Every answer was written and checked ahead of time, with the official document next to it. Nothing is made up on the spot.
Do I need a license to run a non-medical home care agency in Texas?
Yes, if you provide personal care.
Personal assistance services need a Home and Community Support Services Agency license from HHSC. HHSC's rule defines them as routine ongoing help with daily living, including personal care such as bathing, dressing, grooming, feeding, toileting, help with self-administered medicines and moving around, and respite. The law exempts sitter-companion, chore or household services that do not involve personal care, health or health-related services. It also exempts registries that only put clients in touch with workers, and workers hired and paid directly by the client or family.
Written and checked September 23, 2026
How long does an HCSSA license last, and what does it cost?
Three years; $2,625.
HHSC's rule sets the initial license fee, including a change of ownership, at $2,625, and the three-year renewal fee at $2,625; each branch office pays the same. Renewing after the 45th day before expiration adds a late fee of half the renewal fee, and fees are not refundable. HHSC reviews an application only after TULIP shows the payment as received.
Written and checked September 23, 2026
What do I have to do after I get my first HCSSA license?
Serve clients and ask for a survey within six months.
No later than six months after the initial license takes effect, admit clients, provide services and send Form 2020 to your designated survey office, unless you are exempt because you hold accreditation for those services and sent HHSC the documents. When the surveyor arrives, have your client list, client records, agency policies and personnel records ready. HHSC says missing the deadline can lead to license revocation or denial of renewal.
Written and checked September 23, 2026
What background checks do I need for home care staff in Texas?
Criminal history, the Nurse Aide Registry and SEMARC.
Get the applicant's criminal history from the Department of Public Safety; if you hire before it comes back, the person may not have direct contact with clients until you have it. Before hiring and every year, search the Nurse Aide Registry and the Employee Misconduct Registry in TULIP and keep the results. Since August 3, 2026, HHSC requires HCSSAs to use SEMARC, which includes the Employee Misconduct Registry, along with the Nurse Aide Registry. You may not employ someone listed as unemployable.
Written and checked September 23, 2026
What is SEMARC?
A cross-agency misconduct search, required since Aug. 3, 2026.
SEMARC, the Search Engine for Multi-Agency Reportable Conduct, is created by Health and Safety Code Chapter 810. It combines HHSC's Employee Misconduct Registry with DFPS's confirmed child abuse, neglect and exploitation cases, the Texas Education Agency's Do Not Hire Registry and the Texas Juvenile Justice Department's registry. HCSSAs open it in TULIP under "Other Actions"; HHSC won't survey for it until October 6, 2026. Help: SEMARC help desk 877-798-1077, TULIP help desk 512-438-2584.
Written and checked September 23, 2026
Are home care workers in Texas required to report abuse?
Yes, to HHSC within 24 hours.
Anyone who believes a client of a licensed HCSSA is being abused, neglected or exploited must report it to HHSC, and knowingly failing to report is a Class A misdemeanor. If an agency employee, contractor or volunteer may be involved, report to HHSC Complaint and Incident Intake within 24 hours in TULIP, at ciicomplaints@hhs.texas.gov or at 800-458-9858, then send Form 3613 by the 10th day. HHSC says these no longer go to DFPS, although its rule text still names both. Suspected abuse by family or others, and self-neglect, go to DFPS at 800-252-5400 or txabusehotline.org.
Written and checked September 23, 2026
Which services need EVV in Texas?
Medicaid personal care and home health care services.
HHSC's tables list personal attendant services in Primary Home Care, Community Attendant Services and Family Care, CFC, PCS, STAR+PLUS PAS and in-home respite, among others. Home health care services have needed EVV since January 1, 2024; private duty nursing, hospice, telehealth, and nursing or therapy visits that don't begin or end in the member's home are excluded. All EVV claims, including health plan claims, go electronically to TMHP, are matched against your EVV visits by the EVV Aggregator, and are then sent to the payer.
Written and checked September 23, 2026
Who pays for personal care for STAR+PLUS members?
The member's health plan.
STAR+PLUS covers adults 65 and older and adults 21 and older with a disability, with at least two health plans in each of 13 service areas. HHSC's April 2026 EVV tables list Amerigroup, Molina, Superior and UnitedHealthcare for STAR+PLUS, and Aetna, Amerigroup, Blue Cross Blue Shield of Texas, Community First Health Plan, Cook Children's Health Plan, Driscoll Children's Health Plan, Molina, Superior, Texas Children's Health Plan and UnitedHealthcare for STAR Kids. These are the names in the table, which may be older brand names. The plan pays PCS and CFC, except CFC for STAR Kids members in the CLASS, DBMD, HCS or TxHmL waivers, which TMHP pays. EVV claims still go through TMHP first for matching.
Written and checked September 23, 2026
What does the administrator of a personal assistance agency need?
Set qualifications and training, but no license.
Each HCSSA has one administrator and one alternate. For a PAS-only agency, each needs a high school diploma or GED with one year of experience or training in caring for people with functional disabilities, or two years of full-time study in a health-related field at an accredited college, or the home health qualifications. A first-time administrator needs 24 hours of training in the first year (8 before designation, 16 within 12 months), then 12 hours of continuing education each year. Both must enroll in HHSC's AlertMedia emergency communication system.
Written and checked September 23, 2026
Do I still have to pay attendants the Texas base wage?
No; it ended Aug. 31, 2025.
HHSC says the personal attendant base wage requirement ended August 31, 2025, and providers now set attendant pay, at or above the federal minimum wage. Rates from September 1, 2025, assume an average wage of $13.00 an hour. HHSC will compare each provider's attendant wage and benefit spending with its attendant revenue from cost reports and list providers below 0.90; there is no recoupment. Health plans may keep their own attendant rate enhancement programs.
Written and checked September 23, 2026