HB 2938 was introduced in 2025 but did not pass. Separately, HHSC implemented rate changes effective Sept 1, 2025 to support an average $13.00/hr attendant wage under the 2026–27 budget (Rider 23).
This article explains what’s in force now vs what’s proposed so you can prepare responsibly.
Change is coming to the Texas home care industry – and it’s coming fast. If you’re an owner of a home care agency in Texas, you’ve probably heard whispers about House Bill 2938 (HB 2938).
This proposed law aims to shake up how caregivers are paid and who can provide care.
In simple terms, HB 2938’s goal is to pay caregivers more (a lot more) and even allow family members to get paid to care for their loved ones at home. Why? Because Texas is facing a caregiver crisis – high turnover, massive shortages, and seniors and people with disabilities unable to get the help they need.
In fact, not long ago, Texas was reimbursing community caregivers at an average of just $10.60 an hour, leading to a 34% staff vacancy rate and nearly 300 provider closures in two years. – Texas DSP Workforce Crisis Report
HB 2938 was introduced to address this dire situation by doing two big things: raising caregiver pay and expanding the pool of who can be a caregiver. Let’s break down what this bill is all about, what it means for home care agency owners like you, and what steps you should be taking now to stay ahead of the curve.
Let’s dive in.
HB 2938 is a Texas House bill that tackles attendant care services (the non-medical care that helps folks with daily living, like bathing, cooking, and transportation). The bill’s purpose is to improve the quality and availability of home care by addressing the elephant in the room: low caregiver pay.
HB 2938 proposed a $20/hr minimum base wage (did not pass in 2025). Today, HHSC has adopted payment rates supporting an average $13.00/hr for attendants effective Sept 1, 2025. Budget accordingly for rising floors.
The bill also proposed allowing spouses and parents as paid caregivers to the extent permitted by federal law. Current HHSC policy still prohibits spouses/parents as paid providers in CFC PAS/HAB (and PHC), while some CDS options allow other family members.
Essentially, HB 2938 aims to pay caregivers a livable wage and broaden who can provide care, so more people get the help they need.
Simply put, Texas has been experiencing a caregiver workforce crisis. Low wages have made it incredibly hard for home care agencies to attract and keep staff. When caregivers quit, seniors and people with disabilities suffer – some end up going without care or even find themselves hospitalized or in nursing homes because there’s no one available to help at home.
HB 2938 was a wake-up call that something must change. By proposing a $20/hour base wage and allowing family caregivers, lawmakers hoped to stabilize the workforce and reward those doing this critical work. As an agency owner, even if you’re not in the Medicaid space, these trends matter: they signal rising wage expectations across the industry.
Not yet – and here’s where it gets interesting. The bill was introduced in the 2025 legislative session, but didn’t make it to the finish line in that form.
However, Texas lawmakers did approve a budget increase that pushed up the wage floor for home care Medicaid programs to $13/hour in September 2025, up from $10.60 (which itself was raised from $8.11 in 2023).
Advocates say this is still not enough – they had pushed for $15 and even $20 per hour. Now that $13 is on the books (well below those goals), expect to hear a lot more noise heading into the next session in 2027.
In other words, the fight for higher caregiver wages in Texas is far from over. HB 2938’s spirit is alive and well, and parts of it could resurface sooner than later.
For you, the takeaway is clear: significant changes are likely coming, and some are here already. Preparing now will keep your agency ahead of the curve (and compliant) rather than scrambling at the last minute.
Let’s talk about what these changes mean for your home care business. Whether you serve clients on Medicaid waiver programs or strictly private-pay, HB 2938 and related reforms will influence the landscape. Here’s the impact and what agency owners need to do to stay on the right side of compliance:
The headline from HB 2938 is the push to raise caregiver wages to at least $20/hour for Medicaid-funded services. While $20 isn’t law (yet), Texas has already increased Medicaid caregiver pay rates to support an average of $13/hour as of late 2025.
That trend is likely to continue upward. Smart agency owners should start budgeting for higher caregiver pay now. Take a hard look at your current pay rates and profit margins. If you rely on Medicaid contracts, make sure you’re utilizing the increased reimbursements to boost wages – those funds are meant for your front-line staff.
If you’re private-pay only, be aware that you may need to offer more competitive pay to attract and keep talent, since caregivers can find $15+ elsewhere. The cost of compliance with wage mandates is far less than the cost of constant turnover or, worse, losing your license for not following the law.
One innovative aspect of HB 2938 is recognizing family members (yes, even a client’s spouse or parent) as eligible personal attendants. Many agencies have historically avoided hiring family due to conflict-of-interest concerns, but the reality is that family caregivers are already out there, often caring for free or under separate programs.
If this provision becomes law, be ready to adapt. Start reviewing your hiring and caregiver training policies now. How will you onboard a mother caring for her adult son, or a husband caring for his wife? What boundaries and documentation will you need? You might create a compliance checklist for family caregiver hires – including background checks, training on professional boundaries, timesheet verification, etc.
Being proactive here not only keeps you compliant but can also fill caregiver shortages by tapping into clients’ existing support networks.
When wage mandates and new caregiver categories kick in, expect regulators to keep a close eye on agency compliance. Texas HHSC will likely issue rules requiring proof that caregivers are paid the required minimum.
This could mean submitting cost reports or being subject to audits where you must show payroll records. Don’t wait – ensure your record-keeping is airtight. Maintain organized logs of caregiver hours, pay rates, and benefits.
If you increase wages, document the date and communicate it to staff in writing. For any family caregivers on board, keep files of their relationship disclosure and training completion. Treat compliance as an ongoing process and not a one-time scramble.
