Texas Senior Living

There has been an increase in senior population in Texas as well as the numerous new facilities for senior living in the Lone Star State. Texas is a large state with a variety of small towns, rural areas, and big cities. Will the increase in the senior population make the “Lone Star State” the best state for senior citizens to retire?

Services for a senior living in Texas

Most states, Texas included, have realized that it is far less expensive to care for a person in their homes than it is to care for them in nursing facilities, and that is also where most people would rather be. To try and keep people in their homes or at least in a community setting, programs are offered in Texas to help maintain and restore independence for these individuals. There are 28 Texas AAAs in the state who help provide and access to services to Texas seniors over the age of 60 and their caregivers. Although the AAAs are available to any senior in Texas or caregiver, priority is given to those with the greatest economic and social need. This includes: minorities, those with low-incomes, those who live in rural areas, those with limited English, people with Alzheimer’s or related disorders, and those who are at risk of being placed in a nursing facility.

Along with the Area Agency on Aging, there are also Texas Aging and Disability Resource Centers (ARDCs) which are supposed to help Texas residents navigate the requirements system. These centers give help to Texans in all 254 counties in the state and simplify the complicated system for them.

In Texas, home and community-based waiver services (HCBS) have been available to some individuals through Medicaid waiver programs. However, as the numbers of seniors in Texas increase and the seniors who wish to remain in their houses get frailer, the number of caregivers increase as well. Texas is finally encouraging people to utilize the services offered rather than wait until they need nursing facility care. A list of the available programs can be found at https://hhs.texas.gov/hhs-services.

Some of the programs that are offered by the state of Texas include:

• Community Resource Coordination Group (CRCG) – these are groups of professionals that help Texans with complex needs that cannot be met by a single agency. They help facilitate communication between clients, public, and private agencies to get people the help that they need;
• Caregiver services – Almost 3.4 million Texans are being cared for informally by friends and family. Caregivers are typically female, between 40-64, unemployed, live within ten miles of the person that they provide care for, and are the spouse or child of the person for whom they provide care. 75% are Caucasian or Hispanic. These caregivers develop chronic health problems at twice the rate of non-caregivers, and 70% of them have depression or anxiety. To help alleviate the stress on caregivers, there is a program called Take Time Texas that is solely for caregivers;

The state of Texas has been behind the curve when it comes to caring for the growing senior and disabled population, although things are changing so that they can try and remain on par with other states. If you are looking for other services or information then calling the Texas Area Agency on Aging or the ARDC would be a good place to begin.

Costs of Assisted Living in Texas

The cost for an Assisted Living Facility in Texas averages about $3,515 per month in the state (almost $42,200 per year), however, the cost for care often increase depending on the amount and magnitude of services that the client requires, as well as the city you choose. For example, Texas residents with dementia and Alzheimer's disease will pay higher assisted living fees. However, the expense of an Assisted Living Facility in Texas is still much lower than comparable costs of Texas nursing homes, where even a semi-private room costs $54,020 per year on average, and a private room costs around $72,000.

Assisted Living in Texas is quite a bit more expensive than Adult Day Health Care, which averages about $8,500 per year. Moreover, assisted living facilities are cheaper than hiring a Texas Home Health Aide, which currently costs $43,472 annually on average, based on a 44-hour workweek. An Assisted Living Facility provides 24-hour care, which would be approximately the equivalent of 3.8 Home Health Aids working 44-hour weeks, which would be a cost of close to $170,000 annually. These costs will only continue to rise, as it is projected that by the year 2030, assisted living in Texas will cost $63,801 - an increase of almost $19,000.

Here are assisted living costs in 24 of Texas's popular cities:

• El Paso, TX - $2,000 per month. El Paso is more than two times cheaper when it comes to assisted living than the most expensive city in Texas for assisted living, which is Austin.
• Texarkana, TX - $2,250 per month
• Corpus Christi, TX - $2,350 per month
• Waco, TX - $2,641 per month
• Brownsville, TX - $2,750 per month
• San Angelo, TX - $2,853 per month
• Wichita Falls, TX - $2,971 per month
• Tyler, TX - $3,250 per month
• Lubbock, TX - $3,253 per month
• Sherman, TX - $3,253 per month
• McAllen, TX - $3,300 per month
• Abilene, TX - $3,460 per month
• Longview, TX - $3,500 per month
• College Station, TX - $3,648 per month
• Midland, TX - $3,679 per month
• Beaumont TX - $3,690 per month
• Dallas, TX - $3,700 per month
• Killeen, TX - $3,769 per month
• Houston, TX - $3,825 per month
• San Antonio, TX - $4,040 per month
• Odessa, TX - $4,071 per month
• Amarillo, TX - $4,118 per month
• Victoria, TX - $4,250 per month
• Austin, TX - $4,576 per month

Who pays for Assisted Living Care in Texas?

