(a) Purpose. This section establishes the requirements for homemaker services, a service provided under the Older Americans Act and funded, in whole or in part, by DADS.
(b) Eligibility. A AAA must ensure that a program participant who receives homemaker services is:
  (1) 60 years of age or older; and
  (2) functionally impaired in the ability to perform instrumental activities of daily living as described in DADS Program Instruction AAA - PI 310 Activities of Daily Living/Instrumental Activities of Daily Living NAPIS Mapping Requirements.
(c) Type of provider. A AAA may provide homemaker services as an agency managed service or as a consumer directed service, or as both.
  (1) Agency managed. Homemaker services that are agency managed are provided only by a vendor.
  (2) Consumer directed. Homemaker services that are consumer directed are provided by furnishing vouchers to a program participant, allowing the program participant to select a homemaker, establish a work schedule and payment rate, and provide the homemaker information and training on the program participant's needs.
(d) Informing program participant of options. If a AAA provides homemaker services as both an agency managed service and as a consumer directed service, the AAA must inform a program participant that he or she may choose to receive homemaker services in either of those two ways.
(e) Service authorization. Before homemaker services are provided by a vendor to a program participant, the AAA must ensure that the vendor obtains prior written authorization for the services from the AAA in accordance with §83.3(o)(2)(B) of this title (relating to System of Access and Assistance).
(f) Homemaker services. Homemaker services include:
  (1) cleaning for the program participant, including:
    (A) cleaning after a program participant's personal care tasks;
    (B) emptying and cleaning a program participant's bedside toilet;
    (C) cleaning a program participant's bathroom;
    (D) changing a program participant's bed linens and making the program participant's bed;
    (E) cleaning the floor of a program participant's living area;
    (F) dusting an area used by a program participant;
    (G) taking a program participant's trash to an outside receptacle and moving the receptacle to a location for pick-up;
    (H) cleaning a program participant's stovetop and counters;
    (I) washing a program participant's dishes; and
    (J) cleaning a program participant's refrigerator and stove;
  (2) doing a program participant's laundry, including:
    (A) washing a program participant's laundry by hand or machine;
    (B) gathering and sorting laundry;
    (C) loading and unloading the washing machine and dryer in the program participant's residence;
    (D) using laundromat machines;
    (E) hanging laundry to dry; and
    (F) folding and putting away laundry;
  (3) shopping for the program participant, including:
    (A) preparing a shopping list;
    (B) going to the store and purchasing or picking up items;
    (C) picking up medication; and
    (D) storing the purchased items;
  (4) assisting a program participant in organizing and completing a home management routine;
  (5) performing necessary reading and writing tasks as directed by the program participant;
  (6) preparing meals for the program participant, including:
    (A) assisting in planning menus that are appropriate for the program participant's needs;
    (B) shopping for and storing food;
    (C) preparing and serving meals; and
    (D) utilizing sanitary practices for handling and preparing food; and
  (7) accompanying a program participant to obtain health care services and other necessary items and services unless prohibited by subsection (g)(7) of this section.
(g) Prohibited activities. Homemaker services do not include the following:
  (1) personal assistance services described in §85.305(e)(1) - (2), (4) - (10), and (12) of this subchapter (relating to Personal Assistance Services);
  (2) repairs to the program participant's residence;
  (3) pet grooming;
  (4) yard maintenance;
  (5) moving heavy objects;
  (6) performing services for members of the household other than the program participant;
  (7) transporting the program participant in a vehicle unless proof of liability insurance covering such transportation has been verified, in writing, by the vendor;
  (8) performing tasks beyond the scope of the service authorization required by subsection (e) of this section;
  (9) accepting gifts from the program participant;
  (10) bringing persons to the program participant's residence who are not providing homemaker services to the program participant;
  (11) taking personal property from the program participant's residence; or
  (12) assuming control of the financial or personal affairs of the program participant or his or her estate including serving as power of attorney, guardian, or conservator.
(h) Staffing qualification requirements for an agency-managed service.
  (1) A AAA must ensure that a vendor that has a program supervisor for homemaker services requires the program supervisor to:
    (A) meet one of the following criteria:
      (i) be a licensed nurse;
      (ii) have completed two years of full-time study in social or behavioral sciences at an accredited college or university; or
      (iii) have:
        (I) a high school diploma or high school equivalency certificate; and
        (II) have one of the following:
          (-a-) the equivalent of two years experience as a full-time employee in a supervisory capacity in a health care facility, health care agency, or other health care organization; or
          (-b-) the equivalent of one year experience as a full-time employee in a supervisory capacity in a health care facility, health care agency, or other health care organization and have completed one year of full-time study in social or behavioral sciences at an accredited college or university; and
    (B) have experience in:
      (i) housekeeping or home management; and
      (ii) meal preparation activities.
  (2) A AAA must ensure that a vendor requires a homemaker (that is, the person who provides homemaking services to the program participant):
    (A) to be an adult;
    (B) to have the ability to follow oral and written instructions and keep records;
    (C) to have previous experience providing care to a person 60 years of age or older or a disabled adult;
    (D) to demonstrate competency to perform homemaker services;
    (E) to not be the spouse or legal guardian of the program participant; and
    (F) to not live with the program participant.
(i) Training and documentation requirements for an agency managed service. A AAA must ensure that a vendor:
  (1) trains homemakers to recognize and report changes in a program participant's health condition that may require emergency procedures or health services;
  (2) maintains documentation demonstrating compliance with paragraph (1) of this subsection; and
  (3) determines the need for, and requires homemakers to receive, other training as appropriate.
(j) Information and assistance requirements for a consumer directed service. A AAA must:
  (1) give a program participant written information to assist the program participant in performing the following activities:
    (A) interviewing potential homemakers;
    (B) requiring potential homemakers to provide references;
    (C) checking references of homemakers;
    (D) selecting a homemaker who meets the qualifications described in subsection (h)(2) of this section;
    (E) deciding upon, in discussion with the homemaker, an hourly, daily, or weekly rate to be paid to the homemaker;
    (F) informing or training the homemaker on the specific needs of the program participant;
    (G) ensuring proper payment for homemaker services by recording the number of hours or days homemaker is used and the total amount claimed against the voucher;
    (H) ensuring federal tax guidelines for household employees are followed in accordance with IRS Publication 926;
    (I) notifying the AAA if the program participant's address changes;
    (J) monitoring the quality of the homemaker service provided; and
    (K) notifying the AAA if the program provider is dissatisfied with a homemaker; and
  (2) assist a program participant in finding a homemaker if such assistance is requested by the program participant.

Source Note: The provisions of this §213.207 adopted to be effective September 1, 2008, 33 TexReg 7293; transferred effective November 15, 2020, as published in the Texas Register October 30, 2020, 45 TexReg 7721