McAllen Senior AdvisorHow do McAllen families pay for adult day care?
Most participants in Hidalgo County's licensed adult day (DAHS) centers attend through a STAR+PLUS Medicaid health plan, which authorizes attendance by the day after a physician's order and the center nurse's assessment; others pay privately, near the Texas median of $90 a day.
Medicaid managed care plans authorize DAHS by the day: one unit covers at least three but fewer than six hours, and more than six hours a day is approved only case by case. A participant who changes health plans or moves needs a new authorization, so ask the center to coordinate before any change. VA health care can also pay for adult day health care for eligible enrolled veterans.
How are in-home attendants paid for in the Valley?
Medicaid pays for most in-home attendant care through STAR+PLUS personal attendant services, authorized by the health plan's service coordinator after an assessment; families without Medicaid pay an agency privately, at a Texas median of about $30 an hour.
Hidalgo County has 257 agencies licensed only for personal assistance, besides the home health agencies that also offer it. HHSC's community care programs also fund attendant help for some people who do not qualify for full Medicaid, often with an interest list; 2-1-1 Texas, option 2, can explain which program fits. Attendant visits paid by Medicaid are tracked through electronic visit verification.
Can a family member be paid as an attendant in Texas?
Sometimes. STAR+PLUS offers a consumer-directed services option in which the member, or a representative, hires and supervises their own attendant through a financial management services agency, and that attendant can be a relative in many cases.
Rules on who may be hired, such as a spouse or legal guardian, are set by the program; ask the health plan's service coordinator about the consumer-directed option and its limits before counting on it.
What free help does the Area Agency on Aging give?
The Area Agency on Aging of the Lower Rio Grande Valley, at (956) 682-3481 in Weslaco, provides case management, caregiver support, information and assistance, and contracts for homemaker services, respite, home-delivered meals and minor home repairs for people 60 and older in Hidalgo, Cameron and Willacy counties.
These Older Americans Act services are not Medicaid and do not require it, but funding is limited and they are prioritized by need. The agency also runs a Care Transitions health coach program after hospital stays and a medication review program.
Side by side
| These programs can pay for | These programs do not pay for | |
|---|---|---|
| Adult day | DAHS attendance authorized by a STAR+PLUS plan | Attendance without a physician's order |
| Attendants | Personal attendant hours set in a service plan | Unlimited hours on request |
| Family | A relative in the consumer-directed option, within limits | Every family caregiver automatically |
| Without Medicaid | Area Agency on Aging services when funded | A guaranteed slot with no wait |
Sources: Texas Health and Safety Code ch. 247 and 242; 26 TAC chapters 553, 554, 558 and 559; HHSC directories, TULIP and handbooks; CMS; CareScout; VA rate tables, as cited above. See our editorial standards.
