88R24873 SCP-F
 
  By: Howard, Stucky, Klick H.B. No. 1798
 
  Substitute the following for H.B. No. 1798:
 
  By:  Campos C.S.H.B. No. 1798
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the development of a strategic plan for home and
  community-based services provided under Medicaid and the child
  health plan program and the establishment of an advisory committee
  on home and community-based services.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 531, Government Code, is amended by
  adding Subchapter T to read as follows:
  SUBCHAPTER T. HOME AND COMMUNITY-BASED SERVICES
         Sec. 531.801.  DEFINITIONS. In this subchapter:
               (1)  "Home and community-based services" means
  person-centered care that addresses the needs of an individual with
  functional limitations who needs assistance with daily living, is
  delivered to the individual in the individual's home or community,
  and enables the individual to remain in the individual's home or
  community, including:
                     (A)  acute care and long-term services and
  supports;
                     (B)  services and supports for an individual's
  physical, emotional, mental, social, and vocational needs; and
                     (C)  any other services necessary to enable an
  individual to remain in the individual's home or community.
               (2)  "Home and community support services agency" means
  a person licensed under Chapter 142, Health and Safety Code, who
  provides for pay or other consideration home health, hospice, or
  personal assistance services as those terms are defined by Section
  142.001, Health and Safety Code, in a client's residence, an
  independent living environment, or another appropriate location.
         Sec. 531.802.  STRATEGIC PLAN; REPORT. (a) The commission
  shall develop and, subject to Subsection (c), implement a strategic
  plan to ensure that Medicaid recipients and child health plan
  program enrollees in this state have access to home and
  community-based services provided by a home and community support
  services agency.
         (b)  The strategic plan must include:
               (1)  a proposal for developing a viable rate
  methodology for each home and community-based service provided by a
  home and community support services agency that will ensure access
  to the service;
               (2)  an assessment of the unmet needs for home and
  community-based services of Medicaid recipients and child health
  plan program enrollees;
               (3)  access to care standards for services provided by
  a home and community support services agency specific to each home
  and community-based services program under Medicaid and the child
  health plan program, which may include standards based on:
                     (A)  the amount of delivered units of service as a
  percentage of authorized units of service;
                     (B)  the number of in-network home and community
  support services agencies;
                     (C)  the types of services provided;
                     (D)  the geographic areas served;
                     (E)  vacancy rates; and
                     (F)  the capacity to provide services;
               (4)  an assessment of the potential costs, including
  costs to the state, associated with the lack of adequate access to
  home and community-based services in this state, including an
  analysis of:
                     (A)  any projected long-term savings from
  providing timely access to home and community-based services;
                     (B)  the costs associated with providing services
  in an institutional or hospital setting, as compared to providing
  services in a home or community-based setting; and 
                     (C)  the potential immediate and long-term costs
  associated with a lack of access to services in a timely manner; and
               (5)  set dates for achieving the goals identified in
  the strategic plan.
         (b-1)  Not later than January 1, 2024, the commission shall
  submit the strategic plan developed under Subsection (b) to the
  Legislative Budget Board for approval. The board must review and
  provide the commission with comments on the plan before determining
  whether to approve the plan. This subsection expires September 1,
  2025.
         (c)  The commission may not implement the proposal described
  by Subsection (b)(1) until the Legislative Budget Board approves
  the strategic plan.
         (d)  Not later than November 1 of each even-numbered year,
  the commission shall submit a report on the commission's
  development and implementation of the strategic plan to:
               (1)  the legislature;
               (2)  the governor; and
               (3)  the Legislative Budget Board.
         Sec. 531.803.  ADVISORY COMMITTEE. (a) In this section,
  "advisory committee" means the home and community-based services
  advisory committee established under this section.
         (b)  The commission shall establish the home and
  community-based services advisory committee as an advisory
  committee or a subcommittee of the medical care advisory committee
  established under Section 32.022, Human Resources Code, to:
               (1)  advise the commission on:
                     (A)  developing a viable long-term payment
  methodology for services provided by home and community support
  services agencies; and
                     (B)  addressing issues relating to home and
  community-based services;
               (2)  develop a sustainable strategy to support home and
  community-based services;
               (3)  make recommendations for cost savings in program
  areas, including:
                     (A)  program integrity;
                     (B)  reductions in hospitalizations;
                     (C)  prior authorization of services; and
                     (D)  care coordination efforts; and
               (4)  review and offer comments on the strategic plan
  described by Section 531.802.
         (c)  The advisory committee is composed of the following
  members appointed by the executive commissioner:
               (1)  one member who is an ex officio nonvoting
  representative of the commission; and
               (2)  an odd number, not to exceed 15, of voting members
  who are:
                     (A)  representatives of:
                           (i)  at least one association representing
  managed care organizations;
                           (ii)  at least one association representing
  home and community support services agencies;
                           (iii)  at least two associations or
  coalitions representing Medicaid recipients who receive home and
  community-based services in this state;
                           (iv)  at least one rural home and community
  support services agency providing services to Medicaid recipients
  who receive home and community-based services;
                           (v)  at least one statewide home and
  community support services agency providing services to Medicaid
  recipients who receive home and community-based services; and
                           (vi)  another discipline involving
  expertise in financing Medicaid home and community-based services;
                     (B)  at least one person who is the parent of and
  caregiver to a child who receives home and community-based services
  as a Medicaid recipient or child health plan program enrollee;
                     (C)  at least one person who is a recipient of home
  and community-based services under Medicaid;
                     (D)  at least one person who provides financial
  management services; and
                     (E)  at least one person who provides electronic
  visit verification services.
         (d)  A member of the advisory committee serves without
  compensation.
         (e)  The advisory committee is abolished and this section
  expires September 1, 2027.
         SECTION 2.  As soon as practicable after the effective date
  of this Act, the executive commissioner of the Health and Human
  Services Commission shall appoint the members of the home and
  community-based services advisory committee established under
  Subchapter T, Chapter 531, Government Code, as added by this Act.
         SECTION 3.  This Act takes effect September 1, 2023.