| 1 | 1 | | 89R11873 LRM-D |
|---|
| 2 | 2 | | By: Y. Davis of Dallas H.B. No. 4282 |
|---|
| 3 | 3 | | |
|---|
| 4 | 4 | | |
|---|
| 5 | 5 | | |
|---|
| 6 | 6 | | |
|---|
| 7 | 7 | | A BILL TO BE ENTITLED |
|---|
| 8 | 8 | | AN ACT |
|---|
| 9 | 9 | | relating to the provision of residential services under the |
|---|
| 10 | 10 | | Medicaid home and community-based services (HCS) waiver program. |
|---|
| 11 | 11 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|---|
| 12 | 12 | | SECTION 1. Subchapter G, Chapter 546, Government Code, as |
|---|
| 13 | 13 | | effective April 1, 2025, is amended by adding Section 546.0303 to |
|---|
| 14 | 14 | | read as follows: |
|---|
| 15 | 15 | | Sec. 546.0303. PROVISION OF RESIDENTIAL SERVICES UNDER HOME |
|---|
| 16 | 16 | | AND COMMUNITY-BASED SERVICES (HCS) WAIVER PROGRAM. (a) In this |
|---|
| 17 | 17 | | section, "Medicaid residential facility" means a Medicaid provider |
|---|
| 18 | 18 | | that is a group home, host home, or similar congregate care setting |
|---|
| 19 | 19 | | operated under the commission's authority and that provides |
|---|
| 20 | 20 | | residential services to recipients under the home and |
|---|
| 21 | 21 | | community-based services (HCS) waiver program. |
|---|
| 22 | 22 | | (b) A Medicaid residential facility may refuse to accept a |
|---|
| 23 | 23 | | recipient as a resident of the facility if: |
|---|
| 24 | 24 | | (1) the facility has reached the facility's service |
|---|
| 25 | 25 | | capacity as identified in the commission's data system; |
|---|
| 26 | 26 | | (2) the recipient has a history of or propensity for |
|---|
| 27 | 27 | | engaging in: |
|---|
| 28 | 28 | | (A) severe emotional behavior that has resulted |
|---|
| 29 | 29 | | or may result in violence; or |
|---|
| 30 | 30 | | (B) actions that could severely affect the health |
|---|
| 31 | 31 | | or safety of other facility residents; or |
|---|
| 32 | 32 | | (3) the recipient is physically aggressive in a manner |
|---|
| 33 | 33 | | that presents a danger to other facility residents or to facility |
|---|
| 34 | 34 | | staff and has continuing episodes of that physical aggression that |
|---|
| 35 | 35 | | are unresponsive to: |
|---|
| 36 | 36 | | (A) medical or behavioral treatment; and |
|---|
| 37 | 37 | | (B) redirection measures. |
|---|
| 38 | 38 | | (c) Before a recipient who is medically fragile or has |
|---|
| 39 | 39 | | serious bodily injuries is placed in a Medicaid residential |
|---|
| 40 | 40 | | facility, the commission shall determine whether the facility has |
|---|
| 41 | 41 | | the capacity and capability to provide the necessary care and |
|---|
| 42 | 42 | | services to the recipient. In making the determination, the |
|---|
| 43 | 43 | | commission shall consider the scope of services the facility may |
|---|
| 44 | 44 | | provide in accordance with the facility's current license or other |
|---|
| 45 | 45 | | authorization. The commission may not require the facility to make |
|---|
| 46 | 46 | | any modifications that would enable the facility to serve the |
|---|
| 47 | 47 | | recipient. |
|---|
| 48 | 48 | | SECTION 2. If before implementing any provision of this Act |
|---|
| 49 | 49 | | a state agency determines that a waiver or authorization from a |
|---|
| 50 | 50 | | federal agency is necessary for the implementation of that |
|---|
| 51 | 51 | | provision, the agency affected by the provision shall request the |
|---|
| 52 | 52 | | waiver or authorization and may delay implementing that provision |
|---|
| 53 | 53 | | until the waiver or authorization is granted. |
|---|
| 54 | 54 | | SECTION 3. This Act takes effect September 1, 2025. |
|---|