Texas 2021 - 87th Regular

Texas Senate Bill SB651 Compare Versions

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

Old	New	Differences
1	1	87R2189 MM-D
2	2	By: Johnson S.B. No. 651
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to a pilot project to improve health care outcomes and
8	8	reduce costs under Medicaid by providing participating recipients
9	9	with enhanced case management and other services to address certain
10	10	social determinants of health.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Chapter 533, Government Code, is amended by
13	13	adding Subchapter F to read as follows:
14	14	SUBCHAPTER F. PILOT PROJECT TO ADDRESS CERTAIN SOCIAL DETERMINANTS
15	15	OF HEALTH
16	16	Sec. 533.101. DEFINITIONS. In this subchapter:
17	17	(1) "Pilot project" means the pilot project
18	18	established under Section 533.102.
19	19	(2) "Project participant" means an individual who
20	20	participates in the pilot project.
21	21	(2) "Social determinants of health" means the
22	22	environmental conditions in which an individual lives that affect
23	23	the individual's health and quality of life.
24	24	Sec. 533.102. PILOT PROJECT FOR PROVIDING ENHANCED CASE
25	25	MANAGEMENT AND OTHER SERVICES TO ADDRESS SOCIAL DETERMINANTS OF
26	26	HEALTH. (a) The executive commissioner shall seek a waiver under
27	27	Section 1115 of the federal Social Security Act (42 U.S.C. Section
28	28	1315) to the state Medicaid plan to develop and implement a
29	29	five-year pilot project to improve the health care outcomes of
30	30	Medicaid recipients and reduce associated health care costs by
31	31	providing enhanced case management and other coordinated,
32	32	evidence-based, nonmedical intervention services designed to
33	33	directly address recipient needs related to the following social
34	34	determinants of health:
35	35	(1) housing instability;
36	36	(2) food insecurity;
37	37	(3) transportation insecurity;
38	38	(4) interpersonal violence; and
39	39	(5) toxic stress.
40	40	(b) The commission shall develop and implement the pilot
41	41	project with the assistance and involvement of Medicaid managed
42	42	care organizations, public or private stakeholders, and other
43	43	persons the commission determines appropriate.
44	44	(c) A pilot project established under this section shall be
45	45	conducted in one or more regions of this state as selected by the
46	46	commission.
47	47	Sec. 533.103. BENEFITS: CASE MANAGEMENT AND INTERVENTION
48	48	SERVICES. (a) The pilot project must assign a case manager to each
49	49	project participant. The case manager will determine, authorize,
50	50	and coordinate individualized nonmedical intervention services for
51	51	participants that directly address and improve the participants'
52	52	quality of life respecting one or more of the social determinants of
53	53	health described by Section 533.102.
54	54	(b) The commission shall prescribe the nonmedical
55	55	intervention services that may be provided to project participants,
56	56	which may include:
57	57	(1) the following services to address housing
58	58	instability:
59	59	(A) tenancy support and sustaining services;
60	60	(B) housing quality and safety improvement
61	61	services;
62	62	(C) legal assistance with connecting
63	63	participants to community resources to address legal issues, other
64	64	than providing legal representation or paying for legal
65	65	representation;
66	66	(D) one-time financial assistance to secure
67	67	housing; and
68	68	(E) short-term post-hospitalization housing;
69	69	(2) the following services to address food insecurity:
70	70	(A) assistance applying for benefits under the
71	71	supplemental nutrition assistance program or the federal special
72	72	supplemental nutrition program for women, infants, and children
73	73	administered by 42 U.S.C. Section 1786;
74	74	(B) assistance accessing school-based meal
75	75	programs;
76	76	(C) assistance locating and accessing food banks
77	77	or community-based summer and after-school food programs;
78	78	(D) nutrition counseling; and
79	79	(E) financial assistance for targeted nutritious
80	80	food or meal delivery services for individuals with medically
81	81	related special dietary needs if funding cannot be obtained through
82	82	other sources;
83	83	(3) the following services to address transportation