Big changes can be unsettling. Your caregivers might be anxious (though a raise will surely be welcome!), and clients may have questions too (“Can my daughter get paid to help me now?”).
Take a human, empathetic approach: communicate early and often. Let your team know you are on top of the new requirements. For example, you might hold a staff meeting or send a friendly memo: “Hey team, here’s what HB 2938 could mean for us. We support the push for higher wages and are working on a plan to implement changes smoothly.”
Invite their input – caregivers on the ground may have great ideas for making family-as-caregiver arrangements work. Likewise, inform clients and families that you’re aware of the evolving laws. It’s reassuring for them to hear that their home care provider is proactive.
You might be thinking, “HB 2938 isn’t even fully law yet – do I really need to worry about this now?” Yes, and here’s why: The issues HB 2938 targets are urgent.
Add a blurb:stats icon – (alt – Stats about Texas caregiver wage crisis)
Texas ranks dead last (50th out of 50 states) in average home care aide pay, and our rapidly growing senior population means demand for care keeps climbing. – ZipRecruiter
Every indicator – from vacancy rates to legislative debates – points to a future where paying caregivers a living wage won’t be optional, it will be mandatory. Agencies that adapt early will have a competitive advantage in recruiting staff and avoiding compliance scrapes—those who bury their heads in the sand risk playing catch-up or facing fines down the road.
By acting now – boosting wages as much as budgets allow, professionalizing your processes, and leveraging technology for efficiency – you’re not just avoiding a future scramble, you’re also doing right by your staff & clients today. Compliance is important, but the why behind it is even more important: better care & stability for all.
Implementing changes like these manually can feel like a LOT. This is where technology can be your best friend. CareSmartz360, an AI-powered, all-in-one home care management platform, is designed to take the heavy compliance burden off your shoulders.
After all, it’s about working smarter, not harder, especially when new rules kick in. Here are some ways in which CareSmartz360 can help you sail through HB 2938 changes with confidence:
| Feature | Description | Compliance & operational benefits | Real-world use |
|---|---|---|---|
| Smart Scheduling & Payroll Management | Custom scheduling rules and pay-rate controls; update caregiver rates once and changes flow to billing & payroll automatically; auto-calculates overtime, travel time, wage differentials. | Prevents underpaying, reduces manual errors, ensures compliance with labor laws and HB 2938; accurate payroll calculations save time and liability. | Update minimum wage in the system → any caregiver scheduled below the new rate is flagged; payroll reflects new rate and overtime automatically. |
| Electronic Visit Verification (EVV) & Documentation | EVV via caregiver mobile app (GPS + timestamp) for every visit; digital document library for training certificates, policy acknowledgments and checklists. | Meets Medicaid EVV requirements, creates auditable visit logs, and provides instant proof of training/pay for audits—eliminates paper-chase. | During an audit, you pull up the EVV log and Jane’s training certificate and pay record within seconds. |
| Real-Time Alerts & Reporting | Configure alerts for expiring certifications, approaching overtime, regulation changes; one-click reports (pay rates, certifications, EVV logs). | Proactive compliance monitoring, better cost control as wages change, and fast, accurate reporting for audits or regulator requests. | Run a one-click report of all caregiver pay rates to verify everyone meets the $20/hr requirement. |
| Texas EVV System | Integrates with a Texas-approved aggregator (HHAeXchange) and offers a GPS/telephony-enabled mobile app for caregivers to clock in/out, capture point-of-care documentation, and verify visits in real time. It supports scheduling alignment, automated billing, and offline functionality. | Ensures compliance with Texas EVV mandates by validating time, location, and caregiver/client pairing before claims submission. Reduces errors and fraudulent claims by enforcing rules, capturing signatures, automating data flow into billing/payroll, and maintaining audit logs. Improves operational efficiency via real-time shift tracking, alerts, schedule adjustments, and streamlined back-office processing. | In Texas, agencies using CareSmartz360’s EVV solution have migrated to HHAeXchange integration to meet the October 2023 transition requirements. |
Navigating HB 2938 & the changes it brings may feel challenging, but it’s also an opportunity. It’s a chance to professionalize our industry, honor the value of caregivers, and provide even better care to Texans who depend on us.
As a home care agency owner, you’ve weathered many storms – you’ve got this one too. The key is to be proactive, not reactive: start adjusting wages where you can, tidy up your compliance processes, educate your team, and equip yourself with smart tools that make the whole process easier.
At the heart of HB 2938 is a positive vision: a home care field where caregivers earn a decent living (and stick around), clients see familiar faces instead of constant turnover, and even family members can be supported for the crucial role they play. It’s hard to argue with that vision from a human standpoint.
If you’re feeling overwhelmed, take a deep breath. Break down the steps one by one And, know that you’re not alone. Don’t hesitate to reach out to peers, join industry forums, or consult with solution providers like CareSmartz360 for guidance.
On September 1, 2025, as directed under Rider 23 of the Texas budget (Senate Bill 1, 89th Legislature), the base wage for personal attendants in Medicaid was raised in rate setting to support an average wage of $13.00/hour, and attendant reimbursement rates, payroll, taxes, and benefits percentages were increased.
Simultaneously, the existing Attendant Compensation Rate Enhancement (ACRE) program was discontinued.
The change also included an administrative bump of $0.24 per attendant hour to the administrative rate for personal attendant services.
Under HB 2938’s language, one proposal was to allow family members, including spouses, to serve as personal attendants when permitted by federal law.
But because HB 2938 has not passed, that provision is not law currently. So as of today, paying a spouse would still depend on existing HHSC / Medicaid / waiver program rules and must align with federal guidelines.
So your wage model should be: base wage $13.00 + appropriate benefits burden + ensure that your reimbursement claims align with the new adopted rates.
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