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Texas PAS Policy and Procedure Manual (HCSSA)

For Texas agencies licensed by HHSC as a Home and Community Support Services Agency (HCSSA) in the Personal Assistance Services (PAS) category. The manual has 46 policies and 12 forms, with the client forms in English and Spanish. It is written to 26 TAC Chapter 558, the HCSSA licensing rules. Each policy opens with a plain-English summary and names the rule section it follows, and every one is filled in with your agency's name and details. You get Word and PDF files to keep, and your staff read and sign each policy on their phone.

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Texas · Home care

46 policies written to the Texas rules, with 12 forms. Every one is filled in with your agency's details.

  • A plain-English summary first
  • The rule each policy follows
  • Word and PDF downloads, yours to keep
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Policies
46
Forms
12
Categories
13
Policy Pack · required
$700one-timeIncludes 90 days in the portal with Premium. To keep it open after that, Premium is $79 a month or $790 a year.

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3 free sample policies, shown in full for a sample agency.

TX-CR-01Free sample Client rights

Client Rights, Responsibilities, and Complaint Process

Sets out every client right the Agency protects, the notices a client must receive before care begins, and a complaint process that is free of reprisal, with a separate route for allegations of abuse, neglect, or exploitation.

Read the full policy TX-ANE-01Free sample Safeguarding

Reporting Abuse, Neglect, and Exploitation

Every employee, contractor, and volunteer who has cause to believe a client has been abused, neglected, or exploited makes sure it is reported at once. Abuse, neglect, or exploitation by Agency staff is reported to HHSC immediately, and never later than 24 hours; abuse by anyone else, and self-neglect, is reported to DFPS; suspected abuse or neglect of a child is reported to DFPS. The Agency begins its own investigation immediately and sends HHSC Form 3613 no later than the 10th day after its report.

Read the full policy TX-IC-01Free sample Infection control

Infection Control

The Agency prevents the spread of infection through standard precautions, hand hygiene, personal protective equipment, staff health screening including tuberculosis screening, and an OSHA exposure control plan, and it tracks infections and exposures through the QAPI program.

Read the full policy
Texas rules

What 26 TAC Chapter 558 asks your policies to cover

  • Client rights and complaints. A written statement of client rights and a complaint process free of reprisal, with a separate route for abuse, neglect or exploitation. 26 TAC §558.282
  • Client agreement. A written agreement before services begin, covering what the rule lists: client rights, the advance directive notice, services, supervision, charges and the complaint procedure. 26 TAC §558.292
  • Abuse, neglect and exploitation. Staff report at once. Abuse by agency staff goes to HHSC immediately, never later than 24 hours, and HHSC Form 3613 follows no later than the 10th day after the report. 26 TAC §558.249
  • Backup and after-hours care. A client is not left without a scheduled service when an attendant is unavailable, and can reach a responsible employee at any hour. 26 TAC §558.290
  • Infection control. How the agency prevents the spread of infection: standard precautions, hand hygiene, protective equipment and staff health screening. 26 TAC §558.285
  • Emergency preparedness. A written emergency preparedness and response plan, with a disaster coordinator and an alternate. 26 TAC §558.256

Questions a surveyor may ask

Every policy lists questions a surveyor may ask about it, so your staff can practice the answers. A few from this manual:

Show me a signed client agreement and tell me what date services actually started. TX-CR-02Agency and Client Agreement and Disclosure What happens when an attendant calls in sick at 6 a.m.? TX-SVC-03Backup Services and After-Hours Care Show me your last self-report to HHSC and the Form 3613 that followed it. How many days apart are they? TX-ANE-01Reporting Abuse, Neglect, and Exploitation Show me your written exposure control plan and the date it was last reviewed. TX-IC-01Infection Control Who is your disaster coordinator, who is the alternate, and how do staff reach them after hours? TX-EP-01Emergency Preparedness and Response Plan
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Browse all 46 policies

Search by title, policy number or rule. Open any policy to see its summary, the rules it follows and what is inside.

