HOME CARE SERVICES PROVIDER IN TEXAS

Fatumata Kaba
2 days ago
3 min read

DELIVERING NON-SKILLED PERSONAL ASSISTANCE AND COMPANIONSHIP TO SUPPORT DAILY LIVING IN HOME AND COMMUNITY SETTINGS

Home Care Services in Texas offer non-medical, personal assistance to Medicaid participants who need help with activities of daily living (ADLs) to remain safely in their homes. These services are distinct from home health (which involves skilled nursing or therapies) and are authorized under various Medicaid programs, including STAR+PLUS, MDCP, and State Plan Personal Care Services (PCS). The Texas Health and Human Services Commission (HHSC) regulates provider enrollment and oversight.

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1. GOVERNING AGENCIES

Agency: Texas Health and Human Services Commission (HHSC)

Role: Administers Medicaid and waiver programs, authorizes home care services, and oversees compliance.

Agency: Texas Department of State Health Services (DSHS)

Role: Licenses Home and Community Support Services Agencies (HCSSAs) to deliver non-skilled personal assistance services.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Regulates Medicaid standards and ensures compliance with federal home care delivery rules.

2. HOME CARE SERVICES OVERVIEW

Home care services support individuals with functional impairments, offering hands-on assistance and supervision tailored to the participant’s daily routines and personal needs.

Common services include:

Bathing, grooming, and dressing
Mobility assistance and transfers
Meal preparation and feeding support
Toileting and incontinence care
Light housekeeping and laundry
Accompaniment to appointments or errands (non-medical transport may be separate)
Monitoring for safety and companionship

These services are authorized based on a physician’s order or waiver service plan and must be documented daily.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Texas Secretary of State
Obtain EIN and Type 2 NPI
Apply for an HCSSA license from the Texas DSHS with “Licensed Home Care Services” as the license category
Enroll with TMHP (Texas Medicaid & Healthcare Partnership)
Contract with HHSC for waiver-based programs (STAR+PLUS, MDCP, etc.)
Maintain general liability and workers’ compensation insurance
Develop a Home Care Services Policy & Procedure Manual

4. TEXAS PROVIDER ENROLLMENT PROCESS

Step 1: Form legal entity and obtain EIN/NPI

Step 2: Apply for HCSSA licensure through DSHS (includes application, fees, survey)

Step 3: Enroll with TMHP as a Medicaid provider

Step 4: Apply for waiver contracts with HHSC (if serving MDCP, STAR+PLUS, etc.)

Step 5: Undergo readiness review and receive referrals post-approval

5. REQUIRED DOCUMENTATION

Business formation documents (Articles, EIN, NPI)
HCSSA license from DSHS
TMHP enrollment and HHSC approval letters
Insurance coverage documentation
Home Care Services Policy Manual including:
- Participant intake and assessment process
- Staff supervision and scheduling
- Daily service notes and timekeeping tools
- Incident reporting, abuse prevention, and emergency protocols
- Participant rights and HIPAA protections
- Billing templates and authorization tracking forms

6. STAFFING REQUIREMENTS

Role: Personal Care Attendant / Direct Care Worker

Requirements: Age 18+, background check, CPR/First Aid, orientation training (no license required for non-skilled care)

Role: Supervisor / Home Care Manager

Requirements: Experience in personal care, documentation, and staff oversight

Optional Role: RN Supervisor (for agencies providing both home care and skilled services)

Requirements: Texas RN license and HCSSA supervisory qualifications

All staff must complete:

Orientation on ADLs, personal hygiene, and safety
Participant-specific training
Abuse, neglect, and exploitation prevention
Documentation and daily note writing
HIPAA and confidentiality practices

7. MEDICAID PROGRAMS

Home Care Services are covered under:

STAR+PLUS HCBS Waiver – For elderly and disabled adults
MDCP (Medically Dependent Children Program)
State Plan PCS (Personal Care Services) – For children and youth under 21
Community First Choice (CFC) – Attendant care for individuals with functional needs

8. TIMELINE TO LAUNCH

Phase: Business Registration & Licensure Preparation

Timeline: 2–4 months (HCSSA licensure can be time-consuming)

Phase: Medicaid Enrollment & Waiver Contracts

Timeline: 2–3 months

Phase: Staff Hiring, Orientation & System Setup

Timeline: 30–45 days

Phase: Begin Services Post-Authorization

Timeline: Once referrals and authorizations are received

9. CONTACT INFORMATION

Texas Health and Human Services Commission (HHSC)

Website: https://www.hhs.texas.gov