What background checks and training does a Texas HCS provider need before a DSP works alone?

What has to happen before a DSP works alone?

Three things: the background checks clear, the DSP meets the job qualifications, and the DSP is trained and observed doing the work for each individual they will serve. HCS rules tie readiness to documented training and observed competency, not to a set number of hours or shifts.

The HCS certification standards in Title 26, Chapter 565 of the Texas Administrative Code (TAC) carry most of these duties. Section 565.9 covers background checks and registries, Section 565.7 covers training and competency, and Section 565.31 covers abuse, neglect, and exploitation (ANE) training.

The HCS Program Billing Requirements add the qualifications a service provider needs before their time can be billed. A DSP who is not qualified on the day of service puts that day's claim at risk.

What background checks does a Texas HCS provider run?

Under 26 TAC §565.9, the provider gets a criminal history record from DPS, directly or through a private agency, before hiring or contracting. It searches the Employee Misconduct Registry and Nurse Aide Registry before hire and every 12 months, and the federal HHS-OIG and HHSC OIG exclusion lists before hire and every month.

The same rule says the provider may not hire or keep anyone listed in the Employee Misconduct Registry as unemployable, listed in the Nurse Aide Registry as revoked or suspended, or listed on either exclusion list. The rule covers staff members, service providers, and volunteers.

Section 565.9 also points to the HHSC rule on employability checks, now 26 TAC §52.107. That rule adds a notice: within five business days of hire, the provider gives the new employee written notice that a person listed in the Employee Misconduct Registry cannot work for the provider.

Texas Health and Safety Code §250.003 lets some employers make an emergency temporary hire while a check is pending. HCS providers should not lean on it, because 26 TAC §565.9 requires the criminal history record before hiring or contracting.

Which convictions bar a DSP from HCS work?

Texas Health and Safety Code §250.006(a) lists offenses that bar employment with no time limit, such as murder, kidnapping, sexual assault, aggravated assault, and injury to a disabled individual. Section 250.006(b) lists offenses that bar direct-contact jobs for five years after the conviction, such as Class A or felony assault, burglary, and felony theft.

Chapter 250 covers HCS providers. Its definition of a facility includes providers exempt from home health licensing under Health and Safety Code §142.003, and that exemption names HCS and Texas Home Living (TxHmL) providers.

Under §250.006(d), deferred adjudication that was completed and dismissed does not count as a conviction for these bars.

26 TAC §565.9 goes further than the statute. It also bars registered sex offenders, and it bars a person with any conviction the provider decides is a contraindication to the job.

What qualifications does a DSP need?

A DSP must be an adult (18 or older) with a high school diploma or equivalency certificate, or a passed written competency-based assessment plus written references from at least three people who are not relatives. A DSP who drives individuals needs a valid driver's license and insurance.

In the HCS Program Billing Requirements, Section 3410 sets the base rules for a qualified service provider: an adult, no conviction listed in Health and Safety Code §250.006, and no disqualifying registry listing. The education rule sits in each service's section, such as Section 4560 for residential support and Section 4570 for supervised living.

Section 3830 lists the proof the provider keeps on file, and Section 3420 lists who is not qualified, such as a spouse, or a relative or guardian for residential support or supervised living.

Under 26 TAC §565.9(c), only staff with a valid driver's license and insurance may transport individuals.

What training does a DSP need before serving an individual?

Two kinds of training come first. ANE training, a written instruction to report suspected abuse to DFPS within one hour, and a signed acknowledgment, all before the DSP assumes job duties. Then training specific to each individual's needs, with observed competency, before the DSP serves that individual.

Under 26 TAC §565.31, ANE training covers what abuse, neglect, and exploitation are, their signs, and how to prevent them. The provider repeats it at least once a year. Our abuse and neglect reporting guide covers the one-hour reporting rule and what follows a report.

Under 26 TAC §565.7(b)(2), individual-specific training happens before service provision and at least every 12 months after, and the provider documents observed competency. In practice that means a supervisor or nurse watches the DSP do the person's routines, such as a diet texture, a transfer, or a behavior support plan, and signs that they did it right.

A few more items come before service. Under 26 TAC §565.23, the DSP reviews each individual's emergency plans before providing services. If an individual uses an enclosed bed or a protective device, Sections 565.35 and 565.37 require the DSP to read the plan or be trained on the device first.

Is there a minimum number of training hours or a shadowing period?

No. Neither 26 TAC Chapter 565 nor the HCS Program Billing Requirements sets a number of training hours or a shadowing period before a DSP works alone. The standard is competency: documented, individual-specific training and observed competency for each person served.

An agency may set its own shadowing period, such as a few shifts beside an experienced DSP, as a way to produce observed competency for every individual in a home. If you set one, write it into your policy and document each shift.

HHSC offers a free ANE Competency Training course. HCS Handbook Appendix XII says the course is optional, a person who takes the final test must score at least 80 percent, and the provider keeps each certificate.

CPR and first aid are not HCS certification requirements in Chapter 565. An agency may still require them by policy, so check your own policies and contracts.

What is due in the first 90 days and every year after?

In the first 90 days, each DSP takes part in a fire drill, and staff who help write a CFC PAS/HAB implementation plan take HHSC's online introductory person-centered planning course. Every year, the provider repeats the registry searches, ANE training, individual-specific training, and a fire drill. The exclusion lists are searched every month.

The fire drill rule is 26 TAC §565.23(e)(2): each staff member takes part in a fire drill within 90 days of hire and at least once a year after.

The person-centered planning course is narrower than many checklists suggest. Under 26 TAC §565.7(b)(2)(C), it applies to staff who help develop an implementation plan for Community First Choice personal assistance and habilitation (CFC PAS/HAB), within 90 days of hire.

Behavioral support service providers have their own HHSC web-based policy training under 26 TAC §565.7(c), before providing that service and every three years. That rule is for the behavioral support provider, not every DSP.

Can a new DSP pass medications?

Only after an RN trains and delegates them, or under the narrow Human Resources Code Chapter 161 path for oral, topical, and metered dose inhaler medications for a stable condition. Under 26 TAC §565.23, staff who administer medications must be trained and delegated by a registered nurse.

26 TAC §565.13 adds that an RN nursing assessment comes before unlicensed staff perform any nursing task, and it sets the conditions for the Chapter 161 path, including an RN assessment, training or a competency check, and an RN review at least once a year.

Our guide Can DSPs pass medications in Texas? walks through both paths, and the MAR guide covers how each dose is charted.

How does Sereniq help track DSP training and credentials?

Sereniq tracks DSP training and credentials, such as CPR, First Aid, Med Admin, and Abuse/Neglect, with expiration dates and a requirements matrix by staff member. Reminders go out 30 days and 7 days before a credential lapses and again when it expires, and expired credentials appear in the survey-prep packet.

Administrators assign training, record completions, and attach certificates in the same record as homes, shifts, and notes, so a supervisor can see who is current before building the schedule. See staff credential tracking and employee training tracking.

Sereniq does not run criminal history checks, registry searches, or exclusion list searches. Your HR team runs those with DPS, the HHSC Employee Misconduct Registry and Nurse Aide Registry search, and the OIG lists, and keeps the results in the personnel file. This guide is not legal advice; confirm every requirement with HHSC.