All 46 policies

Client rights3

TX-AD-01 Advance Directives Sets out the written notice every client receives about the Agency’s advance directive policy, who receives it when the client is incapacitated, how a directive is recorded and honored, and the $500 penalty for failing to give the notice. 26 TAC §558.283 TX-CR-01Free sample Client Rights, Responsibilities, and Complaint Process Sets out every client right the Agency protects, the notices a client must receive before care begins, and a complaint process that is free of reprisal, with a separate route for allegations of abuse, neglect, or exploitation. 26 TAC §558.282 TX-CR-02 Agency and Client Agreement and Disclosure Requires a written agreement with every client or family before services begin that includes everything 26 TAC §558.292 lists (client rights, the advance directive notice, services, supervision, charges, and the complaint procedure) plus payment responsibility, contact details, and the conditions under which services change or end, and requires the client’s acknowledgment of receipt. 26 TAC §558.292

Service delivery8

TX-PAS-01 Standards Specific to Personal Assistance Services Defines the personal assistance services the Agency may provide under its license, the tasks its attendants may and may not perform, how the individualized service plan is developed and reviewed, and how attendants are qualified and supervised. 26 TAC §558.404 TX-SVC-01 Coordination of Services Requires that everyone who serves a client works from the same current service plan, that changes in the client’s condition or schedule are passed on the same day, and that services from other providers are coordinated and recorded. 26 TAC §558.288 TX-SVC-02 Independent Contractors and Arranged Services Requires a written contract before any independent contractor or other organization furnishes services to a client on the Agency’s behalf, sets what the contract must contain, and confirms that the Agency remains responsible for the care. 26 TAC §558.289 TX-SVC-03 Backup Services and After-Hours Care Ensures a client is not left without a scheduled service when the assigned attendant is unavailable, and that the client can reach a responsible Agency employee outside office hours at a number that is answered at all times. 26 TAC §558.290 TX-SVC-04 Initiation of Care Timeframes Sets the Agency’s written timeframe for starting care after a referral is accepted, what happens when care cannot start in time, and how the client and referral source are told. 26 TAC §558.294 TX-SVC-05 Client Transfer or Discharge Sets the grounds on which the Agency may transfer or discharge a client, the written notice the client receives before it happens, the limited situations in which shorter notice is allowed, and how the client is helped to find other care. 26 TAC §558.295 TX-SVC-06 Client Care Policies and Scope of Services Sets out which services the Agency provides and which it does not, how each client’s care is assessed, planned, started, paused, and ended, how staff handle emergencies and their own safety in the home, and how staff are supervised while they give care. It also sets out the workplace violence prevention committee, policy, plan, training and incident response that Texas Health and Safety Code Chapter 331 requires while the Agency employs at least two registered nurses. 26 TAC §558.281 TX-SVC-07 Laboratory Services States whether the Agency performs any laboratory test or handles any specimen, tells staff what to do when asked, and, for an agency that chooses to perform waived tests or carry specimens, sets out the CLIA certificate, safe testing and handling, and how results reach the client’s practitioner. 26 TAC §558.284

Clinical tasks7

TX-CL-01 Physician Delegation of Tasks States whether the Agency accepts tasks that a client’s physician delegates to a staff member, tells staff exactly what to do if they are asked to perform such a task, and sets out the conditions and procedure that apply if the Agency ever decides to accept physician delegation. 26 TAC §558.296 TX-CL-02 Receipt of Physician Orders Sets out whether the Agency acts on orders from a client’s physician or other practitioner, who in the Agency may receive them, the Agency’s time frame for getting a verbal order countersigned, and the safeguards for orders sent by fax, including what staff do when a fax goes to the wrong place. 26 TAC §558.297 TX-CL-03 RN Delegation to Unlicensed Staff Sets out whether the Agency provides health-related tasks that need a registered nurse, what an attendant does if asked to perform a nursing task, and, where the Agency does provide such tasks, how the registered nurse assesses the client, decides whether the task may be delegated, teaches and checks the attendant, and supervises the task under the Texas Board of Nursing rules. 26 TAC §558.298 TX-CL-04 Nursing Education, Licensure, and Practice Makes sure any nurse who works for the Agency, in any role, holds a current license to practice in Texas that is verified before the nurse starts and kept under watch, and practices only within that license, the Texas Board of Nursing rules, and the limits of the Agency’s personal assistance services license. 26 TAC §558.299 TX-CL-05 Medication Administration Says what staff may and may not do with a client’s medicines, who to call when something is wrong, and the medication list, administration record, and delegation safeguards that apply if Agency staff ever administer medications. 26 TAC §558.300 TX-CL-06 Pronouncement of Death Says what staff do if a client dies during a visit: call 911 and the office, stay with the client, and leave the pronouncement of death to the people the law allows. 26 TAC §558.302 TX-CL-07 Sterile Water, Saline, Vaccines, and Drugs Covers whether the Agency keeps or gives sterile water, saline, vaccines, or other drugs, and how they are stored and recorded if it does. 26 TAC §558.303

