2023 Texas Statutes › Health and Safety Code › Title 2 - Health › Subtitle G - Licenses and Other Regulation › Chapter 142 - Home and Community Support Services › Subchapter A. Home and Community Support Services License › Section 142.003. Exemptions From Licensing Requirement

Sec. 142.003.  EXEMPTIONS FROM LICENSING REQUIREMENT.
Text of subsection effective until April 01, 2025
(a)  The following persons need not be licensed under this chapter:
(1)  a physician, dentist, registered nurse, occupational therapist, or physical therapist licensed under the laws of this state who provides home health services to a client only as a part of and incidental to that person's private office practice;
(2)  a registered nurse, licensed vocational nurse, physical therapist, occupational therapist, speech therapist, medical social worker, or any other health care professional as determined by the department who provides home health services as a sole practitioner;
(3)  a registry that operates solely as a clearinghouse to put consumers in contact with persons who provide home health, hospice, habilitation, or personal assistance services and that does not maintain official client records, direct client services, or compensate the person who is providing the service;
(4)  an individual whose permanent residence is in the client's residence;
(5)  an employee of a person licensed under this chapter who provides home health, hospice, habilitation, or personal assistance services only as an employee of the license holder and who receives no benefit for providing the services, other than wages from the license holder;
(6)  a home, nursing home, convalescent home, assisted living facility, special care facility, or other institution for individuals who are elderly or who have disabilities that provides home health or personal assistance services only to residents of the home or institution;
(7)  a person who provides one health service through a contract with a person licensed under this chapter;
(8)  a durable medical equipment supply company;
(9)  a pharmacy or wholesale medical supply company that does not furnish services, other than supplies, to a person at the person's house;
(10)  a hospital or other licensed health care facility that provides home health or personal assistance services only to inpatient residents of the hospital or facility;
(11)  a person providing home health or personal assistance services to an injured employee under Title 5, Labor Code;
(12)  a visiting nurse service that:
(A)  is conducted by and for the adherents of a well-recognized church or religious denomination; and
(B)  provides nursing services by a person exempt from licensing by Section 301.004, Occupations Code, because the person furnishes nursing care in which treatment is only by prayer or spiritual means;
(13)  an individual hired and paid directly by the client or the client's family or legal guardian to provide home health or personal assistance services;
(14)  a business, school, camp, or other organization that provides home health or personal assistance services, incidental to the organization's primary purpose, to individuals employed by or participating in programs offered by the business, school, or camp that enable the individual to participate fully in the business's, school's, or camp's programs;
(15)  a person or organization providing sitter-companion services or chore or household services that do not involve personal care, health, or health-related services;
(16)  a licensed health care facility that provides hospice services under a contract with a hospice;
(17)  a person delivering residential acquired immune deficiency syndrome hospice care who is licensed and designated as a residential AIDS hospice under Chapter 248;
(18)  the Texas Department of Criminal Justice;
(19)  a person that provides home health, hospice, habilitation, or personal assistance services only to persons receiving benefits under:
(A)  the home and community-based services (HCS) waiver program;
(B)  the Texas home living (TxHmL) waiver program;
(C)  the STAR + PLUS or other Medicaid managed care program under the program's HCS or TxHmL certification; or
(D)  Section 534.152, Government Code;
(20)  a person who provides intellectual and developmental disabilities habilitative specialized services under Medicaid and is:
(A)  a certified HCS or TxHmL provider; or
(B)  a local intellectual and developmental disability authority contracted under Section 534.105; or
(21)  an individual who provides home health or personal assistance services as the employee of a consumer or an entity or employee of an entity acting as a consumer's fiscal agent under Section 531.051, Government Code.
