(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
(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, 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 §97.401 (relating to Standards Specific to Licensed Home
(2) Licensed and Certified Home Health Services, as
set out in 40 TAC §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 §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 Care Services).
(e) Provider organizations and FMSAs, must successfully
enroll as a Texas Medicaid provider 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.
Source Note: The provisions of this §363.603 adopted to be effective September 1, 2007, 32 TexReg 5355; amended to be effective September 1, 2014, 39 TexReg 5890