Safeguarding1

TX-ANE-01Free sample Reporting Abuse, Neglect, and Exploitation Every employee, contractor, and volunteer who has cause to believe a client has been abused, neglected, or exploited makes sure it is reported at once. Abuse, neglect, or exploitation by Agency staff is reported to HHSC immediately, and never later than 24 hours; abuse by anyone else, and self-neglect, is reported to DFPS; suspected abuse or neglect of a child is reported to DFPS. The Agency begins its own investigation immediately and sends HHSC Form 3613 no later than the 10th day after its report. 26 TAC §558.249

Infection control3

TX-IC-01Free sample Infection Control The Agency prevents the spread of infection through standard precautions, hand hygiene, personal protective equipment, staff health screening including tuberculosis screening, and an OSHA exposure control plan, and it tracks infections and exposures through the QAPI program. 26 TAC §558.285 TX-IC-02 Disposal of Special Waste How the Agency identifies, contains, and disposes of special waste generated in a client’s home or at the Agency office, including sharps, in line with the Texas Department of State Health Services special waste rules and the OSHA bloodborne pathogens standard. 26 TAC §558.286 TX-IC-03 Bloodborne Pathogens Exposure Control Plan Protects staff from blood and other body fluids: gloves and other protective equipment, safe work practices including handling of sharps found in a client's home, hepatitis B vaccination, and what to do after a needlestick or a splash, under the Agency's written OSHA Exposure Control Plan. 29 CFR §1910.1030

Emergency preparedness1

TX-EP-01 Emergency Preparedness and Response Plan The Agency maintains a written emergency preparedness and response plan built on a documented risk assessment, names a disaster coordinator and alternate, keeps operations running through a continuity plan, assigns staff roles across mitigation, preparedness, response, and recovery, helps clients register with STEAR, and reviews and exercises the plan every year. 26 TAC §558.256

Records2

TX-RM-01 Client Records and Retention Sets what every client record must contain, including the signed acknowledgments the rule requires, how records are kept confidential and secure, how they are released, and the five-year retention period after discharge. 26 TAC §558.301 TX-RM-02 Client List and Service Records Keeps a current list of every client for each licensed category of service, with the details the rule requires and every service delivered directly or under contract, and a dated record of each service given, so the office and an HHSC surveyor can see who is served, by whom, and when. 26 TAC §558.293

Privacy3

TX-PRV-01 HIPAA Privacy Explains how staff protect clients’ health information: who may see it, when it may be shared, and what clients can ask for, applying the HIPAA Privacy Rule together with the stricter Texas rules on electronic disclosure and on the records of clients age 60 and over. 45 CFR Part 164 Subpart E TX-PRV-02 HIPAA Security Explains how the Agency keeps electronic client records safe: passwords, locked phones and computers, who has access, backups, and what staff do when a device is lost or something looks wrong, applying the HIPAA Security Rule and the Texas duty to protect sensitive personal information. 45 CFR §§164.302-164.318 TX-PRV-03 HIPAA Breach Notification Explains what to do if client information is lost, stolen, or sent to the wrong person: tell the office at once, so the Agency can assess the incident and notify every person, agency, and outlet the law requires, within the deadlines federal and Texas law set. 45 CFR §§164.400-164.414

Human resources6

TX-HR-01 Staffing Sets the Agency’s written staffing policies under 26 TAC §558.245: orientation, job-specific training and competency, continuing training, job descriptions, background checks, annual evaluations, discipline, volunteers, care of pediatric clients, and the signed policy compliance statement, and the Agency’s own staffing standards. 26 TAC §558.245 TX-HR-02 Personnel Records Lists what every personnel record must contain for employees, contractors, and volunteers, how long the Agency keeps it, who may see it, and how it is produced for a surveyor. 26 TAC §558.246 TX-HR-03 Verification of Employability and Background Checks Requires a criminal history check and Nurse Aide Registry and Employee Misconduct Registry searches (the Employee Misconduct Registry through SEMARC from August 3, 2026) before an unlicensed person has face-to-face contact with a client, repeats the registry searches at least every 12 months, and requires immediate discharge of anyone listed as unemployable or with a barring conviction. 26 TAC §558.247 TX-HR-04 Volunteers Sets the conditions under which the Agency may use volunteers: the same background checks as employees, written role descriptions, orientation, supervision, and a volunteer record for each person. 26 TAC §558.248 TX-HR-05 Drug Testing Policy States the Agency’s written drug testing policy for personnel who have direct contact with clients, including the testing method, and requires that a copy be given to everyone who applies for services and to anyone who asks, and to every employee. 26 TAC §558.253 TX-HR-06 Home Health Aide Training and Supervision Sets who may be used as a home health aide (26 TAC §558.701), the training and competency evaluation the rule requires, and the in-service training and nurse supervision the Agency applies, if it uses home health aides. Personal assistance services attendants are covered by Policy TX-PAS-01. 26 TAC §558.701