The state of Texas has Medicaid Waiver programs to help elderly and disabled people with their monthly expenses; however, there are eligibility requirements for these waivers, both functional and financial.

First, let’s discuss Medicaid eligibility criteria in Texas as well as the difference between Supplemental Security Income (SSI) and Medicaid. SSI is a federally-funded program funded by general tax revenue, NOT by Social Security Taxes. It is designed to help people who are aged, blind, and/or disabled who have little or no income and it provides cash to people to meet their basic needs, including food, clothing, and shelter.

Medicaid, on the other hand, is a state-funded program and the financial eligibility requirements change yearly. You must be pregnant, a parent or relative caretaker of a dependent child (or children) who is under 19, blind, have a disability, or have a family member in your household with a disability, or be 65-years-old or older.

Other general requirements include:

• A resident of Texas;
• A U.S. Citizen, national, permanent resident, or legal alien;
• In need of health care or insurance assistance; and
• Be considered low-income or very low-income.

For last year, elderly Medicaid applicants must have limited resources and a limited monthly income. For an individual, the monthly income cannot exceed $2,199/month, $4,398/month for a couple. There is an asset limit of $2,000 for an individual and $3,000 for a couple. Some programs have extended those limits to $5,000/individual, and $6,000/couple and a person’s home and their vehicle do not count in the calculation of assets.

The waiver programs that will help pay for Assisted Living Services in Texas include:

• STAR+PLUS – this program replaced what was called Community Based Alternatives (CBA). It is a program for Texans aged 65 or older who are appropriate for placement in a nursing facility but can stay in either their home or the community with services being brought to them. STAR+PLUS is different from other Texas Medicaid Programs because the services are provided by a managed care organizations (MCOs). Each county has different MCOs from which the client can choose, and each client also has a service coordinator to help them navigate the process, services, and levels of care. An interesting feature of STAR+PLUS is that it allows families members to be hired to provide personal care, although spouses are not included. There is a limit on the number of enrollees, and waiting lists often exist.
• Community First Choice (CFC) – this program is also available to those who are eligible for Medicaid and require a level of care that is usually associated with nursing facilities; however, they can remain in their homes, or in the community, with the use of personal assistance services, emergency response services, support management, and financial management services.

Pros and Cons of Senior Living in Texas

Financially, Texas is a low-cost state, both to live in and to retire. On a 100-point scale, Texas comes in overall at 90.40, with Groceries at 89.6, Health at 97, Housing at 82, Utilities at 96, Transportation at 97 and Miscellaneous items at 95 – all below national the average.

Here are some things to consider when choosing if Texas should be your retirement destination:

• Weather – The state has relatively mild winters and long and hot summers. If you enjoy spending time outside in extremely hot weather, then Texas may be the place for you. In Dallas for example, there are 136 clear days per year with 61% sun, allowing plenty of good weather for retirees to explore all that Texas offers.
• Average Cost of Living – Texas is around average nationally with housing at a low of 86. Texas also comes in at #27 for its value of $100, meaning that what $100 will buy you in Texas would cost $103.52 in other states;
• Places to retire – there are large senior retirement communities throughout Texas, ranging from active Independent Living Retirement communities with great amenities to Assisted Living, and Nursing Homes. There are three Del Webb communities in the state alone;
• Healthcare – Texas ranks 3rd worst in the nation when it comes to healthcare and ranks close to last in access to healthcare, quality of care, and avoidable hospital spending. It is the state that is 15th highest in adult obesity and the highest maternal mortality rate in the developed world. Ironically, some of the best hospitals and researchers are in Texas. There are nine medical schools, three dental schools, and two optometry schools in Texas as well as the “Texas Medical Center” which performs the most heart transplants in the world. “M.D. Anderson Cancer Center” in Houston is world known for its cancer care and both the “American Heart Association” and the “University of Texas Southwestern Medical Center” are in Dallas, TX. The Southwestern Medical Center that's located in Texas has the most medical school Nobel laureates in the world
• Arts and Culture – the city of Houston, TX alone has the Houston Symphony Orchestra, Houston Grand Opera, Alley Theatre and Houston Ballet. The city is known for its visual and performing arts. In the northern part of the state, Ft. Worth, TX has the “Modern Art Museum of Fort Worth,” the “Kimbell Art Museum,” the “Amon Carter Museum,” the “National Cowgirl Museum and Hall of Fame, the “Will Rogers Memorial Center,” and the “Bass Performance Hall.” Austin, TX is known as “the live music capital of the world” and is known for the “South by Southwest” festival held there yearly, as well as the longest-running concert music program on American television “Austin City Limits.” Dallas, Wichita Falls, and other cities are also known for their cultural importance;
• History – from the history of the Alamo to the provision in the Texas Constitution allowing Texas to secede from the U.S., this state is one that is known for its bigger than life persona and uniqueness.

