I. Paying for Memory Care in Texas

The Cost of Memory Care in Texas

Because of the specialized staff training and resources required to provide high-quality memory care, memory care typically costs more than other types of residential care. On average, memory care will cost 20-30% more than assisted living.

The average monthly cost of assisted living in Texas is $3,750 per month, which is about $300 less than the national monthly average of $4,051. Assuming that the cost of memory care is an average of 25% more than assisted living, seniors and their families can expect to pay an approximate cost of $4,688 per month for memory care in Texas.

The cost of memory care varies between different cities throughout the state. For example, the average monthly cost of assisted living in Houston is $3,750, while in the Dallas area it’s $400 more at an average of $4,150. In Austin, the cost is considerably higher at an average of $5,395 per month. Keeping in mind that these prices are for assisted living, it’s reasonable to assume that the cost of memory care may be as much as $1,000 to $2,000 more per month.

   

Texas Medicaid Programs for Memory Care

STAR+PLUS

The STAR+PLUS Medicaid waiver provides care to seniors aged 65 and older, as well as adults with disabilities. The program provides participants with reimbursements for the cost of residential memory care, as well as services such as physical and occupational therapy and transitional assistance services for seniors who are transitioning from a higher or lower level of care.

  • Who is Eligible:Seniors who wish to receive benefits under the STAR+PLUS waiver must be at least 65 years old and financially eligible for Texas Medicaid. As of 2019, the household income limit for an individual was $24,731 per year, while the limit for a couple was $33,482. Additionally, seniors applying for STAR+PLUS must medically require long-term care.
  • How to Apply: To apply for STAR+PLUS or to learn more about this waiver program, seniors or their representatives can contact their local Area Agency on Aging or visit Your Texas Benefits online. This is not an entitlement waiver, which means that seniors may have to be placed on a waiting list before they’re eligible to receive benefits.

Community First Choice (CFC) Waiver

The CFC waiver provides seniors living in a home care, assisted living, or memory care setting with personal care and assistance with activities of daily living. In the interest of promoting independence, it also provides services that are intended to help the beneficiary care for themselves whenever possible.

  • Who is Eligible: The CFC waiver is available to seniors aged 65 and over who are financially eligible for Medicaid and who require an institutional level of care.
  • How to Apply: Seniors who wish to apply for the CFC waiver can apply online at Your Texas Benefits or contact 2-1-1 for assistance. Those who wish to learn more about the program can also contact their local Area Agency on Aging. This waiver is an entitlement program, which means that any person who is eligible can start receiving benefits as soon as they’re approved.

Non-Medicaid Financial Assistance Programs for Memory Care in Texas

PACE

PACE is an all-inclusive care program that helps seniors access all healthcare services within the same network. The program provides personal care services, as well as medical care and prescription medications. While it’s designed to help seniors avoid institutionalization, it does cover the cost of memory care or nursing home care for those who truly need it and continues to provide services regardless of whether or not a participant lives at home or in a care facility.

  • Who is Eligible: There are no financial eligibility requirements for PACE and the cost of the program is determined by a sliding scale. Individuals with little to no income may receive PACE services at no charge. To qualify for PACE, seniors must require a nursing-home level of care and be at least 65 years of age. This program is only available in certain parts of the state, including El Paso, Lubbock and Amarillo.
  • How to Apply: Seniors can find out if they’re eligible for PACE by contacting their local Area Agency on Aging or calling 2-1-1.

More Ways to Pay for Memory Care

In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:

  • Long-Term Care Insurance: Depending on the policy details, long-term care insurance may be used to pay for memory care services. It’s best to sign up for a policy early, as coverage will likely be denied if one already has long-term care needs. More information about the intricacies of long-term care insurance can be found at longtermcare.acl.gov.
  • Reverse Mortgages: Reverse mortgages allow some homeowners to take out a loan as an advance from the eventual sale of their primary residence. This can be a good way to fund memory care in the short-term, but the loans will need to be paid back after the sale of the home. The most commonly used type of reverse mortgages for seniors is the Home Equity Conversion Mortgage, which is the only reverse mortgage insured by the federal government.
  • Veterans Benefits: The Department of Veterans Affairs offers several programs that veterans and their spouses may use to cover health care needs such as memory care. More information about these programs can be found on the VA website.
  • Life Insurance: Some life insurance policies allow policyholders to cash out their policy before a qualifying death. There may be some downsides to accessing a life insurance benefit early, so be sure to read more about the process.

II. Memory Care Laws and Regulations in Texas

Memory Care Regulation

In Texas, assisted living facilities that provide memory care to seniors with Alzheimer’s disease or other forms of dementia are officially classified as Type B assisted living facilities. All ALFs in the state are licensed and regulated by the Health and Human Services Commission.

