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HCS Group Home (IDD)

Medicaid-funded home for 3–4 adults with intellectual disabilities

No ALF License — Medicaid Funded

Time to open

2–4 months

Gov't fees (total)

$338

State license

None

Max residents

4

Who this serves

Adults with intellectual or developmental disabilities (IDD) who qualify for the Texas HCS Medicaid waiver

Best fit: Someone committed to serving the IDD population — Medicaid pays reliably, no ALF license required, small residential setting

Actual Costs

Government fees are exact. Variable costs are estimates — tips show how to minimize them.

EXACT

Government Fees — You Will Pay These

HHSC HCS Provider Enrollment

No application fee

$0

one time

Texas LLC Formation (SOS filing)

$300

one time

DPS Background Check

Required for all staff and household members ($11.50 IdentoGO + $15.00 DPS + $13.25 FBI = $39.75)

$39.75

per person

HHSC LIDDA Enrollment

Free — LIDDA manages resident placement

$0

one time

Local business registration

$0–50

annual

Guaranteed minimum (gov't fees)

$338

VARIABLE

Costs That Depend on Your Property & Choices

General liability + professional liability insurance

$2,400–$6,000/annual

💡 HCS group home insurance — get quotes from Markel, GuideOne, or Philadelphia Insurance

Home modifications for accessibility

$2,000–$15,000/one time

💡 Grab bars, ramps, wider doorways — depends on residents' specific needs

Staff training (HCS required)

$500–$2,000/annual

💡 HHSC requires specific HCS training — some free online through HHSC portal

Supplies, adaptive equipment

$1,500–$5,000/one time

💡 Per individual service plans — Medicaid often covers specialized equipment

Physical & Building Requirements

Stories allowed

Any

Sq ft / resident (single room)

Residential standard

Sq ft / resident (shared room)

Residential standard

Bedroom min width

No minimum

Bathroom ratio

Adequate per individual resident service plans

Sprinklers

Per local residential building code

  • •Must have adequate outdoor space (a real backyard) — confirm exact size requirement with your LIDDA before opening
  • •Needs full kitchen, bathroom, and adequate storage
  • •Must meet HCBS Settings Rule: must look and feel like a real home, not an institution
  • •Fair Housing Act: cities CANNOT block a group home for 6 or fewer residents in any residential zone

Can I Use My Home?

✅

1-Story Home

✅

2-Story Home

1,400

sq ft minimum

3+

bedrooms

  • →1-story preferred — easier accessibility for residents
  • →2-story ok with proper safety planning
  • →Must have a real backyard — confirm exact outdoor space requirement with LIDDA
  • →Fair Housing Act protects you: zoning CANNOT block you in residential areas

Why operators choose this

  • +Medicaid pays — residents never pay out of pocket
  • +No ALF license required
  • +Guaranteed enrollment fee: $0
  • +Strong, stable government reimbursement rates
  • +Fair Housing Act protects you from zoning challenges

Know before you start

  • –Serves only IDD population — specialized knowledge required
  • –Hard cap at 4 residents limits total revenue
  • –Medicaid documentation and compliance requirements
  • –Getting residents matched through LIDDA can take time

⚠️ Key Restrictions — Know These Before You Start

  • !Residents must be IDD-eligible and enrolled in the HCS Medicaid waiver program
  • !Maximum 4 residents — hard cap built into the HCS program
  • !Medicaid-funded only — no private pay option in this program model
  • !Must comply with HCBS Settings Rule (community integration, individual rights)
  • !Must contract with your Local IDD Authority (LIDDA) for resident placement

Apply Directly

Every link goes to the exact page — no searching.

Always verify at hhs.texas.gov — regulations change.

Revenue Potential

Per resident / month$3,000–$8,000
At capacity (4 residents)$32,000/mo
Guaranteed gov't fees total$338

License

✅ No State License Required

No ALF license needed — requires HCS provider contract with HHSC and enrollment with your Local IDD Authority (LIDDA)

Is this right for your home?

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⚡ After you open

Let AI handle the admin

Scheduling, documentation, family updates — PoweredByErika builds your care home AI system.

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