Weather in Texas

Due to Texas’ large size, there are varying climates throughout the state. There are distinctly different climates in the various regions of Texas – the Northern Plains; the Trans-Pecos Region; the Hill Country; the Piney Woods; and South Texas. The Northern Plains is a semi-arid climate that is prone to drought, yet the Panhandle, which is in the Northern Plains is known for its cold winters and snow is not uncommon during the winter months. The Trans-Pecos Region often referred to as “Big Bend” country, is in the Western and west-central part of the state and includes the Chihuahuan Desert and mountain ranges. This area is the driest area in Texas and snowfall is rare except in the higher elevations of the mountains.

Central Texas is known as the Hill Country due to its hills and many rivers. Winters in Central Texas are cool and summers are extremely warm. This area has a lot of precipitation during a year and flooding is common. The Piney Woods is the Eastern part of the state and is a humid subtropical climate. This area gets more rain than any other part of Texas and is prone to severe thunderstorms and tornadoes. South Texas includes the semiarid ranch area as well as the Rio Grande Valley. Summers are hot and humid while winters can be cold, yet it is rare to have snow in this part of Texas.

Severe weather can occur in Texas in any of the seasons, which makes it one of the more unpredictable states for senior living. Thunderstorms occur frequently in the northern and eastern part of the state and Texas is in what is called “Tornado Alley” and has more tornadoes than any other state in the nation annually, with an average of 139 per year. Tornadoes happen most frequently in North Texas in May, June, and April. Texas is also susceptible to hurricanes and the state has been hit by some of the worst hurricanes in American history. The most dangerous part of the Hurricane in Texas is the flooding that occurs when the hurricane or tropical storm stalls over the state and rains heavily.

The temperatures in the summer months can get extraordinarily hot and unbearable for senior citizens – 120° F is the record high in August, and often the high temperature is over 100° F for more than 50 days in a row. The hot weather could make it difficult for a senior living in Texas to tolerate the weather. The summer transition into Fall occurs late in the year, October usually if not later and it is quite normal to have temperatures in the 60s during December. While the weather in the winter is mild compared to other states, parts of Texas often see icy conditions that make driving hazardous and the state is known to shut schools and government offices if there is even the hint of winter weather conditions.

Texas Demographics

Texas is the second most populous state in America (behind California) with a population of over 25 million as well as the second largest state, 268,581 square miles, (behind Alaska) with almost 28 million residents. It ranks quite low on the percentage of seniors in the state, 48th, with just 11.49% of the population being 65 or older - although that will surely change in the future. The population density of Texas is 103.7 people per square miles (26th in the nation.), although that number is a bit skewed as Texas is so large that six of the top 20 most populated U.S. cities are in Texas: #4 – Houston, TX – 2.24 million; #7 – San Antonio, TX – 1.44 million; #9 Dallas, TX – 1.28 million; #16 Ft. Worth, TX – 812,000; and #19 – El Paso,TX – 670,000.

With 254 counties in Texas, there is a huge difference in population of the counties with various senior population in each. Many of the counties that are east of Interstate 35 are considered urban, while many, though not all, that are west of the Interstate are more rural. For example, Harris Country, where Houston is located, has a population of over four million people and is 1,777 square miles. On the opposite end of the spectrum is Loving County, with a population of around 100 and only one town in the entire country, Mentone. Its area is a mere 677 square miles and students must be bused to another county for school.

English is the primary language in Texas, followed by Spanish, Vietnamese, Chinese, and German. Of those five and older almost 70% spoke only English at home, approximately 29% spoke Spanish, 0.75% Vietnamese, and about 0.5% spoke Chinese. Cherokee is the most widely spoken Native American language spoken in Texas. On average, about 34% of the population of Texas aged five and older spoke a language other than English at home.

The racial composition of Texas is 70.5% White American (45.3% being non-Hispanic whites); almost 12% Black or African-American; almost 4% Asian; and 0.7% American Indian. 37.6% of the population are Hispanic or Latino. In 2011, almost 70% of those younger than one had at least one parent who was a minority.

