I recently received this response from HHSC and thought it might be helpful to some providers who may have this concern:
There is no rule or regulation that prohibits an HCS Program Provider from providing services to their own child or family member.
The program provider’s operations must prevent conflict of interest as required by 40 TAC §9.177(f):
§9.177 Certification Principles: Staff Member and Service Provider Requirements
(f) The program provider’s operations must prevent:
(1) conflicts of interest between the program provider, a staff member, or a service provider and an individual, such as the acceptance of payment for goods or services from which the program provider, staff member, or service provider could financially benefit, except payment for room and board;
(2) financial impropriety toward an individual including:
(A) unauthorized disclosure of information related to an individual’s finances; and
(B) the purchase of goods that an individual cannot use with the individual’s funds;
(3) abuse, neglect, or exploitation of an individual;
(4) damage to or prevention of an individual’s access to the individual’s possessions; and
(5) threats of the actions described in paragraphs (2) – (4) of this subsection.
And, the program provider must ensure they are not disqualified from being a service provider as described in Section 3420(b)-(d) of the HCS Billing Requirements:
3420 Service Provider Not Qualified
Revision 21-3; Effective September 1, 2021
(b) Spouse Not Qualified as Service Provider
A service provider is not qualified to provide a service component or subcomponent to the service provider’s spouse.
(c) Relative, Guardian or Managing Conservator Not Qualified as Service Provider for Certain Services
A service provider is not qualified to provide case management, residential support, supervised living, behavioral support services or social work services to an individual if the service provider is:
(1) a relative of the individual (Appendix II, Degree of Consanguinity or Affinity, explains who is considered a relative for purposes of these requirements);
(2) the individual’s guardian; or
(3) the individual’s managing conservator.
(d) Parent, Spouse of Parent or Contractor Not Qualified as Service Provider for Minor
A service provider is not qualified to provide a service component or subcomponent to a minor if the service provider is:
(1) the minor’s parent;
(2) the spouse of the minor’s parent; or
(3) a person contracting with DFPS to provide residential child care to the minor, or is an employee or contractor of such a person.
According to Section 3430 of the HCS Billing Requirements:
3430 Relative, Guardian or Managing Conservator Qualified as Service Provider
Revision 21-1; Effective January 1, 2021
If a relative, guardian or managing conservator is not otherwise disqualified to be a service provider as described in Section 3420, Service Provider Not Qualified, or in Section 4000, Specific Requirements for Service Components Based on Billable Activity, the relative, guardian or managing conservator may provide audiology services, dietary services, occupational therapy, physical therapy, speech and language pathology services, day habilitation, in-home day habilitation, registered nursing, licensed vocational nursing, specialized registered nursing, specialized licensed vocational nursing, transportation as a supported home living activity, host home/companion care, respite, in-home respite, employment assistance or supported employment if the relative, guardian or managing conservator is a qualified service provider for the particular service component or subcomponent being provided.