1. Program Definition and Services

Homemaker Services in Texas deliver non-medical, non-skilled household maintenance supports to help elderly individuals or persons with disabilities maintain safe, sanitary, and functional living spaces. Authorized across multiple 1915(c) waivers (HCS, CLASS, TxHmL, DBMD) and the STAR+PLUS HCBS framework, these services support environmental stability without providing hands-on personal care (ADL) assistance. Services include:

• Essential Housekeeping: Sweeping, vacuuming, mopping floors, dust mitigation, kitchen surface sanitization, washing dishes, bathroom cleaning, trash disposal, changing bed linens, and laundry
• Household Management Assistance: Basic meal preparation, grocery shopping coordination, and domestic sorting or organization within the participant's primary residence

2. Regulations

The program is governed by the following regulations:

• Texas Administrative Code (TAC), Title 26, Part 1, Chapter 558 (Licensing Standards for Home and Community Support Services Agencies)
• Texas Administrative Code (TAC), Title 26, Part 1, Chapter 213, Subchapter B, §213.207 (Homemaker Services Provisions and Scopes)
• Texas Administrative Code (TAC), Title 26, Part 1, Chapter 565 (HCS and TxHmL Quality Frameworks)
• Federal Home and Community-Based Services (HCBS) Final Settings Rule (42 CFR 441.301)

3. Licensing or Certification

To operate an agency delivering homemaker lines, providers must obtain a Home and Community Support Services Agencies (HCSSA) License under the Personal Assistance Services (PAS) category code issued by the state. Entities must also complete formal waiver provider contracting with Texas Medicaid Managed Care Organizations (MCOs) or the targeted HHSC waiver network.

4. Responsible State Agency

The Texas Health and Human Services Commission (HHSC) functions as the primary regulatory, licensing, and monitoring entity. HHSC controls the HCSSA licensing structure, establishes reimbursement protocols, and executes quality assurance field reviews.

5. Application Process

• Register the legal corporate entity via the Texas Secretary of State and secure federal EIN/NPI codes
• Complete and upload the initial HCSSA license application and licensing fees via the online Texas Unified Licensure Information Portal (TULIP)
• Enroll the corporation through the web-based Texas Medicaid & Healthcare Partnership (TMHP) Provider Enrollment and Management System (PEMS)
• Apply for an open enrollment waiver contract through the electronic HHSC system (CAMP) or individual regional MCO networks

6. Required Documentation

• Verified business formation records, active Federal EIN, and corporate Type 2 NPI
• Approved state HCSSA license validation parameters from the TULIP platform
• Homemaker Services Policy & Procedure Manual (covering housecleaning safety practices, chemical sanitation workflows, backup scheduling infrastructure, time sheet protocols, and participant right forms)
• Current Employee Misconduct Registry (EMR) and Nurse Aide Registry (NAR) background checks for all workers
• Certificates of commercial general liability insurance and state-compliant workers' compensation coverage lines

7. Timeline for Approval

The combined processing timeline across TULIP HCSSA licensing, mandatory physical or administrative initial surveys, and final TMHP PEMS enrollment typically spans 4 to 6 months, depending on state agency survey backlogs.

8. Pre-Application Process

Prospective providers must form an LLC or Corporation with the Texas Secretary of State, establish their commercial business framework, and register a corporate Type 2 National Provider Identifier (NPI) configured with personal assistance or home care service taxonomy codes.

9. Pre-Application Training

Before submitting the initial HCSSA application in TULIP, the designated agency Administrator and Alternate Administrator must successfully complete the mandatory HHSC HCSSA Pre-Licensure Computer-Based Training (CBT) modules and submit their passing certificates.

10. Additional Notes

• Homemaker tasks must be meticulously documented on daily task logs or time sheets, specifying the exact household maintenance actions performed during each distinct service shift
• All household cleaning, cooking, or shopping parameters must align explicitly with the authorized service hours and target goals built into the participant's individual Care Plan
• Homemaker employees are strictly prohibited from performing skilled nursing care, professional home structural repairs, yard maintenance, or direct personal physical care (like bathing or dressing)
• Providers must track employee hours using the state's Electronic Visit Verification (EVV) data systems for applicable home care service lines to satisfy standard billing compliance reviews

Why Choose Waiver Consulting Group?

Starting or expanding your Medicaid waiver-funded agency can feel overwhelming, but it doesn't have to be. At Waiver Consulting Group, we simplify the process by guiding you through licensing, compliance, provider enrollment, policies & procedures, and regulatory approvals in any state.

With proven expertise, a structured process, and ongoing support, we take the guesswork out of launching your healthcare business. Whether you're a first-time entrepreneur or an established provider looking to expand, our team ensures you stay compliant, competitive, and fully operational.

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