Regarding religion, 77% of the population are Christians (of any denomination), 18% are unaffiliated, and 4% are of Non-Christian faiths. In terms of adherents, The Roman Catholic Church has approximately 4.6 million, the Southern Baptist Convention 3.7 million, the United Methodist Church 1.04 million, and Islam almost 500,000. Texas is often called the “buckle of the Bible Belt” with East Texas considered socially conservative, the Dallas-Fort Worth Metroplex home to three evangelical seminaries as well as some of the “mega-churches” that are often on TV. There is a large Muslim population in Richardson, Texas (a suburb of Dallas) and Texas is the 5th largest Muslim-populated state in the U.S.

Texas is one of seven states that have no taxes on any income, which can help seniors tremendously. It does have a 6.25% sales tax with cities and counties permitted to add additional taxes, although the maximum allowable is 8.25%. There is no estate tax in the state of Texas.

Texas property taxes are among the highest in the nation, with rates averaging 1.94%. However, your property tax burden will depend on where you live. For example, Dallas County’s average effective rate is 2.19% whereas Houston, in Harris County, has an average effective property tax of 2.3%. (There is a difference between the “taxable value” and “effective value.” Most areas use the property’s taxable value, which is usually based on market value.)

There are exemptions for certain situations, including:

• Residence Homestead;
• For person age 65 or older, or for those who are disabled;
• Veterans;
• Solar and Wind-Powered Energy Device; and
• Charitable Organizations and Businesses.

Texas is also considered to be a tax friendly state for seniors, due to the following:

• Income from Social Security is not taxed;
• Withdrawals from retirement accounts are not taxed;
• Currently, there is no estate tax in Texas;
• Wages are not taxed; and
• Both public and private pension income are not taxed.

Some cities to consider for Texas Senior Living:

There are many large cities in Texas to consider when looking for a destination for retiring, but these are some of the smaller cities that have been highly rated for Texas senior living .

• Burnet, Texas – located in Burnet County in the Hill Country of Texas, Burnet is the County Seat of Burnet County. The average monthly mortgage in Burnet is $872 with a low crime rate, which makes it a very safe city for seniors. Restaurants and libraries are close, and the beautiful Hill Country landscape is all around you. It’s about a 90-minute drive to Austin, 35 miles west of Georgetown, and 100 miles north of San Antonio. With a population of around 6,100 almost 15% are 65 or older;
• Cameron, Texas – the county seat of Milam County, Cameron is about 70 miles northeast of Austin. The population is around 5,500 with approximately 22% over the age of 65. The average mortgage is $603 and golf, libraries, restaurants are close-by;
• Aransas Pass, Texas – located on the coast of the Gulf of Mexico, this city is on the mainland of Texas but is connected to Mustang Island (where the city of Port Aransas is located), by a 6-mile bridge as well as a ferry. Aransas Pass is only 20 miles away from Corpus Christi, yet it has everything seniors would want in a retirement location: great medical care, close to grocery stores, restaurants, and recreation and the mortgage averages around $666/month. It is a popular area for water sports, fishing, birding, and hunting and even has the largest hummingbird garden in Texas. The population is less than 10,000, approximately 11% of whom are 65 or older;
• Granbury, Texas – located about 35-miles south of Ft. Worth, this quaint little town is also rich in history and has a square that is filled with quaint antique shops and restaurants. Lake Granbury is nearby, as are Fossil Rim Wildlife Center and Ft. Worth. There is also the common legend and belief that Granbury is where Jesse James is buried if you want to check out some interesting history. The population is less than 10,000 and 27.1% of the residents are seniors;
• Kerrville, Texas – located in the Texas Hill Country, this town is known among locals and younger Texans as the city where the summer camps are located. The Guadalupe River runs through the city. It’s a beautiful area and is close enough to San Antonio or Austin should seniors want to leave the peaceful town and spend the day back amid the hustle and bustle. It is home to the Kerrville Folk Festival, James Avery Jewelry, and the Museum of Western Art. With an estimated population of less than 25,000, the percentage of elders is around 8%; and
• Fredericksburg, Texas – located in the Hill Country, this town is the County Seat of Gillespie County and has a strong history with German roots. It boasts a beautiful downtown with shops and antiques and a low crime rate. It is the birthplace of Admiral Chester W. Nimitz and the home of the National Museum of the Pacific War, as well as the Peach Capital of Texas. The population is estimated to be around 12,000, with 31.4% of the residents who are 65 or older.