El Paso Senior AdvisorDoes Texas license non-medical home care agencies?
Yes. Texas licenses home and community support services agencies (HCSSAs) under Health and Safety Code chapter 142 and 26 TAC chapter 558, and an agency that sends paid workers into homes for personal assistance services, such as bathing, dressing, meals and housekeeping, needs that license even if it provides no nursing.
That makes Texas stricter than many states, and it means you can check any El Paso agency on HHSC's directory. El Paso County has 108 agencies licensed for personal assistance services alone, more than the number of assisted living and nursing facilities combined. A private caregiver hired directly by a family is not an agency and does not need a license, but the family then becomes the employer, with responsibility for taxes, backup coverage and background checks.
What categories appear on a Texas home care agency license?
An HCSSA license lists the services the agency may provide: licensed home health services, licensed and certified home health services (Medicare-certified), hospice, and personal assistance services; our roster shows each El Paso agency's categories exactly as HHSC lists them.
Only an agency licensed and certified for home health can bill Medicare for skilled visits, and only a licensed hospice can provide Medicare hospice care. An agency licensed only for personal assistance services cannot send a nurse to change a dressing or manage medications. HHSC's directory shows 93 home health agencies and 43 hospice agencies with offices in El Paso County, plus 108 agencies licensed only for personal assistance services.
What must a Texas home care agency check before hiring caregivers?
Texas requires agencies to run criminal history checks and to search the employee misconduct registry and the nurse aide registry before hiring, and a person listed as unemployable on those registries may not work with clients.
Ask an agency how it trains caregivers, whether caregivers are employees or contractors, what supervision a registered nurse provides, how it covers a missed shift, and whether the same caregiver will come each time. For Spanish-speaking parents, ask how many of the agency's caregivers are bilingual and whether you can meet the caregiver before the first shift.
How does Medicaid pay for home care in El Paso?
For eligible El Paso residents, Texas Medicaid pays licensed agencies for attendant care through STAR+PLUS managed care and the Community Attendant Services program, and Primary Home Care serves some people with lower needs; the health plan or HHSC sets the number of hours.
El Paso's large number of licensed personal assistance agencies reflects how many families use these programs to keep a parent at home. If your parent qualifies, the health plan's service coordinator arranges the agency; you can ask for a different agency if the fit is wrong. See community care programs and PACE.
How are adult day centers licensed in Texas?
Adult day centers are licensed by HHSC as day activity and health services (DAHS) facilities under 26 TAC chapter 559, which sets standards for nursing oversight, meals, activities, staffing and the building.
HHSC licenses 24 adult day (DAHS) centers in El Paso County, from 80 to 380 licensed participants. DAHS centers serve adults who live at home and need supervision or help during the day, and many in El Paso provide transportation. Texas Medicaid and the state's community care programs pay for eligible participants. See every licensed center.
Side by side
| An HCSSA license covers | An HCSSA license does not cover | |
|---|---|---|
| Personal assistance | Non-medical help at home from an agency | A private caregiver a family hires directly |
| Home health | Skilled nursing and therapy visits, Medicare-billable if certified | 24-hour nursing at home |
| Hospice | Comfort care at home or in a facility | Room and board in a facility |
| Checks | Required registry and criminal history checks | A rating of the agency |
Sources: Texas Health and Safety Code chapters 142, 242 and 247; 26 Texas Administrative Code chapters 553, 554, 558 and 559; HHSC program handbooks; CareScout, CMS and VA rate tables, as cited above. See our editorial standards.
