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A BILL TO BE ENTITLED
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AN ACT
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relating to the development of a strategic plan for home and |
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community-based services provided under Medicaid and the child |
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health plan program and the establishment of an advisory committee |
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on home and community-based services. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Chapter 531, Government Code, is amended by |
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adding Subchapter T to read as follows: |
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SUBCHAPTER T. HOME AND COMMUNITY-BASED SERVICES |
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Sec. 531.801. DEFINITIONS. In this subchapter: |
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(1) "Home and community-based services" means |
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person-centered care that addresses the needs of an individual with |
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functional limitations who needs assistance with daily living, is |
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delivered to the individual in the individual's home or community, |
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and enables the individual to remain in the individual's home or |
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community, including: |
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(A) acute care and long-term services and |
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supports; |
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(B) services and supports for an individual's |
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physical, emotional, mental, social, and vocational needs; and |
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(C) any other services necessary to enable an |
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individual to remain in the individual's home or community. |
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(2) "Home and community support services agency" means |
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a person licensed under Chapter 142, Health and Safety Code, who |
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provides for pay or other consideration home health, hospice, or |
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personal assistance services as those terms are defined by Section |
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142.001, Health and Safety Code, in a client's residence, an |
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independent living environment, or another appropriate location. |
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Sec. 531.802. STRATEGIC PLAN; REPORT. (a) The commission |
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shall develop and, subject to Subsection (c), implement a strategic |
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plan to ensure that Medicaid recipients and child health plan |
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program enrollees in this state have access to home and |
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community-based services provided by a home and community support |
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services agency. |
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(b) The strategic plan must include: |
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(1) a proposal for developing a viable rate |
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methodology for each home and community-based service provided by a |
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home and community support services agency that will ensure access |
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to the service; |
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(2) an assessment of the unmet needs for home and |
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community-based services of Medicaid recipients and child health |
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plan program enrollees; |
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(3) access to care standards for services provided by |
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a home and community support services agency specific to each home |
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and community-based services program under Medicaid and the child |
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health plan program, which may include standards based on: |
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(A) the amount of delivered units of service as a |
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percentage of authorized units of service; |
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(B) the number of in-network home and community |
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support services agencies; |
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(C) the types of services provided; |
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(D) the geographic areas served; |
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(E) vacancy rates; and |
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(F) the capacity to provide services; |
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(4) an assessment of the potential costs, including |
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costs to the state, associated with the lack of adequate access to |
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home and community-based services in this state, including an |
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analysis of: |
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(A) any projected long-term savings from |
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providing timely access to home and community-based services; |
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(B) the costs associated with providing services |
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in an institutional or hospital setting, as compared to providing |
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services in a home or community-based setting; and |
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(C) the potential immediate and long-term costs |
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associated with a lack of access to services in a timely manner; and |
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(5) set dates for achieving the goals identified in |
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the strategic plan. |
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(b-1) Not later than January 1, 2024, the commission shall |
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submit the strategic plan developed under Subsection (b) to the |
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Legislative Budget Board for approval. The board must review and |
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provide the commission with comments on the plan before determining |
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whether to approve the plan. This subsection expires September 1, |
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2025. |
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(c) The commission may not implement the proposal described |
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by Subsection (b)(1) until the Legislative Budget Board approves |
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the strategic plan. |
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(d) Not later than November 1 of each even-numbered year, |
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the commission shall submit a report on the commission's |
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development and implementation of the strategic plan to: |
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(1) the legislature; |
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(2) the governor; and |
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(3) the Legislative Budget Board. |
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Sec. 531.803. ADVISORY COMMITTEE. (a) In this section, |
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"advisory committee" means the home and community-based services |
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advisory committee established under this section. |
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(b) The commission shall establish the home and |
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community-based services advisory committee as an advisory |
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committee or a subcommittee of the medical care advisory committee |
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established under Section 32.022, Human Resources Code, to: |
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(1) advise the commission on: |
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(A) developing a viable long-term payment |
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methodology for services provided by home and community support |
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services agencies; and |
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(B) addressing issues relating to home and |
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community-based services; |
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(2) develop a sustainable strategy to support home and |
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community-based services; |
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(3) make recommendations for cost savings in program |
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areas, including: |
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(A) program integrity; |
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(B) reductions in hospitalizations; |
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(C) prior authorization of services; and |
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(D) care coordination efforts; and |
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(4) review and offer comments on the strategic plan |
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described by Section 531.802. |
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(c) The advisory committee is composed of the following |
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members appointed by the executive commissioner: |
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(1) one member who is an ex officio nonvoting |
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representative of the commission; and |
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(2) an odd number, not to exceed 15, of voting members |
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who are: |
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(A) representatives of: |
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(i) at least one association representing |
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managed care organizations; |
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(ii) at least one association representing |
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home and community support services agencies; |
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(iii) at least two associations or |
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coalitions representing Medicaid recipients who receive home and |
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community-based services in this state; |
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(iv) at least one rural home and community |
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support services agency providing services to Medicaid recipients |
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who receive home and community-based services; |
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(v) at least one statewide home and |
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community support services agency providing services to Medicaid |
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recipients who receive home and community-based services; and |
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(vi) another discipline involving |
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expertise in financing Medicaid home and community-based services; |
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(B) at least one person who is the parent of and |
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caregiver to a child who receives home and community-based services |
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as a Medicaid recipient or child health plan program enrollee; |
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(C) at least one person who is a recipient of home |
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and community-based services under Medicaid; |
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(D) at least one person who provides financial |
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management services; and |
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(E) at least one person who provides electronic |
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visit verification services. |
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(d) A member of the advisory committee serves without |
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compensation. |
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(e) The advisory committee is abolished and this section |
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expires September 1, 2027. |
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SECTION 2. As soon as practicable after the effective date |
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of this Act, the executive commissioner of the Health and Human |
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Services Commission shall appoint the members of the home and |
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community-based services advisory committee established under |
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Subchapter T, Chapter 531, Government Code, as added by this Act. |
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SECTION 3. This Act takes effect September 1, 2023. |