Current through Reg. 49, No. 38; September 20, 2024
(a) Personal care services (PCS) must be
provided by an individual who:
(1) is 18
years of age or older;
(2) is an
attendant who:
(A) is an employee of a
provider organization licensed as a home and community support services agency
(HCSSA) per 40 TAC Chapter 97 (relating to Licensing Standards for Home and
Community Support Services Agencies); or
(B) if the recipient is receiving PCS through
the consumer directed services (CDS) option described in 40 TAC Chapter 41
(relating to Consumer Directed Services Option), is an employee of:
(i) the recipient; or
(ii) the recipient's responsible adult or
legally authorized representative (LAR);
(3) has demonstrated the competence
necessary, when competence cannot be demonstrated through education and
experience, to perform the personal assistance tasks assigned by the provider
organization supervisor or by the recipient or the recipient's responsible
adult or LAR acting as employer through the CDS option described in 40 TAC
Chapter 41;
(4) is not the
responsible adult of the recipient if the recipient is under the age of 18;
and
(5) is not the legal spouse of
the recipient.
(b) HHSC
may establish rates of reimbursement based on the level of care required by the
recipient and the qualifications of and tasks performed by the PCS
attendant.
(c) An organization that
employs attendants who provide PCS must meet the licensing standards set out in
40 TAC Chapter 97 for one of the following license categories or special
service types:
(1) Licensed Home Health
Services, as set out in 40 TAC §RSA
97.401(relating to Standards Specific to
Licensed Home Health Services);
(2)
Licensed and Certified Home Health Services, as set out in 40 TAC §RSA
97.402(relating to Standards Specific to
Licensed and Certified Home Health Services); or
(3) agencies licensed to provide personal
assistance services, as set out in 40 TAC §RSA
97.404(relating to Standards Specific to
Agencies Licensed to Provide Personal Assistance Services).
(d) An organization serving as a Financial
Management Services Agency (FMSA) providing financial management services and
other employer support services to a recipient receiving PCS through the CDS
option must meet the FMSA contracting requirements specified in 40 TAC Chapters
41 and 49 (relating to Consumer Directed Services Option and Contracting for
Community Services).
(e) Provider
organizations and FMSAs must successfully enroll as Texas Medicaid providers
prior to seeking authorization or payment for PCS.
(f) Any organization that employs attendants
who provide PCS and any organization serving as an FMSA must comply with all
documentation requirements as specified in PCS program policy.
(g) Provider organizations, recipients, and
responsible adults or LARs of recipients who employ attendants for PCS must:
(1) pay each attendant at least the base wage
specified in § 355.7051 of this title (relating to Base Wage for a
Personal Attendant); and
(2) notify
any person employed as an attendant of the requirement that the provider
organizations, recipients, and responsible adults or LARs of recipients who
employ attendants for PCS must pay each attendant at least the base wage
specified in § 355.7051 of this title.
