per performance-contract term to confirm interest and update your contact information. HHSC’s handbook says that if they can’t reach you, the record is flagged as unable to contact and stays “Interested” until you respond.
• MDCP: HHSC’s handbook says staff contact you every year to confirm your address and phone. With no response within 120 days, your status goes inactive until you tell them you are still interested.
• CLASS and others: HHSC’s FY 2026-27 data shows closures for “no response,” not just enrollments. Of 3,485 CLASS closures, 2,091 (60.0%) were “no response,” compared with 471 enrolled. Treat any letter from HHSC or your local authority as urgent.

Write down the date you signed up and who took your request. Give a mailing address and phone number that won’t change, plus a second contact, and tell the authority when you move.

What is happening with the Children’s Autism Program?

The Children’s Autism Program (CAP) is a state-funded program that pays community agencies for focused ABA for children 3 through 15 with a documented autism diagnosis who live in Texas. HHSC says services end on the child’s 16th birthday, are capped at 180 hours in 12 months and 720 hours over a lifetime, and require parent training. You apply by calling 2-1-1 or searching 211texas.org for the nearest contractor.

No decision has been made. In its 2028-2029 budget request, HHSC’s three percent reduction summary lists the “GR Funded Autism Program (non-Medicaid)” among client services it proposes to eliminate, at $13,663,084 over the two years. The Texas Tribune reported on October 12, 2026 that this would end CAP, that CAP funded treatment for 583 children in fiscal year 2026, and that contractors report at least 1,000 more children waiting. HHSC said children would keep services through the end of August 2027 if the Legislature agrees. The reduction summary says the reductions respond to a July 14, 2026 directive from state leaders to cut 3 percent from base requests.

Only the Legislature can eliminate the funding, and we found no report of a decision. If your child is already in CAP, ask your contractor how many hours remain. If your child qualifies for Medicaid, ABA is available through the Medicaid benefit regardless of CAP. We’ll update this guide when the Legislature acts.

What should you do this week?

Call your local authority and ask for HCS and TxHmL, call 877-438-5658 for CLASS (and MDCP if it fits), ask for the request date in writing, and set a yearly reminder to confirm your place. While you wait, check Medicaid-accepting providers or browse Houston, Katy and The Woodlands.