84	84	insecurity:
85	85	(A) educational assistance to gain access to
86	86	public and private forms of transportation, including
87	87	ride-sharing; and
88	88	(B) financial assistance for public
89	89	transportation or, if public transportation is not available,
90	90	private transportation to support participants' ability to access
91	91	pilot project services; and
92	92	(4) the following services to address interpersonal
93	93	violence and toxic stress:
94	94	(A) assistance with locating and accessing
95	95	community-based social services and mental health agencies with
96	96	expertise in addressing interpersonal violence;
97	97	(B) assistance with locating and accessing
98	98	high-quality child-care and after-school programs;
99	99	(C) assistance with locating and accessing
100	100	community engagement activities;
101	101	(D) navigational services focused on identifying
102	102	and improving existing factors posing a risk to the safety and
103	103	health of victims transitioning from traumatic situations,
104	104	including:
105	105	(i) obtaining a new phone number or mailing
106	106	address;
107	107	(ii) securing immediate shelter and
108	108	long-term housing;
109	109	(iii) making school arrangements to
110	110	minimize disruption of school schedules; and
111	111	(iv) connecting participants to
112	112	medical-legal partnerships to address overlap between health care
113	113	and legal needs;
114	114	(E) legal assistance for interpersonal
115	115	violence-related issues, including assistance securing a
116	116	protection order, other than providing legal representation or
117	117	paying for legal representation;
118	118	(F) assistance accessing evidence-based
119	119	parenting support; and
120	120	(G) assistance accessing evidence-based
121	121	maternal, infant, and early home visiting services.
122	122	Sec. 533.104. PARTICIPANT ELIGIBILITY. An individual is
123	123	eligible to participate in the pilot project if the individual:
124	124	(1) is a Medicaid recipient and receives benefits
125	125	through a Medicaid managed care model or arrangement under this
126	126	chapter;
127	127	(2) resides in a region in which the pilot project is
128	128	implemented; and
129	129	(3) meets other eligibility criteria established by
130	130	the commission for project participation, including:
131	131	(A) having or being at a higher risk than the
132	132	general population of developing a chronic or serious health
133	133	condition; and
134	134	(B) experiencing at least one of the social
135	135	determinants of health described by Section 533.102.
136	136	Sec. 533.105. RULES. The executive commissioner may adopt
137	137	rules to implement this subchapter.
138	138	Sec. 533.106. REPORT. Not later than September 1 of each
139	139	even-numbered year, the commission shall submit to the legislature
140	140	a report on the pilot project. The report must include:
141	141	(1) an evaluation of the pilot project's success in
142	142	reducing or eliminating poor health outcomes and reducing
143	143	associated health care costs; and
144	144	(2) a recommendation on whether the pilot project
145	145	should be continued, expanded, or terminated.
146	146	Sec. 533.107. EXPIRATION. This subchapter expires
147	147	September 1, 2027.
148	148	SECTION 2. As soon as practicable after the effective date
149	149	of this Act, the executive commissioner of the Health and Human
150	150	Services Commission shall apply for and actively pursue a waiver
151	151	under Section 1115 of the federal Social Security Act (42 U.S.C.
152	152	Section 1315) to the state Medicaid plan from the federal Centers
153	153	for Medicare and Medicaid Services or any other federal agency to
154	154	implement Subchapter F, Chapter 533, Government Code, as added by
155	155	this Act. The commission may delay implementing Subchapter F,
156	156	Chapter 533, Government Code, as added by this Act, until the waiver
157	157	applied for under this section is granted.
158	158	SECTION 3. This Act takes effect immediately if it receives
159	159	a vote of two-thirds of all the members elected to each house, as
160	160	provided by Section 39, Article III, Texas Constitution. If this
161	161	Act does not receive the vote necessary for immediate effect, this
162	162	Act takes effect September 1, 2021.