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