88R7617 JG-F
 
  By: Campos H.B. No. 2244
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the establishment of a pilot project to provide
  supportive housing services through Medicaid to persons
  experiencing chronic homelessness.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle I, Title 4, Government Code, is amended
  by adding Chapter 542 to read as follows:
  CHAPTER 542. TEXAS PATHWAYS PILOT PROJECT
         Sec. 542.001.  DEFINITION. In this chapter, "pilot project"
  means the Texas pathways pilot project established by the
  commission under this chapter.
         Sec. 542.002.  CHRONIC HOMELESSNESS. (a) For purposes of
  this chapter, an individual or family is considered to be
  experiencing chronic homelessness if the individual or family:
               (1)  is homeless and living or residing in a safe haven,
  emergency shelter, or place not meant for human habitation;
               (2)  for a continuous year during the preceding year or
  on at least four separate occasions during the preceding three
  years, was homeless and lived or resided in a safe haven, emergency
  shelter, or place not meant for human habitation; and
               (3)  is the head of household who has, or is a member of
  a household whose head of household has:
                     (A)  a diagnosed substance use disorder, serious
  mental illness, developmental disability, post-traumatic stress
  disorder, cognitive impairment resulting from a brain injury, or
  chronic illness or disability; or
                     (B)  the simultaneous occurrence of any two or
  more of the diagnosed conditions listed in Paragraph (A).
         (b)  Notwithstanding Subsection (a)(1), an individual who
  lives or resides in an institutional care facility, including a
  jail, substance use or mental health treatment facility, hospital,
  or other similar facility, for a period of not more than 90 days is
  considered to be experiencing chronic homelessness if, before
  living or residing in the institutional care facility, the
  individual met the requirements of Subsection (a).
         Sec. 542.003.  ESTABLISHMENT AND OPERATION OF PILOT PROJECT.
  (a) The commission shall establish and operate a statewide Texas
  pathways pilot project to provide to individuals experiencing
  chronic homelessness supportive housing services through Medicaid,
  including the following services:
               (1)  behavioral health services, including mental
  health and substance use services;
               (2)  case management services;
               (3)  personal care and personal assistance services;
               (4)  home and community-based services; and
               (5)  other housing support services.
         (b)  In establishing the pilot project, the commission shall
  consider and determine:
               (1)  eligibility criteria for participation in the
  pilot project, including criteria on:
                     (A)  an individual's health conditions;
                     (B)  an individual's housing status; and
                     (C)  current or potential costs of providing
  supportive housing services to pilot project participants through
  Medicaid;
               (2)  supportive housing services to be provided to
  pilot project participants, including:
                     (A)  outreach and engagement services;
                     (B)  housing search assistance;
                     (C)  education on tenants' rights and
  responsibilities;
                     (D)  eviction prevention services;
                     (E)  supportive housing service plans;
                     (F)  the coordination of supportive housing
  services with:
                           (i)  primary and health home care;
                           (ii)  substance use treatment;
                           (iii)  mental health treatment;
                           (iv)  vision and dental services; and
                           (v)  hospital and emergency room services;
                     (G)  crisis intervention and critical time
  intervention services;
                     (H)  education on independent living skills; and
                     (I)  services to link pilot project participants
  to education, job skills training, and employment opportunities;
               (3)  financing and reinvestment strategies that
  account for:
                     (A)  the health care costs and housing status of
  Medicaid recipients;
                     (B)  the degree to which accurate and current
  information on the housing status of Medicaid recipients is
  available;
                     (C)  the health care costs of individuals
  receiving supportive housing services;
                     (D)  the health care costs of Medicaid recipients
  who receive Medicaid benefits from federal matching funds available
  under the Patient Protection and Affordable Care Act (Pub. L.
  No. 111-148), as amended by the Health Care and Education
  Reconciliation Act of 2010 (Pub. L. No. 111-152), if applicable;
                     (E)  the pilot project's potential impact on costs
  to other entities, such as jails, long-term care facilities, and
  treatment facilities;
                     (F)  affordable housing investments that can be
  leveraged to create new housing opportunities for pilot project
  participants; and
                     (G)  the amount of flexible service dollars
  available to cover pilot project costs not covered under Medicaid;
  and
               (4)  the administration of benefits under the pilot
  project, including;
                     (A)  the role of managed care;
                     (B)  the role of supportive housing service
  providers; and
                     (C)  the coordination of the pilot project with
  existing and emerging health care systems.
         Sec. 542.004.  REPORTS. (a) Not later than June 1, 2024,
  the commission shall prepare and submit to the governor, lieutenant
  governor, and speaker of the house of representatives a written
  report that includes:
               (1)  a summary of the pilot project's progress;
               (2)  an assessment of the impact of providing
  supportive housing services through Medicaid, including the costs
  to provide the services, to individuals experiencing chronic
  homelessness;
               (3)  an update on any waiver or amendment request
  necessary to modify the state Medicaid plan to provide supportive
  housing services under the pilot project;
               (4)  a description of the supportive housing services
  being provided to individuals experiencing chronic homelessness at
  the time the report is prepared;
               (5)  an analysis of the effectiveness of providing
  supportive housing services at the level at which those services
  are provided at the time the report is prepared;
               (6)  estimates of the costs and potential savings of
  expanding health programs administered by the commission to meet
  the needs of individuals experiencing chronic homelessness;
               (7)  proposed modification to eligibility criteria for
  supportive housing services; and
               (8)  any legislative recommendations.
         (b)  Not later than September 1, 2026, the commission shall
  prepare and submit to the governor, lieutenant governor, and
  speaker of the house of representatives a final written report on
  the pilot project that includes:
               (1)  a summary of the results of the pilot project;
               (2)  a statement on the pilot project's success in
  providing supportive housing services to individuals experiencing
  chronic homelessness;
               (3)  a recommendation as to whether the pilot project
  should be continued as a pilot project or permanent program; and
               (4)  any legislative recommendations.
         Sec. 542.005.  CONCLUSION; EXPIRATION. (a) The pilot
  project established under this chapter concludes September 1, 2025.
         (b)  This chapter expires September 1, 2027.
         SECTION 2.  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 3.  This Act takes effect September 1, 2023.