Text of subsection effective on April 01, 2025
(a)  The following persons need not be licensed under this chapter:
(1)  a physician, dentist, registered nurse, occupational therapist, or physical therapist licensed under the laws of this state who provides home health services to a client only as a part of and incidental to that person's private office practice;
(2)  a registered nurse, licensed vocational nurse, physical therapist, occupational therapist, speech therapist, medical social worker, or any other health care professional as determined by the department who provides home health services as a sole practitioner;
(3)  a registry that operates solely as a clearinghouse to put consumers in contact with persons who provide home health, hospice, habilitation, or personal assistance services and that does not maintain official client records, direct client services, or compensate the person who is providing the service;
(4)  an individual whose permanent residence is in the client's residence;
(5)  an employee of a person licensed under this chapter who provides home health, hospice, habilitation, or personal assistance services only as an employee of the license holder and who receives no benefit for providing the services, other than wages from the license holder;
(6)  a home, nursing home, convalescent home, assisted living facility, special care facility, or other institution for individuals who are elderly or who have disabilities that provides home health or personal assistance services only to residents of the home or institution;
(7)  a person who provides one health service through a contract with a person licensed under this chapter;
(8)  a durable medical equipment supply company;
(9)  a pharmacy or wholesale medical supply company that does not furnish services, other than supplies, to a person at the person's house;
(10)  a hospital or other licensed health care facility that provides home health or personal assistance services only to inpatient residents of the hospital or facility;
(11)  a person providing home health or personal assistance services to an injured employee under Title 5, Labor Code;
(12)  a visiting nurse service that:
(A)  is conducted by and for the adherents of a well-recognized church or religious denomination; and
(B)  provides nursing services by a person exempt from licensing by Section 301.004, Occupations Code, because the person furnishes nursing care in which treatment is only by prayer or spiritual means;
(13)  an individual hired and paid directly by the client or the client's family or legal guardian to provide home health or personal assistance services;
(14)  a business, school, camp, or other organization that provides home health or personal assistance services, incidental to the organization's primary purpose, to individuals employed by or participating in programs offered by the business, school, or camp that enable the individual to participate fully in the business's, school's, or camp's programs;
(15)  a person or organization providing sitter-companion services or chore or household services that do not involve personal care, health, or health-related services;
(16)  a licensed health care facility that provides hospice services under a contract with a hospice;
(17)  a person delivering residential acquired immune deficiency syndrome hospice care who is licensed and designated as a residential AIDS hospice under Chapter 248;
(18)  the Texas Department of Criminal Justice;
(19)  a person that provides home health, hospice, habilitation, or personal assistance services only to persons receiving benefits under:
(A)  the home and community-based services (HCS) waiver program;
(B)  the Texas home living (TxHmL) waiver program;
(C)  the STAR + PLUS or other Medicaid managed care program under the program's HCS or TxHmL certification; or
(D)  Section 542.0152, Government Code;
(20)  a person who provides intellectual and developmental disabilities habilitative specialized services under Medicaid and is:
(A)  a certified HCS or TxHmL provider; or
(B)  a local intellectual and developmental disability authority contracted under Section 534.105; or
(21)  an individual who provides home health or personal assistance services as the employee of a consumer or an entity or employee of an entity acting as a consumer's fiscal agent under Subchapter C, Chapter 546, Government Code.
(b)  A home and community support services agency that owns or operates an administrative support site is not required to obtain a separate license under this chapter for the administrative support site.
(c)  A hospice that operates or provides hospice services to an inpatient unit under a contract with a licensed health care facility is not required to obtain an alternate delivery site license for that inpatient unit.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.  Amended by Acts 1993, 73rd Leg., ch. 800, Sec. 6, eff. Sept. 1, 1993;  Acts 1995, 74th Leg., ch. 769, Sec. 2, eff. Sept. 1, 1995;  Acts 1999, 76th Leg., ch. 276, Sec. 3, eff. Sept. 1, 1999;  Acts 2001, 77th Leg., ch. 1420, Sec. 14.777, eff. Sept. 1, 2001;  Acts 2003, 78th Leg., ch. 198, Sec. 2.55, eff. Sept. 1, 2003.
Amended by:
Acts 2013, 83rd Leg., R.S., Ch. 1310 (S.B. 7), Sec. 1.02, eff. September 1, 2013.
Acts 2015, 84th Leg., R.S., Ch. 826 (H.B. 4001), Sec. 4, eff. September 1, 2015.
Acts 2021, 87th Leg., R.S., Ch. 958 (S.B. 1808), Sec. 1, eff. September 1, 2021.
Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 2.40, eff. April 1, 2025.