PAS agencies are one of the fastest-growing businesses not only in Texas but also in the United States.
Why is that? Because there are over 73 million baby boomers – almost 25% of the U.S. population that either use PAS services or will require assistance.
This is excellent news for you and if you execute well, you can be profitable in this business for years and years. In this comprehensive guide, you'll learn how to start your PAS agency in Texas with ease.
PAS stands for Personal Attendant Services. PAS is a category within the Home and Community Support Service Agency (HCSSA) licensure. The licensing authority is the Texas Health and Human Services Commission (HHSC) The HHSC gives licenses to operate a PAS agency. Nationally PAS is called home care, also referred to as non-medical care.
PAS agencies within the HCSSA in Texas provide assistive services to individuals in their homes, independent living facilities, or assisted living facilities.
One of the main goals that home care clients choose PAS services is to stay independent and live life by their rules instead of moving to a retirement home that is controlled by staff.
PAS services in Texas are provided by:
Private pay agencies
Home health agencies that do both skilled and non-medical services, and
Home care agencies receive referrals from caseworkers who work with the State Medicaid program.
Agencies that accept referrals from MCOs which include Superior, Molina, Amerigroup, United Healthcare, and the VA.
Traditionally home health agencies provided the bulk of these services but now there are private pay agencies that specialize in non-medical care. This might be why you decided to start your own agency.
PAS agencies offer a range of services that can be categorized into two types: Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs).
Activities of Daily Living (ADLs) include:
Ambulating (walking)
Transferring (e.g., moving from chair to bed, bed to shower)
Dressing
Eating
Drinking
Personal hygiene
Taking medication
Instrumental Activities of Daily Living (IADLs) comprise:
Driving
Meal preparation
Housework
Shopping
Medication management
Under the State Medicaid program, clients' family members and friends can provide these services, with hourly wages ranging from $11.35 to $14, subject to fluctuations due to rule changes and rate enhancements.
For private pay agencies, caregivers are typically recruited through job platforms such as indeed.com, monster.com, and care.com, among others.
The cost of services varies based on the area and the specific services rendered, ranging from $15 to $30 per hour. Keep in mind that these rates may vary and are influenced by location and service scope.
Before you start your PAS business in Texas, you have to know the requirements.
HHSC states that you will need an administrator and an alternate administrator just in case you or whoever the administrator is not available to care for the clients and to attend the state survey.
Administrators and alternate administrators have the same qualifications.
Qualifications for the position include being:
A physician or registered nurse
A social worker or a licensed nursing facility administrator
Alternatively, they must have the following requirements:
A high school diploma or GED
Two years of supervisory/management experience in a health-related setting
One year of experience as a caregiver for a person with functional disabilities or dementia
Completed two years of full-time study at an accredited college or university in a health-related setting
We have assisted clients who come up with the most interesting names. The problem is the name they choose either becomes a hindrance or it isn’t a marketable tool.
Always keep this in mind from the time you start your agency, you are in this for the client, not for yourself.
Home care business owners choose their names, use names that memorialize family members, or use names that have nothing to do with what they do. Always keep your clients in mind by using names that they can:
Easily remember
Easily pronounce
Easily associate your business name with the services provided.
We urge our clients to use names that begin at the top of the alphabetical list for example 123 Home Care Services, Assisted Care Services, etc.
The reason is that discharge planners in many hospitals aren’t allowed to recommend an agency for the client but provide the client with a booklet that contains the list of PAS agencies, and yes, they are in alphabetical order. Why not give yourself a fair advantage?
To register your business entity in Texas, follow these steps:
Visit the Texas Secretary of State website.
Create an account on the website.
Check the availability of your desired business name to ensure it's not already taken.
Complete the registration process for your chosen business entity.
There are several types of business structures available, including:
Sole Proprietorship
Partnership
Corporation
Limited Liability Company (LLC).
The choice of your business structure has significant implications, such as tax obligations, organizational structure, and personal liabilities. It's advisable to consult with your accountant before proceeding to ensure that your chosen structure aligns with your future business goals.
Having an EIN is one of the requirements of starting a PAS agency. Head over to the IRS.gov website to obtain your company's Employer Identification Number (EIN) number.
