Employer of Record in Texas CDS: What It Means for Family Caregivers

If your family is setting up Consumer Directed Services in Texas so a relative can be your
loved one’s paid caregiver, you’ll need to designate an employer of record. This is the
person who formally manages the employment relationship with the attendant — and
Texas requires that it be a different person from the attendant providing hands-on care.

This rule trips up more Dallas families than any other CDS requirement. Here’s how it
works.

What the Employer of Record Does

The employer of record is responsible for choosing who to hire as the attendant, setting
the work schedule, directing the day-to-day care tasks, approving timesheets before
the FMSA processes payroll, and making the decision to terminate the attendant if the
arrangement isn’t working.

The employer doesn’t handle payroll, taxes, or insurance — the FMSA does all of that.
The employer’s role is oversight and direction. Think of it as the difference between a
manager and an HR department. The employer manages the care; the FMSA manages
the paperwork.

Why the Employer and Attendant Must Be Different People

Texas built this separation into CDS to ensure accountability. If the same person directs
the care and provides it, there’s no independent check on whether services are actually
being delivered as authorized. By separating the roles, the system creates a two-party
verification: the attendant provides care and submits hours, and the employer confirms
those hours before payment is processed.

Common Arrangements We See

The care recipient is their own employer. This is the simplest and most common
arrangement. Your mother directs her own care — telling her daughter (the attendant)
what she needs, when she needs it, and approving the timesheets. This works well when
the care recipient is cognitively intact and can meaningfully direct their care.

A different family member is the employer. When the care recipient has cognitive
impairment or difficulty managing the employment relationship, another family member
steps in. A sibling of the attendant, a different adult child, or another relative can serve
as the employer while the designated family member provides the care.

A Legally Authorized Representative (LAR) is the employer. If someone has power
of attorney or legal guardianship for the care recipient, they can serve as the employer of record. This is common when the care recipient is unable to direct their own care.

What the Employer Role Actually Looks Like Day to Day

In our experience, the employer role is lighter than most families fear. It’s not a full-time
job. In practice, the employer’s daily involvement amounts to ensuring the attendant’s
schedule matches the care plan, being available to sign or approve timesheets (usually a
quick electronic process through the FMSA), and communicating with the MCO service
coordinator if the care plan needs adjustment.

Most families tell us that the employer/attendant split feels artificial at first — especially
when it’s a mother directing care and a daughter providing it, which is how the family
already operates informally. The formal designation just puts a structure around what
was already happening naturally.

Planning Before You Start CDS

Before requesting CDS from your MCO, map out who will fill each role. Identify the
employer of record and the attendant. Confirm they’re two different people. If the care
recipient can serve as their own employer, that’s the simplest path. If not, identify the
family member who will take on the management role.

CareChoice helps Dallas families structure this arrangement before the CDS enrollment
begins — preventing delays and confusion during the FMSA onboarding process.

Plan your CDS arrangement → Contact CareChoice in Dallas

Written by Sophia Aloia, Content & SEO Manager | CareChoice

Related: CDS in Texas → | Family Member as Caregiver Rules → | What Is an FMSA? →