Current through Reg. 49, No. 38; September 20, 2024
(a) Independent contractors. If an agency
uses independent contractors, there must be a contract between each independent
contractor that performs services and the agency. The contract must be enforced
by the agency and clearly designate:
(1) that
clients are accepted for care only by the agency;
(2) the services to be provided by the
contractor and how they will be provided (i.e. per visit, per hours,
etc.);
(3) the necessity of the
contractor to conform to all applicable agency policies, including personnel
qualifications;
(4) the
contractor's responsibility for participating in developing the plan of care,
care plan, or individualized service plan;
(5) the way services will be coordinated and
evaluated by the agency in accordance with §558.288 of this division
(relating to Coordination of Services);
(6) the procedures for:
(A) submitting information and documentation
by the contractor, in accordance with the agency's client record
policies;
(B) scheduling of visits
by the contractor or the agency;
(C) periodic client evaluation by the
contractor; and
(D) determining
charges and reimbursement payable by the agency for the contractor's services
under the contract.
(b) Arranged services. Home health services,
hospice services, or personal assistance services provided by an agency under
arrangement with another agency or organization must be provided under a
written contract conforming to the requirements specified in subsection (a) of
this section.
(c) If an agency
contracts with another agency or organization for an unlicensed person to
provide home health services, hospice services, or personal assistance services
under arrangement, the agency must ensure that either it or the contracting
agency or organization:
(1) searches the
nurse aide registry (NAR) and the employee misconduct registry (EMR) before the
unlicensed person's first face-to-face contact with a client of the agency,
using the HHSC Internet website to confirm that the unlicensed person is not
listed in either registry as unemployable;
(2) provides written information to the
unlicensed person about the EMR that complies with the requirements of 40 TAC
§93.3(c) (relating to Employment and Registry Information); and
(3) searches the NAR and the EMR at least
every 12 months using the HHSC Internet website to confirm that the person is
not listed in either registry as unemployable.
(d) If an agency contracts with another
agency or organization for an unlicensed person to provide home health
services, hospice services, or personal assistance services under arrangement,
the agency must ensure that the contracting agency or organization:
(1) conducts a criminal history check before
the unlicensed person's first face-to-face contact with a client of the agency;
and
(2) verifies that the
unlicensed person's criminal history information does not include a conviction
that bars employment under Texas Health and Safety Code §
250.006.
(e) Documentation for contract staff. An
agency is not required to maintain a personnel record for independent
contractors or staff who provide services under arrangement with another agency
or organization. Upon request by HHSC, an agency must provide documentation at
the site of a survey within eight working hours of the request to demonstrate
that:
(1) independent contractors or staff
under arrangement meet the agency's written job qualifications for the position
and duties performed;
(2) the
agency ensures compliance with subsection (c) of this section for unlicensed
staff providing services to the agency's clients under arrangement;
and
(3) the agency complies with
subsection (d) of this section for unlicensed staff providing services to the
agency's clients under arrangement by providing a written statement, signed by
a person authorized to make decisions on personnel matters for the contracting
agency or organization, attesting that a criminal history check was conducted
before an unlicensed person's first face-to-face contact with a client, and did
not include a conviction barring employment under Texas Health and Safety Code
§
250.006.
