Consumer Directed Services (CDS)

What is Consumer Directed Services? CDS offers you the opportunity to direct your own attendant care (and in some programs nursing and therapies). You become the employer and are responsible for recruiting, training, managing and firing your attendants. You choose a CDS agency, like us, to provide you with initial training on your responsibilities and on being an employer. We continue to give you ongoing support. We do your payroll, file federal and state employer taxes for you, and do your quarterly and annual employer tax returns. We also report to you and your case manager or service coordinator on a quarterly basis letting you know what hours you have used.

We support the CDS option in all of Texas’ long term care programs. To see the programs and what can be self directed, click the “Programs” button below.

Who does what in consumer direction can be confusing. Click the “Roles and Responsibilities” button for a complete explanation.


Individuals participating in CDS can choose to manage all or some of the services which can be self directed.

  • Community Attendant Services (CAS) – attendant services
  • Community Based Alternatives (CBA) – attendant services, nursing, physical therapy, occupational therapy and speech therapy
  • Community Living Support Services (CLASS) – habilitation services, respite, nursing, physical therapy, occupational therapy and speech therapy
  • Deaf-Blind Multiple Disabilities (DBMD) – residential habilitation services, intervenor and respite
  • Family Care (FC) – attendant services
  • Home and Community-based Service (HCS) – supported home living and respite services
  • Medically Dependent Children Program (MDCP) – respite and adjunct services provided by either an attendant or a nurse
  • Personal Care Services (PCS) – attendant services
  • Primary Home Care (PHC) – attendant services
  • Texas Home Living – all services eligible for self direction, including community support, respite, day habilitation, dental, adaptive aides and minor home modifications
  • Star+Plus (all managed care organizations) – attendant services, respite, nursing, physical therapy, occupational therapy and speech therapy (if authorized)