Texas 2015 - 84th Regular

Texas House Bill HB1873 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	84R5302 LEH-F
2	2	By: Naishtat H.B. No. 1873
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to a pilot project to evaluate the use of self-directed
8	8	mental health services in the integrated Medicaid managed care
9	9	system.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Subchapter D, Chapter 1001, Health and Safety
12	12	Code, is amended by adding Section 1001.085 to read as follows:
13	13	Sec. 1001.085. SELF-DIRECTED MENTAL HEALTH SERVICES PILOT
14	14	PROJECT. (a) The commission and the department jointly shall
15	15	develop and implement a four-year pilot project for self-directed
16	16	mental health services in the integrated Medicaid managed care
17	17	system to maximize patient choice and encourage personal
18	18	responsibility for achieving recovery.
19	19	(b) To be eligible to participate in the pilot project, an
20	20	individual must:
21	21	(1) be at least 18 years of age;
22	22	(2) have a serious mental illness, as defined by
23	23	Section 1355.001, Insurance Code; and
24	24	(3) be receiving Medicaid rehabilitative services
25	25	through a local mental health authority.
26	26	(c) Participation in the pilot project by an individual is
27	27	voluntary, and the decision whether to participate may be made only
28	28	by the individual or the individual's legally authorized
29	29	representative.
30	30	(d) The commission and the department shall develop the
31	31	pilot project with input from relevant stakeholders, including
32	32	patients, advocates, Medicaid managed care organizations,
33	33	providers, and local mental health authorities.
34	34	(e) The pilot project as implemented must include:
35	35	(1) person-centered planning to assist each
36	36	participant in identifying recovery goals and the specific services
37	37	and supports needed to accomplish those goals;
38	38	(2) the development of an individualized budget for
39	39	each participant that is based on the goals identified in
40	40	Subdivision (1) and of which some percentage less than 50 may be
41	41	spent on nontraditional goods and services that the participant
42	42	generally would not receive as part of a package of outpatient
43	43	mental health services delivered through a local mental health
44	44	authority;
45	45	(3) guidelines for nontraditional goods and services
46	46	that may be purchased with a participant's individualized budget to
47	47	ensure that nontraditional goods and services purchased are
48	48	directly related to the participant's recovery goals;
49	49	(4) the option for a participant to use a life coach to
50	50	assist with:
51	51	(A) person-centered planning;
52	52	(B) budgeting;
53	53	(C) identifying and navigating community
54	54	services;
55	55	(D) recruiting, hiring, and releasing service
56	56	providers;
57	57	(E) crisis planning; and
58	58	(F) interactions with the fiscal intermediary
59	59	designated in accordance with Subdivision (7) and billing for goods
60	60	and services;
61	61	(5) specific qualifications for a life coach to be
62	62	eligible to provide services to a participant;
63	63	(6) the option for a participant to receive services
64	64	from a certified peer specialist;
65	65	(7) the designation of a fiscal intermediary who
66	66	provides financial management and billing support for the project;
67	67	and
68	68	(8) a plan for budget neutrality by the end of the
69	69	second year of the project.
70	70	(f) The commission and the department shall select the pilot
71	71	project site based on a competitive application process among the
72	72	local mental health authorities. Applications must include
73	73	evidence of significant patient and certified peer specialist
74	74	participation in the preparation of the application. The
75	75	commission and the department shall select as the pilot project
76	76	site an area of this state where the local mental health authority
77	77	and Medicaid managed care providers have a strong partnership and
78	78	where there is a high commitment to the success of the project.
79	79	(g) The commission and the department shall collect
80	80	information relating to the pilot project, including information
81	81	relating to recovery-focused outcome metrics and to the costs of
82	82	the project.
83	83	(h) Not later than one year after the date the pilot project
84	84	concludes, the commission and the department shall submit to the
85	85	legislature a report evaluating the pilot project, particularly
86	86	with regard to cost-effectiveness and recovery-focused outcomes.
87	87	In developing the report, the commission and the department shall
88	88	seek private funding and support to assist with the evaluation
89	89	process.
90	90	(i) The executive commissioner, with input from patients
91	91	receiving mental health services, certified peer specialists, and
92	92	other interested stakeholders, shall adopt rules necessary to
93	93	implement the pilot project developed under this section.
94	94	SECTION 2. As soon as practicable after the effective date
95	95	of this Act, the Health and Human Services Commission and the
96	96	Department of State Health Services shall begin developing and
97	97	implementing the pilot project under Section 1001.085, Health and
98	98	Safety Code, as added by this Act.
99	99	SECTION 3. This Act takes effect immediately if it receives
100	100	a vote of two-thirds of all the members elected to each house, as
101	101	provided by Section 39, Article III, Texas Constitution. If this
102	102	Act does not receive the vote necessary for immediate effect, this
103	103	Act takes effect September 1, 2015.