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Revision 25-3; Effective Oct. 20, 2025
Senate Bill 7 from the 83rd Legislature, Regular Session, in 2013, required the Texas Health and Human Services Commission (HHSC) to create the State of Texas Access Reform (STAR) Kids program. STAR Kids is a Medicaid managed care program for children with disabilities in Texas. It integrates acute care and long-term services and supports (LTSS) delivered by a managed care organization (MCO).
STAR Kids does:
- not change or impact an individual’s Medicaid eligibility;
- not impact access to Medicaid services and supports; and
- change the way that services are delivered.
Children and young adults under 21 years old and enrolled with a STAR Kids MCO, are called members of the MCO. All STAR Kids members have access to service coordination provided by an MCO employee or through a member’s primary care provider, authorized by the MCO.
Service coordination is specialized case management performed by an MCO service coordinator for program members who need or request it. Service coordination includes, but is not limited to:
- identification of physical health, behavioral health services and LTSS needs;
- development of an individual service plan (ISP) to address the needs noted above;
- help to ensure timely and coordinated access to a range of providers and services;
- attention to addressing unique needs of members; and
- coordination of Medicaid benefits with non-Medicaid services and supports, as necessary and appropriate.
All STAR Kids members receive an annual comprehensive assessment of their physical and functional needs by an MCO service coordinator using the STAR Kids Screening and Assessment Instrument (SK-SAI). The MCO must reassess a member and amend their ISP if the member has a change in their:
- physical or behavioral health;
- functional ability; or
- caregiver supports.
The MCO will update and authorize necessary services requested from the member, legally authorized representative (LAR), authorized representative (AR) or health home within the time frame listed in the STAR Kids Contract, Section 8.1.39, STAR Kids Initial Screening and Assessment Process. The MCO must retain a copy of the amended ISP in the member’s MCO case file. The MCO will not provide the updated ISP to HHSC staff nor submit the updated ISP to the Texas Medicaid & Healthcare Partnership (TMHP) Long Term Care Online Portal (LTCOP).
STAR Kids MCOs are responsible for delivering other services to children enrolled in the Medically Dependent Children Program (MDCP) as well as traditional Medicaid services.
MDCP provides the following services to children and young adults who meet the level of care (LOC) provided in a nursing facility (NF) so they can safely live in the community:
- respite;
- Flexible Family Support Services (FFSS);
- adaptive aids;
- minor home modifications;
- employment services; and
- Transition Assistance Services (TAS).
The STAR Kids Program Support Unit Operational Procedures Handbook (SKOPH) includes operational procedures for the Texas Health and Human Services Commission (HHSC) Program Support Unit (PSU) staff.
The STAR Kids Handbook (SKH) includes policies and procedures for use by MCOs, contractors and service providers to deliver STAR Kids program services to eligible members.