84R5302 LEH-F
 
  By: Naishtat H.B. No. 1873
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to a pilot project to evaluate the use of self-directed
  mental health services in the integrated Medicaid managed care
  system.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter D, Chapter 1001, Health and Safety
  Code, is amended by adding Section 1001.085 to read as follows:
         Sec. 1001.085.  SELF-DIRECTED MENTAL HEALTH SERVICES PILOT
  PROJECT. (a) The commission and the department jointly shall
  develop and implement a four-year pilot project for self-directed
  mental health services in the integrated Medicaid managed care
  system to maximize patient choice and encourage personal
  responsibility for achieving recovery.
         (b)  To be eligible to participate in the pilot project, an
  individual must:
               (1)  be at least 18 years of age;
               (2)  have a serious mental illness, as defined by
  Section 1355.001, Insurance Code; and 
               (3)  be receiving Medicaid rehabilitative services
  through a local mental health authority.
         (c)  Participation in the pilot project by an individual is
  voluntary, and the decision whether to participate may be made only
  by the individual or the individual's legally authorized
  representative.
         (d)  The commission and the department shall develop the
  pilot project with input from relevant stakeholders, including
  patients, advocates, Medicaid managed care organizations,
  providers, and local mental health authorities.
         (e)  The pilot project as implemented must include:
               (1)  person-centered planning to assist each
  participant in identifying recovery goals and the specific services
  and supports needed to accomplish those goals;
               (2)  the development of an individualized budget for
  each participant that is based on the goals identified in
  Subdivision (1) and of which some percentage less than 50 may be
  spent on nontraditional goods and services that the participant
  generally would not receive as part of a package of outpatient
  mental health services delivered through a local mental health
  authority; 
               (3)  guidelines for nontraditional goods and services
  that may be purchased with a participant's individualized budget to
  ensure that nontraditional goods and services purchased are
  directly related to the participant's recovery goals; 
               (4)  the option for a participant to use a life coach to
  assist with:
                     (A)  person-centered planning;
                     (B)  budgeting;
                     (C)  identifying and navigating community
  services;
                     (D)  recruiting, hiring, and releasing service
  providers; 
                     (E)  crisis planning; and
                     (F)  interactions with the fiscal intermediary
  designated in accordance with Subdivision (7) and billing for goods
  and services;
               (5)  specific qualifications for a life coach to be
  eligible to provide services to a participant;
               (6)  the option for a participant to receive services
  from a certified peer specialist;
               (7)  the designation of a fiscal intermediary who
  provides financial management and billing support for the project;
  and
               (8)  a plan for budget neutrality by the end of the
  second year of the project.
         (f)  The commission and the department shall select the pilot
  project site based on a competitive application process among the
  local mental health authorities. Applications must include
  evidence of significant patient and certified peer specialist
  participation in the preparation of the application. The
  commission and the department shall select as the pilot project
  site an area of this state where the local mental health authority
  and Medicaid managed care providers have a strong partnership and
  where there is a high commitment to the success of the project.
         (g)  The commission and the department shall collect
  information relating to the pilot project, including information
  relating to recovery-focused outcome metrics and to the costs of
  the project. 
         (h)  Not later than one year after the date the pilot project
  concludes, the commission and the department shall submit to the
  legislature a report evaluating the pilot project, particularly
  with regard to cost-effectiveness and recovery-focused outcomes.
  In developing the report, the commission and the department shall
  seek private funding and support to assist with the evaluation
  process. 
         (i)  The executive commissioner, with input from patients
  receiving mental health services, certified peer specialists, and
  other interested stakeholders, shall adopt rules necessary to
  implement the pilot project developed under this section.
         SECTION 2.  As soon as practicable after the effective date
  of this Act, the Health and Human Services Commission and the
  Department of State Health Services shall begin developing and
  implementing the pilot project under Section 1001.085, Health and
  Safety 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, 2015.