88R7617 JG-F
By: Campos H.B. No. 2244
A BILL TO BE ENTITLED
AN ACT
relating to the establishment of a pilot project to provide
supportive housing services through Medicaid to persons
experiencing chronic homelessness.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle I, Title 4, Government Code, is amended
by adding Chapter 542 to read as follows:
CHAPTER 542. TEXAS PATHWAYS PILOT PROJECT
Sec. 542.001. DEFINITION. In this chapter, "pilot project"
means the Texas pathways pilot project established by the
commission under this chapter.
Sec. 542.002. CHRONIC HOMELESSNESS. (a) For purposes of
this chapter, an individual or family is considered to be
experiencing chronic homelessness if the individual or family:
(1) is homeless and living or residing in a safe haven,
emergency shelter, or place not meant for human habitation;
(2) for a continuous year during the preceding year or
on at least four separate occasions during the preceding three
years, was homeless and lived or resided in a safe haven, emergency
shelter, or place not meant for human habitation; and
(3) is the head of household who has, or is a member of
a household whose head of household has:
(A) a diagnosed substance use disorder, serious
mental illness, developmental disability, post-traumatic stress
disorder, cognitive impairment resulting from a brain injury, or
chronic illness or disability; or
(B) the simultaneous occurrence of any two or
more of the diagnosed conditions listed in Paragraph (A).
(b) Notwithstanding Subsection (a)(1), an individual who
lives or resides in an institutional care facility, including a
jail, substance use or mental health treatment facility, hospital,
or other similar facility, for a period of not more than 90 days is
considered to be experiencing chronic homelessness if, before
living or residing in the institutional care facility, the
individual met the requirements of Subsection (a).
Sec. 542.003. ESTABLISHMENT AND OPERATION OF PILOT PROJECT.
(a) The commission shall establish and operate a statewide Texas
pathways pilot project to provide to individuals experiencing
chronic homelessness supportive housing services through Medicaid,
including the following services:
(1) behavioral health services, including mental
health and substance use services;
(2) case management services;
(3) personal care and personal assistance services;
(4) home and community-based services; and
(5) other housing support services.
(b) In establishing the pilot project, the commission shall
consider and determine:
(1) eligibility criteria for participation in the
pilot project, including criteria on:
(A) an individual's health conditions;
(B) an individual's housing status; and
(C) current or potential costs of providing
supportive housing services to pilot project participants through
Medicaid;
(2) supportive housing services to be provided to
pilot project participants, including:
(A) outreach and engagement services;
(B) housing search assistance;
(C) education on tenants' rights and
responsibilities;
(D) eviction prevention services;
(E) supportive housing service plans;
(F) the coordination of supportive housing
services with:
(i) primary and health home care;
(ii) substance use treatment;
(iii) mental health treatment;
(iv) vision and dental services; and
(v) hospital and emergency room services;
(G) crisis intervention and critical time
intervention services;
(H) education on independent living skills; and
(I) services to link pilot project participants
to education, job skills training, and employment opportunities;
(3) financing and reinvestment strategies that
account for:
(A) the health care costs and housing status of
Medicaid recipients;
(B) the degree to which accurate and current
information on the housing status of Medicaid recipients is
available;
(C) the health care costs of individuals
receiving supportive housing services;
(D) the health care costs of Medicaid recipients
who receive Medicaid benefits from federal matching funds available
under the Patient Protection and Affordable Care Act (Pub. L.
No. 111-148), as amended by the Health Care and Education
Reconciliation Act of 2010 (Pub. L. No. 111-152), if applicable;
(E) the pilot project's potential impact on costs
to other entities, such as jails, long-term care facilities, and
treatment facilities;
(F) affordable housing investments that can be
leveraged to create new housing opportunities for pilot project
participants; and
(G) the amount of flexible service dollars
available to cover pilot project costs not covered under Medicaid;
and
(4) the administration of benefits under the pilot
project, including;
(A) the role of managed care;
(B) the role of supportive housing service
providers; and
(C) the coordination of the pilot project with
existing and emerging health care systems.
Sec. 542.004. REPORTS. (a) Not later than June 1, 2024,
the commission shall prepare and submit to the governor, lieutenant
governor, and speaker of the house of representatives a written
report that includes:
(1) a summary of the pilot project's progress;
(2) an assessment of the impact of providing
supportive housing services through Medicaid, including the costs
to provide the services, to individuals experiencing chronic
homelessness;
(3) an update on any waiver or amendment request
necessary to modify the state Medicaid plan to provide supportive
housing services under the pilot project;
(4) a description of the supportive housing services
being provided to individuals experiencing chronic homelessness at
the time the report is prepared;
(5) an analysis of the effectiveness of providing
supportive housing services at the level at which those services
are provided at the time the report is prepared;
(6) estimates of the costs and potential savings of
expanding health programs administered by the commission to meet
the needs of individuals experiencing chronic homelessness;
(7) proposed modification to eligibility criteria for
supportive housing services; and
(8) any legislative recommendations.
(b) Not later than September 1, 2026, the commission shall
prepare and submit to the governor, lieutenant governor, and
speaker of the house of representatives a final written report on
the pilot project that includes:
(1) a summary of the results of the pilot project;
(2) a statement on the pilot project's success in
providing supportive housing services to individuals experiencing
chronic homelessness;
(3) a recommendation as to whether the pilot project
should be continued as a pilot project or permanent program; and
(4) any legislative recommendations.
Sec. 542.005. CONCLUSION; EXPIRATION. (a) The pilot
project established under this chapter concludes September 1, 2025.
(b) This chapter expires September 1, 2027.
SECTION 2. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 3. This Act takes effect September 1, 2023.