(a) Orientation. In addition to the requirements described in this section, a provider must ensure each attendant is oriented as described in 26 TAC Chapter 558, Subchapter C, (relating to Minimum Standards for All Home and Community Support Services Agencies) and 26 TAC §558.404 (relating to Standards Specific to Agencies Licensed to Provide Personal Assistance Services). Orientation is not required for a supervisor when providing personal assistance services.
(b) Method of orientation.
  (1) A supervisor must determine the method of attendant orientation, which may be conducted:
    (A) in person, with the participation of the individual; or
    (B) by telephone or in person at any location without the participation of the individual at the discretion of the supervisor, if the attendant:
      (i) meets the requirements described in 26 TAC §558.701 (relating to Home Health Aides);
      (ii) has six continuous months of experience in delivering attendant care;
      (iii) has been oriented to the individual and there are service delivery plan changes; or
      (iv) has previously provided services to the individual.
  (2) The supervisor may use discretion to determine if the attendant needs to be oriented if:
    (A) the attendant previously provided services to the individual; and
    (B) the service delivery plan has not changed since the attendant provided services to the individual.
(c) Due dates. The supervisor must orient each attendant on or before the time the attendant begins to provide attendant services.
(d) Documentation of attendant orientation.
  (1) The supervisor must record the attendant orientation on a single document that includes:
    (A) the individual's name and number assigned to the individual by HHSC;
    (B) the attendant's name;
    (C) the date of the attendant orientation;
    (D) if the orientation was conducted in person with the individual or without the participation of the individual;
    (E) information about how the individual's condition affects the performance of tasks;
    (F) the tasks to be performed;
    (G) the service schedule;
    (H) the number of hours of service the attendant is to provide;
    (I) the total number of hours of service the individual is authorized to receive;
    (J) safety and emergency procedures, including universal precautions;
    (K) specific situations about which the attendant must notify the provider, including:
      (i) changes in the individual's needs;
      (ii) incidents that affect the individual's condition;
      (iii) hospitalization of the individual;
      (iv) the individual's absence or relocation from home; and
      (v) the attendant's inability to work; and
    (L) the signature of:
      (i) the supervisor who conducts the orientation;
      (ii) the attendant who is oriented, if present; and
      (iii) the individual, if present.
  (2) The provider must maintain documentation of the attendant orientation in the individual's file.

Source Note: The provisions of this §277.25 adopted to be effective June 1, 2004, 29 TexReg 5113; amended to be effective June 1, 2009, 34 TexReg 2802; amended to be effective October 1, 2019, 44 TexReg 5138; transferred effective July 1, 2024, as published in the June 14, 2024, issue of the Texas Register, 49 TexReg 4436