Caregiver Training Requirements in Texas

HCSSA licensure. Home and Community Support Services Agencies are licensed by Texas HHSC under Health & Safety Code Chapter 142 and 26 TAC Chapter 558, with license categories including Licensed & Certified Home Health, Licensed Home Health, Hospice, and Personal Assistance Services. Source ↗

HHA qualifications. 26 TAC 558.701 (Subchapter G) sets home health aide qualifications: an aide must meet one of several pathways, including completing a training and competency evaluation program or competency evaluation consistent with the federal standard. Source ↗

Federal 75-hr standard. Aides at Medicare-certified (Licensed & Certified Home Health) agencies must satisfy 42 CFR 484.80 — a 75-hour training and competency evaluation program (minimum 16 supervised practical hours) or a competency evaluation, plus 12 hours of in-service per 12-month period. Source ↗

PAS: no hour minimum. Under 26 TAC 558.404, personal assistance services may be performed by unlicensed personnel who have 'demonstrated competency to perform the tasks assigned by the supervisor' — Texas sets no minimum training-hour requirement for PAS attendants; competency standards are agency-established. Source ↗

Delegated tasks training. When unlicensed PAS or home health personnel perform delegated health-related tasks (e.g., g-tube feedings), 26 TAC 558.404 and Board of Nursing delegation rules require task-specific training and competency validation by an RN, physician, PA, or qualified trainer. Source ↗

No aide registry. Texas maintains no certification or registry for home health aides or PAS attendants (the Nurse Aide Registry applies to facility CNAs); HCSSAs must instead verify competency documentation and run employability/criminal history checks before hire. Source ↗

Full rule text. The complete licensing standards, including personnel, training, and category-specific requirements, are published in 26 TAC Chapter 558 on the Texas Secretary of State TAC site. Source ↗

75-hour HHA training standard. Under 42 CFR 484.80(b), home health aides at Medicare-certified home health agencies must complete a training program of at least 75 hours, including at least 16 hours of classroom training completed before beginning at least 16 hours of supervised practical (hands-on) training. Source ↗

Competency evaluation / CNA pathway. 42 CFR 484.80(a) allows aides to qualify by completing the 75-hour training and competency evaluation program, by passing a competency evaluation alone, or by completing a state nurse aide training and competency evaluation program (CNA) and being in good standing on the state nurse aide registry. Source ↗

12-hour annual in-service. 42 CFR 484.80(d) requires home health aides to receive at least 12 hours of in-service training during each 12-month period, which may occur while the aide is furnishing care and must be supervised by a registered nurse. Source ↗

RN trainer requirements. Under 42 CFR 484.80(b)(3) and (c)(2), classroom and supervised practical training must be performed by or under the general supervision of a registered nurse with at least 2 years of nursing experience, at least 1 year of which must be in home health care; competency evaluations must likewise be performed by an RN in consultation with other professionals. Source ↗