The Truth About the New Attendant Wage Rules in Texas
Welcome to another episode of The Home Care Experience with T&A, where Amy Taylor and Troy Brooks break down the most important issues shaping the home care and hospice industry.
In this special solo episode, Amy unpacks the massive Texas HHSC payment model change that went into effect on September 1, 2025—a shift that impacts reimbursement rates, cost reporting, average wage requirements, and future compliance risk for every home care agency in the state.
If you’re a Texas provider, this episode is essential. If you’re not in Texas, it’s still a powerful preview of where similar policies across the U.S. are heading.
What You’ll Learn in This Episode
- Why ACERS was eliminated and what replaced it
- The real meaning behind the new “$13 average wage” requirement (spoiler: it’s NOT a minimum wage)
- How misinformation from monitors and MCOs created confusion for providers
- What goes into the 90% spend requirement—and how to avoid being placed on the new public “naughty list”
- Why raising wages across the board to $13/hour could put agencies in financial danger
- Strategic guidance on compliance, payroll structure, and preparing for the next cost-reporting cycle
- How the cost report system (STEPS) will change the way providers submit and reconcile their data
Amy breaks down these rules in plain English, providing clear explanations and actionable guidance.
Whether you’re an agency owner, administrator, compliance leader, or just trying to understand the rapidly shifting home care landscape—this episode gives you the clarity you need to protect your agency and plan ahead.
Chapters
00:00 Intro
01:01 What Changed on September 1?
01:16 Why Amy Is Leading This Breakdown Episode
02:12 Understanding the “Naughty List” & 90% Spend Requirement
03:30 The Truth About the $13 Wage Rule (Not a Minimum!)
07:35 Why Legislators Appropriated Funding the Way They Did
08:00 How HHSC Calculated the Statewide Average Wage Expectation
09:00 Misinformation From Monitors & Case Managers
26:55 New STEPS Cost Reporting System & Pre-Populated Data
30:00 What Agencies Should Do Next
31:00 Closing Thoughts
01:01 What Changed on September 1?
01:16 Why Amy Is Leading This Breakdown Episode
02:12 Understanding the “Naughty List” & 90% Spend Requirement
03:30 The Truth About the $13 Wage Rule (Not a Minimum!)
07:35 Why Legislators Appropriated Funding the Way They Did
08:00 How HHSC Calculated the Statewide Average Wage Expectation
09:00 Misinformation From Monitors & Case Managers
26:55 New STEPS Cost Reporting System & Pre-Populated Data
30:00 What Agencies Should Do Next
31:00 Closing Thoughts
Listen On
Apple Podcasts | Spotify | TheHomeCareExperience.com
Hashtags
#HomeCarePodcast #HealthcareLeadership #HomeCareInnovation #TexasHomeCare #HHSCUpdate #MedicaidHomeCare #CostReporting #HealthcareCompliance
Creators and Guests
Host
Amy Taylor
Amy Taylor is the founder of Knight Home Care Financial, specializing in business development and financial solutions for the home care and hospice industries. She is an active member of the Texas Association of Home Care & Hospice and a passionate advocate for caregivers.
Host
Troy Brooks
Troy Brooks is a seasoned healthcare attorney with over 20 years of experience in regulatory compliance, mergers and acquisitions, and home care licensure. A former Assistant General Counsel for the Texas Department of Human Services, he brings deep industry insight and a sharp sense of humor to the show.
Producer
Joshua Long
Joshua Long is a feature film, commercial and new media producer with more than a decade of experience. His experience in digital content production, planning and resource management provide tremendous value to TheRiot Agency’s production capabilities. He also manages TheRiot Agency’s subsidiary, Greenlit Entertainment.
