(a) Purpose. This section establishes the requirements for personal assistance 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 personal assistance services is:
  (1) 60 years of age or older; and
  (2) functionally impaired in his or her ability to perform 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) Requirement for a licensed vendor to provide services. A AAA must enter into a vendor agreement for the provision of personal assistance services with an entity licensed by DADS as a home and community support services agency in accordance with Chapter 97 of this title (relating to Licensing Standards for Home and Community Support Services Agencies).
(d) Service authorization. Before personal assistance services are provided by a vendor to a program participant, a AAA must ensure that the vendor obtains 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).
(e) Personal assistance services. Personal assistance services include:
  (1) bathing, which includes:
    (A) drawing water in sink, basin, or tub;
    (B) hauling or heating water;
    (C) laying out supplies;
    (D) assisting a program participant in or out of tub or shower;
    (E) sponge bathing and drying a program participant;
    (F) bed bathing and drying a program participant;
    (G) tub bathing and drying a program participant; and
    (H) providing standby assistance for a program participant while the program participant is engaged in bathing activities;
  (2) dressing, which includes:
    (A) dressing a program participant;
    (B) undressing a program participant; and
    (C) laying out clothes for a program participant;
  (3) meal preparation for a program participant, which includes:
    (A) assisting in planning menus that are appropriate for the program participant's needs;
    (B) cooking a full meal;
    (C) warming prepared food;
    (D) helping prepare meals;
    (E) planning meals; and
    (F) cutting a program participant's food for eating;
  (4) feeding a program participant, which includes:
    (A) spoon-feeding or bottle-feeding, but not tube feeding;
    (B) assisting a program participant with using eating and drinking utensils and adaptive devices; and
    (C) providing a program participant with standby assistance or encouragement while the program participant is eating;
  (5) exercising by walking with a program participant;
  (6) grooming a program participant, which includes:
    (A) caring for teeth;
    (B) shaving, including face, underarms, and legs;
    (C) caring for nails; and
    (D) laying out supplies;
  (7) routine hair and skin care, which includes:
    (A) washing a program participant's hair;
    (B) drying a program participant's hair;
    (C) assisting with setting, rolling or braiding a program participant's hair but not cutting or chemical processing of hair;
    (D) combing or brushing a program participant's hair;
    (E) applying nonprescription lotion to a program participant's skin;
    (F) washing hands and face of a program participant;
    (G) applying makeup to a program participant; and
    (H) laying out supplies;
  (8) assistance with self-administered medications, which includes:
    (A) reminding a program participant to take a medication at the prescribed time;
    (B) opening and closing a medication container;
    (C) pouring a predetermined quantity of liquid to be ingested;
    (D) returning a medication to the proper storage area; and
    (E) assisting in reordering medications from a pharmacy;
  (9) toileting, which includes:
    (A) changing a program participant's day briefs;
    (B) changing a program participant's colostomy bag, including emptying the catheter bag;
    (C) assisting a program participant with use of a bedpan, including emptying the bedpan;
    (D) assisting a program participant with the use of a urinal, including emptying the urinal;
    (E) assisting a program participant with feminine hygiene needs;
    (F) assisting a program participant with clothing during toileting;
    (G) assisting a program participant with toilet hygiene, including the use of toilet paper and washing hands;
    (H) changing a program participant's external catheter;
    (I) preparing toileting supplies and equipment but not preparing catheter equipment; and
    (J) providing standby assistance to the program participant during toileting activities;
  (10) transfer or ambulation of the program participant, which includes:
    (A) non-ambulatory movement of a program participant from one stationary position to another but not carrying the program participant;
    (B) adjusting or changing a program participant's position in a bed or chair;
    (C) assisting a program participant in rising from a sitting to a standing position;
    (D) assisting a program participant in positioning for use of a walking apparatus;
    (E) assisting a program participant with putting on and removing leg braces and prostheses for ambulation;
    (F) assisting a program participant with ambulation or using steps;
    (G) assisting a program participant with wheelchair ambulation; and
    (H) providing a program participant with standby assistance while the program participant is engaged in any of the activities listed in subparagraphs (A) - (G) of this paragraph;
  (11) home management (that is, assistance with housekeeping activities supporting the program participant's health and safety), which includes:
    (A) changing a program participant's bed linens;
    (B) cleaning a program participant's house;
    (C) laundering a program participant's clothes;
    (D) shopping for a program participant;
    (E) storing purchased items for a program participant; and
    (F) washing a program participant's dishes; and
  (12) escorting a program participant to obtain health care services and other necessary items and services except as prohibited by subsection (f)(6) of this section;
(f) Prohibited activities. Personal assistance services do not include the following activities:
  (1) repairing a program participant's home;
  (2) grooming a program participant's pet;
  (3) moving heavy objects such as furniture for a program participant;
  (4) maintaining a program participant's yard;
  (5) performing services for members of a program participant's household other than the program participant;
  (6) transporting a program participant in a vehicle unless proof of liability insurance covering such transportation has been verified, in writing, by the vendor;
  (7) performing tasks not assigned by the supervisor of the provider of personal assistance services;
  (8) accepting gifts from a program participant;
  (9) bringing persons to a program participant's home who are not providing personal assistance services to the program participant;
  (10) taking personal property from a program participant's home; or
  (11) assuming control of the financial or personal affairs of a program participant or of his or her estate, including serving as power of attorney, guardian, or conservator.
(g) Qualifications. A AAA must ensure that a person providing personal assistance services does not live with the program participant.

Source Note: The provisions of this §213.209 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