H.B. No. 4169
AN ACT
relating to providing prevocational or similar services under
certain Medicaid waiver programs.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 32, Human Resources Code,
is amended by adding Section 32.0755 to read as follows:
Sec. 32.0755. PREVOCATIONAL SERVICES UNDER CERTAIN WAIVER
PROGRAMS. (a) In this section, "prevocational services" means
services that are designed to prepare an individual for paid or
unpaid work and achieve a generalized result rather than being
job-task oriented.
(b) Prevocational services provided under the community
living assistance and support services (CLASS) waiver program or
another medical assistance waiver program providing long-term
services or supports to a medical assistance recipient should be
designed to assist the recipient in achieving competitive
integrated employment in the community receiving compensation at or
above the minimum wage in the recipient's community and in
accordance with state and federal law.
(c) The commission shall seek a waiver or other necessary
authorization from the appropriate federal agency to include
prevocational services as part of the individualized skills and
socialization services delivered under a medical assistance waiver
program providing long-term services and supports.
(d) If the commission's request for a waiver or other
authorization under Subsection (c) is not granted, the commission
shall collaborate with relevant stakeholders and applicable
federal agencies to establish a service similar to prevocational
services in a manner that is authorized by federal law.
(e) If the commission is granted a waiver or other
authorization under Subsection (d):
(1) the reimbursement rate for the service the
commission establishes under that subsection may not exceed the
reimbursement rate for individualized skills and socialization
services; and
(2) if the service is combined with individualized
skills and socialization services, the commission shall ensure the
service may not exceed the total allowable hours or the total costs
for individualized skills and socialization services provided
under a service plan.
(f) The executive commissioner by rule shall establish
clearly stated, service-related performance standards applicable
to providers providing prevocational or similar services to
recipients under a medical assistance waiver program in accordance
with this section. The commission shall monitor the performance of
each provider of prevocational or similar services under a medical
assistance waiver program to ensure compliance with those
standards.
SECTION 2. (a) As soon as practicable after the effective
date of this Act, the Health and Human Services Commission shall
apply for and actively pursue from the appropriate federal agency
the waiver or other authorization required by Section 32.0755(c),
Human Resources Code, as added by this Act. The commission may
delay implementing other provisions of this Act until the waiver or
other authorization applied for under that subsection is granted.
(b) If the waiver or other authorization under Section
32.0755(c), Human Resources Code, as added by this Act, is not
granted, the Health and Human Services Commission shall, not later
than the 60th day after the date the waiver or other authorization
is denied, apply for a waiver or other authorization under Section
32.0755(d), Human Resources Code, as added by this Act.
SECTION 3. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2023.
______________________________ ______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 4169 was passed by the House on May 9,
2023, by the following vote: Yeas 134, Nays 5, 2 present, not
voting; and that the House concurred in Senate amendments to H.B.
No. 4169 on May 25, 2023, by the following vote: Yeas 142, Nays 0,
2 present, not voting.
______________________________
Chief Clerk of the House
I certify that H.B. No. 4169 was passed by the Senate, with
amendments, on May 23, 2023, by the following vote: Yeas 31, Nays
0.
______________________________
Secretary of the Senate
APPROVED: __________________
Date
__________________
Governor