January 1st, 2024

ISS in-Home Attendant Base Wage Rate Requirement


There seems to be a lack of clarification in the HCS program concerning if the ISS base wage rate requirement applies to “in-home ISS”.  It does apply to in-home ISS.  It would seem that most likely a significant number of providers are not aware the base wage requirement applies to in-home individualized skills and socialization (ISS) and that they are currently out of compliance.  That is because the rule applies to “individualized skills and socialization” not clarifying if it applies to all or a portion of the services that fall under that umbrella. Because in-home ISS has significant differences from facility-based and off-site ISS (e.g., in-home ISS does not require a license, typically only applies to one person, may only be delivered in a person’s own home, and the rate issue we have already discussed), providers have assumed the base wage requirement only applies to licensed services.

HHSC states: “The application of the minimum wage for direct care staff providing ISS was adopted in the Texas Administrative Code rules that were promulgated to incorporate the wage increase appropriated by the Texas Legislature. Historically, Day Habilitation did apply a minimum wage requirement for staff providing services to individuals in some waiver programs, but not all waiver programs; consistent with the legislative approach that the minimum wage be uniform across all programs, we also adopted in the TAC the requirement that the minimum wage be paid consistently across all services and waivers.”