Facility Scope of Care

In Texas, all ALFs and memory care facilities can provide assistance with activities of daily living such as bathing, dressing, and mobility. Assistance with medication administration may be provided, as long as the staff is licensed in medication administration. Limited skilled nursing services may be provided in ALFs and memory care facilities, including care coordination, medication administration/supervision and special care in the event of illness or emergencies.

In Type B ALFs, care may be provided to residents who have been diagnosed with dementia or Alzheimer’s Disease, provided they are not permanently bedridden. Additional services may be provided, including:

  • Transportation
  • Entertainment and activities
  • Meals and snacks, which must meet residents’ dietary needs

Admission Requirements

Memory care facilities in Texas may not admit residents whose needs can not be met by their staff unless a licensed home health agency is supplementing that resident’s care. Residents of memory care facilities may not be permanently bedridden. If an ALF is classified as Type B, meaning that it’s permitted to provide specialized memory care to residents, it may admit residents who require the assistance of caregivers in emergency situations, including evacuation, and who require mobility assistance.

Care Plan Requirements

In all ALFs in Texas, including memory care facilities, licensing requirements state that new residents must be provided with a service plan within 14 days of admission. This service plan must include detailed information regarding nursing services and any special care that the resident receives, including medication administration.

Medication Management Requirements

Memory care facility staff in Texas are permitted to provide assistance with medication administration to residents, provided they hold a current Medication Aide license and are acting under the direct supervision of a licensed nurse. Assistance may consist of help with opening packaging, monitoring doses and providing medication reminders. In the event a resident is unable to take medication on their own, licensed staff may provide direct assistance.

Facility Requirements

In Texas, memory care facilities may not assign more than four residents to a single room and no more than half of the units within a facility may be occupied by more than two residents. Each resident must have a minimum of 80 square feet of personal space in shared rooms, and single rooms must be a minimum of 100 square feet. Restrooms may be communal but must be gender-specific and there must be at least one restroom per every six residents. All restrooms must contain at least one shower, one toilet, and one sink.

Staffing Requirements

In Texas, there is no law that states a required staff to resident ratio in ALFs or memory care facilities; however, all facilities must have at least one manager on duty at all times who is in charge of overseeing staffing and ensuring all residents’ needs are met. Each facility must ensure that it employs enough staff to maintain order, safety and cleanliness within the facility at all times and provide assistance in emergency situations, including evacuation. Additionally, facilities must ensure they keep enough staff on duty at all times to assist residents with their needs, serve meals and provide housekeeping and laundry assistance.

Medicaid Policy

Texas Medicaid provides two waiver programs that may cover the cost of care for eligible seniors — the STAR+PLUS program and the Community First Choice waiver. To receive Medicaid waiver benefits in Texas, seniors must reside in a Type B ALF and require a nursing level of care.

Reporting Abuse

The Texas Department of Family and Protective Services manages a Texas Abuse Hotline, which accepts reports of abuse in nursing homes, assisted living facilities and memory care facilities. The hotline accepts reports between the hours of 7 am and 7 pm Monday through Friday. Reports can be made by calling 800-252-5400. Non-urgent matters can be reported online at the Texas Abuse Hotline website.

III. Free Memory Care Resources in Texas

ResourceContactDescription
Alzheimer’s Disease Program1-800-242-3399This state-funded program aims to increase awareness of Alzheimer’s Disease and connects seniors and caregivers with useful resources.
Alzheimer’s Texas512-241-0420Alzheimer’s Texas is a state-funded organization that provides a variety of services to individuals with dementia and their caregivers. These services include education, caregiver training, memory screenings and respite care.
Alzheimer’s Association – Capital of Texas chapter512-592-0990The Alzheimer’s Association provides support groups, education and other resources to individuals who’ve been diagnosed with Alzheimer’s Disease and their caregivers.
Texas Health and Human Services – Aging Department855-937-2372Texas Health and Human Services’ Aging Department acts as an advocate for seniors who are receiving long-term care. It provides a wide range of services, including respite care, Medicaid/Medicare assistance and caregiver support.
AGE of Central Texas512-451-4611AGE of Central Texas offers a variety of support services to seniors and caregivers, including the Memory Connections program, which is a support group that’s specifically tailored to meet the needs of those with early-stage Alzheimer’s Disease and other forms of early-stage dementia.
211 Texas2-1-1211 is a social service hotline that connects citizens to programs across the state, including supports for those with dementia and their caregivers. The program is administered by the Texas Department of Health and Human Services.