Phone: (844) 448-5695
Fax: (956) 353-6011
ADMINISTRATOR JOR FLORES, RN/DOPS
Cell: (956) 929-1204
j.flores@physicianpreferred-hhs.com

Provider Services

FAQ’S about qualifying for Personal Assistant Services at your home.

What does personal care services means?

  • Assistance with feeding, dressing, transfer, bathing, exercise, grooming, routine hair skin care, toileting,
    walking, cleaning, laundry, meal preparation, escort, shopping and asst w/ meds; or
  • General supervision or oversight of the physical and mental well-being of a person who needs assistance
    to maintain a private and independent residence in the facility or who needs assistance to manage his or
    her personal life, regardless of whether a guardian has been appointed for the person.

How long does the process take?

Takes 30-45 days.

Who will determine if I qualify?

  • A TDADS case manager or MCO registered nurse will conduct an assessment on your physical ability to
    perform ADL’s and personal care to determine if you qualify for personal assistance services.

How many hours will I get?

  • A TDADS case manager or MCO registered nurse will conduct an assessment on your physical ability to
    perform ADL’s and personal care to determine how many weekly hours you qualify for.

What will I qualify for?

  • A TDADS case manager or MCO registered nurse will conduct an assessment on your physical ability to
    perform ADL’s and personal care to determine what services you qualify for.

Can I choose my attendant?

  • In most cases you can, depends on restrictions and background.

Who pays for these services?

  • Medicaid through TDADS or MCO
  • Our agency also accepts private pay or private insurance that covers these services.

For how long do I get services?

  • TDADS or MCO determines authorization period based on financial and medical eligibility.

How would I know if I qualify due to monthly income?

Non-Financial Eligibility

  • Age/Disability – You must be at least age 65 or older or, if under age 65, you must get Social Security, Railroad Retirement, or SSI disability benefits.
  • Citizenship – You must be a U.S. citizen or a qualified legal alien.
  • Medicare Savings Programs – You must be entitled to Medicare Part A for QMB, SLMB and QI-1.
  • Medical Necessity/Level of Care for Nursing Facility, ICF/IID and Waiver Programs – Your need for medical care available in a Medicaid facility or a Medicaid waiver program will need to be determined.

Financial Eligibility

  • Income – HHSC must consider your income from all sources. Gross income is usually used for the eligibility determination. Therefore, when comparing your income to the income limit for a program, HHSC includes deductions that are withheld from your income before you get it.
  • Resources – Resources are things that you own or are buying. The resources of both you and your spouse must be reported, regardless if the resources are community or separate property. The total value of resources that must be counted cannot exceed certain resource limits. Resource values are determined as of 12:01 a.m. on the first day of the month(s) that eligibility is determined. Some resources may not be counted.

Who do I call to submit application for services?

  • Your HMO or an Agency of your choice may help submit an application with TDADS if you do not have an HMO.

FAQ’s about transferring from one agency to another.

What do I have to do to transfer to another agency?

  • You or your legally authorized representative (LAR) must contact your TDADS case manager or your MCO to
    request a transfer.

How long does the transfer take?

  • Every payor (TDADS or MCO) processes transfers differently, so it could take anywhere from 1 – 15 days.

How often will the agency visit with me, the client?

  • Agency performs supervisory visits every 6 month or as needed or upon client’s request.

How much does agency pay an attendant per hour?

  • Pay is negotiable with Agency.

Do we have to get devices for providers to report hours worked?

  • It is state required that all members receiving personal assistance services thru TDADS or an MCO to have a
    landline or small alternative token device for attendants to report their hours worked.

Primary Home Care

Primary Home Care (PHC) provides non-technical, non-skilled, in-home attendant services to people who have an approved medical need for assistance with personal care tasks. PHC is available to eligible people whose health problems cause them to be functionally limited in performing activities of daily living according to a practitioner’s statement of medical need. Attendants provide PHC services.

The Consumer Directed Services (CDS) option is available for this program [cds.html].

What services are provided?

  • Escorting a person to medical appointments for diagnosis and/or treatment.
  • Home management to help with housekeeping activities that support the person’s health and
    safety.
  • Personal care related to the care of the person’s physical health.

Who can get services?

  • You must be 21 or older.
  • You must have an unmet need for help with home management and personal care tasks.
  • You must have a practitioner’s statement of medical need.
  • You must be eligible for Medicaid.
  • You must meet a specified functional assessment score and have a functional limitation with at
    least one personal care task based on your medical condition.

How do I apply for services?

  • Contact your local Texas Department of Aging and Disability Services office.

Family Care

Family Care is a non-skilled, non-technical attendant care service available to eligible adults who are functionally limited in performing activities of daily living. Services are provided by an attendant and do not require the supervision of a registered nurse.

The Consumer Directed Services (CDS) option is available for this program [cds.html].

What services are provided?

  • Escort: Accompanying a person to a medical appointment. This service does not include direct
    transportation by an attendant.
  • Home management: Help with housekeeping activities to support the person’s health and
    safety, including cleaning, laundry, shopping, and other household tasks.
  • Personal care: Help with activities related to physical health, including bathing, dressing,
    grooming, routine hair and skin care, preparing meals, feeding, exercising, helping with self-
    administered medication, toileting, and transferring/ambulating.

Who can get services?

  • You must be 18 or older.
  • You must have an unmet need for help with home management and personal care tasks.
  • Your income and resources may not exceed specified limits.
  • You must meet a specified functional assessment score.

How do I apply for services?

  • Contact your local Texas Department of Aging and Disability Services office.

Community Attendant Services

Community Attendant Services (CAS) is a non-technical, non-skilled service providing in-home attendant services to people who need help with personal care tasks. CAS is available to eligible adults and children whose health problems cause them to be functionally limited in performing activities of daily living.

The Consumer Directed Services (CDS) option is available for this program [cds.html].

What services are provided?

  • Escort: Accompanying a person to a medical appointment. This service does not include direct
    transportation by an attendant.
  • Home management: Help with housekeeping activities to support the person’s health and
    safety, including cleaning, laundry, shopping, and other household tasks.
  • Personal care: Help with activities related to physical health, including bathing, dressing,
    grooming, routine hair and skin care, preparing meals, feeding, exercising, helping with self-
    administered medication, toileting, and transferring/ambulating.

Who can get services?

  • You can be of any age.
  • You must be functionally limited in performing at least one personal care task, based on your
    medical condition.
  • You must have a practitioner’s statement of medical need.
  • You must have an unmet need for home management and personal care.
  • Your income and resources may not exceed specified limits.
  • You must not be Medicaid eligible.

How do I apply for services?

  • Contact your local Texas Department of Aging and Disability Services office.