89R2653 AND-D
By: Parker S.B. No. 2062
A BILL TO BE ENTITLED
AN ACT
relating to provision of and access to services for children with
certain health care needs, including access to certain Medicaid
waiver programs.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter B, Chapter 526, Government Code, as
effective April 1, 2025, is amended by adding Section 526.0061 to
read as follows:
Sec. 526.0061. TEXAS PREGNANCY AND PARENT SUPPORT NETWORK
FOR CERTAIN EXPECTANT PARENTS. (a) In this section, "support
network" means the Texas pregnancy and parent support network
established under Subsection (b).
(b) The commission shall establish a statewide network of
service providers, including third-party patient navigators, for
expectant parents who receive a prenatal diagnosis for their unborn
child of a significant fetal anomaly, rare disorder, or other
chronic, medically complex condition or life-altering disability.
(c) A third-party patient navigator who provides services
under the support network shall:
(1) connect expectant and new parents with support and
advocacy groups and services, including support groups specific to
the diagnosis for their child and relevant to their child's
condition or disability; and
(2) assist expectant and new parents in navigating the
process of accessing and applying for home and community-based
supports and services for their child, including medically
dependent children (MDCP) waiver program diversion slots under
Section 546.0506.
SECTION 2. Section 532.0353, Government Code, as effective
April 1, 2025, is amended by amending Subsection (a) and adding
Subsection (a-1) to read as follows:
(a) The executive commissioner shall develop and implement:
(1) a Medicaid buy-in program for individuals with
disabilities as authorized by the Ticket to Work and Work
Incentives Improvement Act of 1999 (Pub. L. No. 106-170) or the
Balanced Budget Act of 1997 (Pub. L. No. 105-33); and
(2) subject to Subsection (a-1), a Medicaid buy-in
program for children with disabilities described by 42 U.S.C.
Section 1396a(cc)(1) whose family incomes do not exceed 300 percent
of the applicable federal poverty level, as authorized by the
Deficit Reduction Act of 2005 (Pub. L. No. 109-171).
(a-1) Notwithstanding any other law, the executive
commissioner by rule shall increase the maximum family income
prescribed by Subsection (a)(2) for determining eligibility for the
buy-in program to the maximum family income amount allowable,
considering available appropriations for that purpose.
SECTION 3. Subchapter K, Chapter 546, Government Code, as
effective April 1, 2025, is amended by adding Sections 546.05031
and 546.0506 to read as follows:
Sec. 546.05031. ASSESSMENT OF CERTAIN CHILDREN. To the
extent possible, the commission shall enroll a child in the
medically dependent children (MDCP) waiver program if the child:
(1) is on the interest list for the program;
(2) receives Supplemental Security Income (SSI) (42
U.S.C. Section 1381 et seq.); and
(3) meets the program's level of care criteria for
medical necessity for nursing facility care.
Sec. 546.0506. ALLOCATION AND RESERVATION OF DIVERSION
SLOTS. (a) To the extent possible, the commission shall allocate
and reserve a portion of medically dependent children (MDCP) waiver
program slots as diversion slots for children who:
(1) meet the program's level of care criteria for
medical necessity for nursing facility care; and
(2) are at high risk of being placed in an
institutional setting.
(b) A parent may apply for a nursing facility diversion slot
described by Subsection (a) after the child's birth if the newborn
child is determined to be at imminent risk of being placed in an
institutional setting.
SECTION 4. Subchapter B, Chapter 32, Human Resources Code,
is amended by adding Section 32.0521 to read as follows:
Sec. 32.0521. ELIGIBILITY FOR TEXAS HOME LIVING (TxHmL)
WAIVER PROGRAM. (a) In this section, "Section 1915(c) waiver
program" has the meaning assigned by Section 521.0001, Government
Code.
(b) To the extent permitted by federal law, an individual is
financially eligible to participate in the Texas home living
(TxHmL) waiver program if the individual's income is not more than
the special income limit established by the commission for other
Section 1915(c) waiver programs, including the home and
community-based services (HCS) waiver program.
(c) The commission may not require that an individual who
has an approved primary diagnosis of a related condition meet
intelligence quotient criteria to be eligible for the Texas home
living (TxHmL) waiver program.
SECTION 5. As soon as practicable after the effective date
of this Act, the executive commissioner of the Health and Human
Services Commission shall adopt rules necessary to implement the
changes in law made by this Act.
SECTION 6. Notwithstanding any other section of this Act,
in a state fiscal year, the Health and Human Services Commission is
not required to implement a provision in another section of this Act
imposing a duty on the commission to take an action, including a
provision that the commission determines would require adding
additional slots under the medically dependent children (MDCP)
waiver program or the Texas home living (TxHmL) waiver program,
unless money is specifically appropriated to the commission for
that fiscal year to carry out that duty. The commission may
implement the provision in that fiscal year to the extent other
funding is available to the commission for the implementation.
SECTION 7. 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 8. This Act takes effect September 1, 2025.