Texas 2025 - 89th Regular

Texas House Bill HB4117 Compare Versions

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

Old	New	Differences
1	1	89R8738 AB-F
2	2	By: Howard H.B. No. 4117
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7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the development of a strategic plan for home and
10	10	community-based services provided under Medicaid and the child
11	11	health plan program and the establishment of an advisory committee
12	12	on home and community-based services.
13	13	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
14	14	SECTION 1. Chapter 526, Government Code, as effective April
15	15	1, 2025, is amended by adding Subchapter R to read as follows:
16	16	SUBCHAPTER R. HOME AND COMMUNITY-BASED SERVICES
17	17	Sec. 526.0851. DEFINITIONS. In this subchapter:
18	18	(1) "Home and community-based services" means
19	19	person-centered care that addresses the needs of an individual with
20	20	functional limitations who needs assistance with daily living, is
21	21	delivered to the individual in the individual's home or community,
22	22	and enables the individual to remain in the individual's home or
23	23	community, including:
24	24	(A) acute care and long-term services and
25	25	supports;
26	26	(B) services and supports for an individual's
27	27	physical, emotional, mental, social, and vocational needs; and
28	28	(C) any other services necessary to enable an
29	29	individual to remain in the individual's home or community.
30	30	(2) "Home and community support services agency" means
31	31	a person licensed under Chapter 142, Health and Safety Code, who
32	32	provides for pay or other consideration home health, hospice, or
33	33	personal assistance services as those terms are defined by Section
34	34	142.001, Health and Safety Code, in a client's residence, an
35	35	independent living environment, or another appropriate location.
36	36	Sec. 526.0852. STRATEGIC PLAN; REPORT. (a) The commission
37	37	shall develop and, subject to Subsection (c), implement a strategic
38	38	plan to ensure that Medicaid recipients and child health plan
39	39	program enrollees in this state have access to home and
40	40	community-based services provided by a home and community support
41	41	services agency.
42	42	(b) The strategic plan must include:
43	43	(1) a proposal for developing a viable rate
44	44	methodology for each home and community-based service provided by a
45	45	home and community support services agency that will ensure access
46	46	to the service;
47	47	(2) an assessment of the unmet needs for home and
48	48	community-based services of Medicaid recipients and child health
49	49	plan program enrollees;
50	50	(3) access to care standards for services provided by
51	51	a home and community support services agency specific to each home
52	52	and community-based services program under Medicaid and the child
53	53	health plan program, which may include standards based on:
54	54	(A) the amount of delivered units of service as a
55	55	percentage of authorized units of service;
56	56	(B) the number of in-network home and community
57	57	support services agencies;
58	58	(C) the types of services provided;
59	59	(D) the geographic areas served;
60	60	(E) vacancy rates; and
61	61	(F) the capacity to provide services;
62	62	(4) an assessment of the potential costs, including
63	63	costs to the state, associated with the lack of adequate access to
64	64	home and community-based services in this state, including an
65	65	analysis of:
66	66	(A) any projected long-term savings from
67	67	providing timely access to home and community-based services;
68	68	(B) the costs associated with providing services
69	69	in an institutional or hospital setting, as compared to providing
70	70	services in a home or community-based setting; and
71	71	(C) the potential immediate and long-term costs
72	72	associated with a lack of access to services in a timely manner; and
73	73	(5) set dates for achieving the goals identified in
74	74	the strategic plan.
75	75	(b-1) Not later than January 1, 2026, the commission shall
76	76	submit the strategic plan developed under Subsection (b) to the
77	77	Legislative Budget Board for approval. The board must review and
78	78	provide the commission with comments on the plan before determining
79	79	whether to approve the plan. This subsection expires September 1,
80	80	2027.
81	81	(c) The commission may not implement the proposal described
82	82	by Subsection (b)(1) until the Legislative Budget Board approves
83	83	the strategic plan.
84	84	(d) Not later than November 1 of each even-numbered year,
85	85	the commission shall submit a report on the commission's
86	86	development and implementation of the strategic plan to:
87	87	(1) the legislature;
88	88	(2) the governor; and
89	89	(3) the Legislative Budget Board.
90	90	Sec. 526.0853. ADVISORY COMMITTEE. (a) In this section,
91	91	"advisory committee" means the home and community-based services
92	92	advisory committee established under this section.
93	93	(b) The commission shall establish the home and
94	94	community-based services advisory committee as an advisory
95	95	committee or a subcommittee of the medical care advisory committee
96	96	established under Section 32.022, Human Resources Code, to:
97	97	(1) advise the commission on:
98	98	(A) developing a viable long-term payment
99	99	methodology for services provided by home and community support
100	100	services agencies; and
101	101	(B) addressing issues relating to home and
102	102	community-based services;
103	103	(2) develop a sustainable strategy to support home and
104	104	community-based services;
105	105	(3) make recommendations for cost savings in program
106	106	areas, including:
107	107	(A) program integrity;
108	108	(B) reductions in hospitalizations;
109	109	(C) prior authorization of services; and
110	110	(D) care coordination efforts; and
111	111	(4) review and offer comments on the strategic plan
112	112	described by Section 526.0852.
113	113	(c) The advisory committee is composed of the following
114	114	members appointed by the executive commissioner:
115	115	(1) one member who is an ex officio nonvoting
116	116	representative of the commission; and
117	117	(2) an odd number, not to exceed 15, of voting members
118	118	as follows:
119	119	(A) representatives of:
120	120	(i) at least one association representing
121	121	managed care organizations;
122	122	(ii) at least one association representing
123	123	home and community support services agencies;
124	124	(iii) at least two associations or
125	125	coalitions representing Medicaid recipients who receive home and
126	126	community-based services in this state;
127	127	(iv) at least one rural home and community
128	128	support services agency providing services to Medicaid recipients
129	129	who receive home and community-based services;
130	130	(v) at least one statewide home and
131	131	community support services agency providing services to Medicaid
132	132	recipients who receive home and community-based services; and
133	133	(vi) another discipline involving
134	134	expertise in financing Medicaid home and community-based services;
135	135	(B) at least one person who is the parent of and
136	136	caregiver to a child who receives home and community-based services
137	137	as a Medicaid recipient or child health plan program enrollee;
138	138	(C) at least one person who is a recipient of home
139	139	and community-based services under Medicaid;
140	140	(D) at least one person who provides financial
141	141	management services; and
142	142	(E) at least one person who provides electronic
143	143	visit verification services.
144	144	(d) A member of the advisory committee serves without
145	145	compensation.
146	146	(e) The advisory committee is abolished and this section
147	147	expires September 1, 2029.
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 appoint the members of the home and
151	151	community-based services advisory committee established under
152	152	Subchapter R, Chapter 526, Government Code, as added by this Act.
153	153	SECTION 3. This Act takes effect September 1, 2025.