Governance4

TX-GOV-01 Organizational Structure and Lines of Authority Requires the Agency to keep a current written organizational chart that shows who reports to whom, from the governing body down to every direct care position, and to make it available to surveyors on request. 26 TAC §558.242 TX-GOV-02 Administrative and Supervisory Responsibilities Sets out what the governing body, the Administrator, the Alternate Administrator, and supervisors are each accountable for, and guarantees that a qualified leader is reachable during every hour the Agency operates. 26 TAC §558.243 TX-GOV-03 Administrator Qualifications and Training Describes who may serve as Administrator or Alternate Administrator of a personal assistance services agency, the 24 clock hours of initial training (eight of them before designation) and the 12 clock hours of continuing education each must complete, and how the Agency proves it. 26 TAC §558.244 TX-GOV-04 Agency Dissolution Sets out the written plan the Agency follows if it closes or gives up its license, so that every client is transferred safely, every record is preserved, and HHSC, staff, and payers are told in time. 26 TAC §558.291

Quality3

TX-QA-01 Quality Assessment and Performance Improvement The Agency runs a written quality assessment and performance improvement program led by a committee that meets at least twice a year, measures negative client outcomes, staff misconduct complaints, infection control, medication errors, and the appropriateness of complaint responses, and corrects any threat to safety immediately. 26 TAC §558.287 TX-QA-02 Agency Investigations How the Agency investigates complaints, incidents, and allegations. Every matter is documented and its investigation started within 10 days of receipt, completed within 30 days unless the reason for delay is recorded, and allegations of abuse, neglect, or exploitation are investigated immediately. 26 TAC §558.250 TX-QA-03 Peer Review How the Agency reviews the professional practice of any licensed health care professional it employs or contracts, including nursing peer review under Texas Occupations Code Chapter 303 whenever the Agency regularly employs, hires, or contracts for eight or more nurses, and the protections a nurse has when requesting safe harbor. 26 TAC §558.251

Business3

TX-FIN-01 Financial Solvency and Business Records The Agency keeps itself financially able to meet its obligations to clients, staff, and creditors, maintains the business and financial records that show this, and makes them available to HHSC on request. 26 TAC §558.252 TX-FIN-02 Billing and Insurance Claims The Agency bills only for services that were actually provided, documented, and authorized, at the rates disclosed to the client or agreed with the payer, and it corrects and refunds any overpayment it discovers. 26 TAC §558.254 TX-FIN-03 Electronic Visit Verification Requires every attendant to record the type, date, location, and start and end time of each Medicaid personal care visit through an approved electronic visit verification system, and sets out what the Agency does when a visit cannot be recorded electronically. 42 U.S.C. §1396b(l)

Ethics2

TX-ETH-01 Prohibition of Solicitation of Patients No one acting for the Agency may pay, offer, or accept anything of value for referring or securing a client, and no one may pressure, deceive, or induce a person into choosing the Agency. Marketing is truthful, respects a client’s freedom of choice, and never involves gifts to referral sources or clients beyond nominal value. 26 TAC §558.255 TX-ETH-02 Compliance Program Sets out how the Agency prevents, finds, and fixes billing and conduct problems through a written compliance program with a compliance lead, training, routine monitoring, and a way for anyone to raise a concern without fear of retaliation. 1 TAC §371.1655
Questions

Questions about this manual

Is this the right manual for my license?

It is for HCSSAs licensed in the Personal Assistance Services category. Agencies licensed for home health (LHHS or LCHHS) or hospice need the Texas home health or Texas hospice manual.

Does it cover workplace violence prevention?

Yes. Since S.B. 463 (effective September 1, 2025), Health and Safety Code Chapter 331 applies to a PAS agency that employs two or more registered nurses, with compliance due September 1, 2026. Policy TX-SVC-06 sets out the committee, the written policy and plan, how incidents are handled and the yearly review.

What about HHSC's proposed rewrite of Chapter 558?

HHSC proposed a rewrite of most of Chapter 558 in the Texas Register on September 18, 2026. It was not in force when this manual was last reviewed, so the policies follow the rules in force today.

Are the client forms in Spanish?

Yes. The client forms come in English and Spanish, filled in with your agency's details.

What do the 46 policies cover?

Client rights (3), service delivery (8), clinical tasks (7), safeguarding (1), infection control (3), emergency preparedness (1), records (2), privacy (3), human resources (6), governance (4), quality (3), business (3) and ethics (2).

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