The federal government will use this number to identify your company and this is the nine-digit number that will be used to file quarterly and annual business taxes.
When establishing your personal care agency, it's essential to address the following considerations:
Numerous PAS agencies choose to operate from home to minimize costs and enhance convenience. If you decide to utilize your home as your agency's base, it's crucial to designate a specific area within your home for the office. This space should be comfortable enough to accommodate state surveyors when they visit and conduct their operations.
Your chosen phone line will serve as the primary point of contact for various stakeholders, including clients, state surveyors, and employees.
It's advisable to avoid using a single phone number for both family and business purposes, as this could create inconvenience and negatively impact your professionalism. To address this, consider employing an internet-based phone line solution like RingCentral.
This service provides you with a dedicated business number and an application for efficiently managing calls.
While many agencies resort to generic email addresses from platforms like Gmail or Yahoo (e.g., 123servicee@gmail.com), it's recommended to establish a more professional email presence.
Gmail offers the option to create a business email address. Before proceeding, it's a good practice to verify the availability of your desired domain name, register the domain if it's available, and subsequently set up an email address using Google Workspace.
Before you can submit your application to the state the administrator and the alternate administrator will need to complete the CPT Presurvey Training.
For the Texas home health licensing, you’ll need to do modules 1, 2, and 3 and save the certificates to be uploaded to TULIP. To do this you’ll need to create an account in TULIP- the Texas Unified Licensure Information Portal.
Once you have the certificates from the CBT modules, the administrator and the alternate administrator will need to complete the Texas Administrator 8 class which you can take at 123consultingsolutions. Print out the two certificates because they will have to be uploaded to TULIP.
You need 24 hours of initial training for the first year but for the sake of getting your license in Texas, the state allows you to upload the Texas Administrator 8 certificate.
When you're ready to submit your application, ensure you have the following three policies ready for upload:
Policy on Organizational Structure: This policy outlines the structure of your company's organization, providing insights into its operational framework.
Policy on Client Transfers or Agency Closure: This policy covers procedures for transferring clients or handling agency closure situations, emphasizing your commitment to smooth transitions.
Plan for Continued Education of Administrative Staff: Highlight your strategy for maintaining the professional development of your administrative staff through ongoing education.
The Texas Health and Human Services (HHS) department requires assurance that your company has a well-defined structure in place. You can access these policy templates for free by clicking on this link.
After completing the policy uploads, the final step involves making the payment. The licensing fee is $2,625 for a three-year license period. Subsequently, you'll need to renew your license every three years.
Once your application has been paid for and submitted, the State has a 45-day window to approve your license. Assuming your application is error-free and complete, the approval process typically occurs within this timeframe
While awaiting your license approval, consider the following actions. If you don’t already have a business bank account, it's recommended to set up a bank account with four distinct categories:
Payroll Account Owner
Compensation Account
Taxes Account
Business Reinvestments Account
Proceed with developing your logo and website. You have options for obtaining a logo, either through inexpensive services or by using platforms like Canva.com for a DIY approach.
If you prefer a professional touch, platforms like Fiverr.com offer logo design services for $25-$50. Your website acts as a digital business card, conveying your company's purpose clearly and facilitating easy user navigation.
In our masterclass, we offer guidance on creating an effective website for lead generation and email list growth.
Ensure your policies and procedures comprehensively cover key areas, including:
New Client Admissions
Plans of Care
Scheduling
Employee and Payroll Records
Hiring Practices
Orientation
Training
Client Billing
Client Rights and Responsibilities.
During the license waiting period, focus on recruiting and training quality staff in preparation for your launch. Having at least two capable caregivers on hand prevents staffing issues upon receiving referrals. Training resources can be found on our sister website, www.quireapp.com.
Establish essential back-office operations such as accounting, billing, payroll, scheduling, and timekeeping software.
Recognizing the potential overwhelm and time required, you might prefer professional guidance. We're available to provide comprehensive support for obtaining your license, assisting with PHC and MCO contracts, creating policy and procedures binders, and even guiding your marketing efforts. If you'd like to focus on building business connections with referral sources, reach out to us for tailored assistance.
