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Home care and hospice organizations in Texas are in crisis. Crippled by stagnant state funding, regulatory hurdles and a burnt-out workforce – all underscored by the ripple effects of COVID-19 on the healthcare industry – home care providers from El Paso to Beaumont are struggling to deliver the care their patients so desperately need. We need our state leaders to implement long-term solutions to support these vulnerable patients, securing home care availability for years to come.


Funding (State)
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In Texas, the state legislature and the Texas Health and Human Services Commission dictate home care provider rates, leaving the industry severely underfunded. In fact, Texas has not set a sustainable rate to support the industry in over 16 years. Especially now, faced with additional pandemic costs, home care providers across the state are starting to close.


This stagnant funding, coupled with rising inflation, has contributed to a funding gap between current Medicaid reimbursement rates and care expenses that home care agencies incur when providing home care for patients.


In order to address this funding gap, TAHCH is calling on legislators to act, starting with three recommendations:

  • Increase Medicaid reimbursement rates for attendant care

  • Increase Private Duty Nursing and Medicaid pediatric therapy rates to ensure access to quality care.

  • Work with HHSC to continually ensure rates can keep up with real costs and inflation.


Tell your state legislator why home care and hospice patients can’t afford to lose access to care as a result of gaps in funding.

Regulatory Burdens (State)


Government red tape and conflicting rules from regulators are complicating the home care and hospice industry even further, limiting care for patients who need it most, as providers try to interpret complicated regulatory requirements.


Medicaid managed care, run by Texas Health and Human Services (HHSC), currently serves 94% of the state’s home care population. Home care providers who contract with Medicaid managed care organizations (MCOs) are facing increased administrative costs, inefficiencies, and payment delays.


To reach these vulnerable patients, the home care industry needs updated rules that modernize care regulations and ensure uninterrupted reimbursements, for the benefit of patients across the state.


In order to simplify regulations for providers and continue quality care for patients, TAHCH recommends:


  • Streamlining licensure and regulatory requirements for home care providers and increasing transparency between HHSC and home care and hospice partners, working together to support vulnerable patients.

  • Improving Medicaid managed care with on-time payments and better collaboration with HHSC.

  • Enabling providers to utilize cost-effective telehealth programs, when safe and appropriate for each patient’s unique needs.


Tell our regulators that it’s time to modernize home care and hospice for our patients today and tomorrow. 

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Home care agencies are facing a historic labor crisis. Nurses in home care make 12% less on average than hospital nurses and direct service workers earn around $9.50 an hour – both dictated by reimbursement rates set by the Texas Health and Human Services Commission, based on money allocated by the state legislature.


Low wages have created high turnover and a shortage of qualified attendants, which is increasing the cost of service and affecting the quality of care provided to patients. 


For the home care and hospice industry to be able to survive the post-COVID landscape, Texas lawmakers must act decisively to raise pay rates for home care providers and include these vital workers in future funding decisions, adjusted for inflation and staying on-par with industry salaries.


In order to compete in today’s competitive health care environment and ensure home health patients have access to the best possible care, TAHCH is asking government leaders to:

  • Allow for pay increases and sign-on bonuses for private duty nurses that keep pace with inflation, keeping the industry competitive in hiring talent.

  • Include home care providers in statewide bonuses or raises for all other medical professionals.

  • Ensure all attendants have access to wage enhancement opportunities.


Join us and let our lawmakers know that home care and hospice workers are a vital part of our healthcare continuum and deserve better. 

Workforce (State)
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