The Family Care Program (FC) in Texas, Explained

Not everyone who needs help at home qualifies for Medicaid — and that's exactly the gap the Texas Family Care (FC) program was built to fill. Family Care pays for a personal attendant for older adults and people with disabilities who need hands-on help but don't qualify for Medicaid-funded attendant care.

Here's what DFW families should know about how Family Care works.

What Is the Family Care Program?

Family Care is a Texas Health and Human Services program funded through the federal Title XX Social Services Block Grant — not Medicaid. It provides non-skilled attendant care: the same kind of everyday help with bathing, dressing, meals, and housekeeping that Medicaid programs like Primary Home Care (PHC) provide, but for people outside Medicaid.

Because the attendant provides non-medical care, no nursing background is required — and in many cases a person the family already knows can be hired to do the work.

What Services Are Covered?

Family Care attendants can help with:

Bathing, dressing, grooming, and toileting
Transfers and help moving around the home
Meal preparation and feeding assistance
Cleaning the client's living areas and laundry
Shopping and picking up medications
Escort to appointments

Skilled medical tasks (injections, wound care, tube feedings) are not covered — those require home health care, which we compare in Home Care vs. Home Health Care.

Who Qualifies for Family Care?

Family Care is the state's "payer of last resort" for attendant care, so eligibility works a little differently:

You must NOT qualify for Medicaid attendant care. Before approving Family Care, the caseworker is required to screen every applicant for the Medicaid-funded Community Attendant Services (CAS) program first. If you qualify for CAS, you'll be served there instead — which is good news, because CAS has no waiting list.

Income and resource limits (2026). For Title XX services, the monthly income limit is $2,982 for an individual ($5,964 for a couple), with countable resources under $5,000 ($6,000 for a couple). These figures adjust periodically, so always confirm current limits with HHS.

Functional need. An HHS caseworker completes an in-home assessment (Form 2060). A score of 24 or higher, with a need for at least six hours of help per week, generally qualifies. Unlike PHC and CAS, Family Care does not require a doctor's statement of medical need — functional limitation is enough.

Applicants must be adults (18+) living in their own home or community setting. Care plans can authorize up to 50 hours per week based on assessed need.

The One Big Catch: The Interest List

Unlike PHC and CAS, Family Care is not an entitlement. Funding is capped, so applicants typically go on an interest list (waiting list) and are served first-come, first-served as funding allows. Two practical tips:

Get on the list early. Even if your loved one's needs are still light, the date you sign up is your place in line. HHS sends an annual letter to confirm you want to stay on the list — always respond to it.
Get screened for CAS first. Many families assume they won't qualify for anything Medicaid-related because income is "too high" — but CAS uses a higher income limit than regular Medicaid and has no waiting list. It's often the faster path.

How to Apply

Call the Texas HHS Community Care Services intake line at 888-241-1570 (or dial 2-1-1) and ask about Family Care. A caseworker will screen for CAS eligibility, complete the in-home assessment, and either authorize services or place your loved one on the interest list. Decisions on completed applications are generally made within about 30 days.

How Rahma Home Care Agency Helps

Rahma Home Care Agency serves families across Dallas, Fort Worth, Arlington, Plano, and nearby North Texas communities. We can help you figure out whether Family Care, CAS, or another program is the right fit — and once services are authorized, provide the caring, reliable attendant your loved one deserves. In many cases, we can hire the family member who's already providing the care.

Call (945) 286-4004 for a free consultation.

Program rules and figures are current as of 2026 and can change. Official details are published by Texas Health and Human Services (hhs.texas.gov).