(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 representative (LAR);
  (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 or by 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 Health Services);
  (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 Services).
(e) Provider organizations and FMSAs must successfully enroll as Texas Medicaid providers 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.
(g) Provider organizations, recipients, and responsible adults or LARs of recipients who employ attendants for PCS must:
  (1) pay each attendant at least the base wage specified in §355.7051 of this title (relating to Base Wage for a Personal Attendant); and
  (2) notify any person employed as an attendant of the requirement that the provider organizations, recipients, and responsible adults or LARs of recipients who employ attendants for PCS must pay each attendant at least the base wage specified in §355.7051 of this title.

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; amended to be effective February 14, 2016, 41 TexReg 962; amended to be effective May 10, 2020, 45 TexReg 2826