H.B. No. 4169
 
 
 
 
AN ACT
  relating to providing prevocational or similar services under
  certain Medicaid waiver programs.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter B, Chapter 32, Human Resources Code,
  is amended by adding Section 32.0755 to read as follows:
         Sec. 32.0755.  PREVOCATIONAL SERVICES UNDER CERTAIN WAIVER
  PROGRAMS. (a)  In this section, "prevocational services" means
  services that are designed to prepare an individual for paid or
  unpaid work and achieve a generalized result rather than being
  job-task oriented.
         (b)  Prevocational services provided under the community
  living assistance and support services (CLASS) waiver program or
  another medical assistance waiver program providing long-term
  services or supports to a medical assistance recipient should be
  designed to assist the recipient in achieving competitive
  integrated employment in the community receiving compensation at or
  above the minimum wage in the recipient's community and in
  accordance with state and federal law.
         (c)  The commission shall seek a waiver or other necessary
  authorization from the appropriate federal agency to include
  prevocational services as part of the individualized skills and
  socialization services delivered under a medical assistance waiver
  program providing long-term services and supports.
         (d)  If the commission's request for a waiver or other
  authorization under Subsection (c) is not granted, the commission
  shall collaborate with relevant stakeholders and applicable
  federal agencies to establish a service similar to prevocational
  services in a manner that is authorized by federal law.
         (e)  If the commission is granted a waiver or other
  authorization under Subsection (d):
               (1)  the reimbursement rate for the service the
  commission establishes under that subsection may not exceed the
  reimbursement rate for individualized skills and socialization
  services; and
               (2)  if the service is combined with individualized
  skills and socialization services, the commission shall ensure the
  service may not exceed the total allowable hours or the total costs
  for individualized skills and socialization services provided
  under a service plan.
         (f)  The executive commissioner by rule shall establish
  clearly stated, service-related performance standards applicable
  to providers providing prevocational or similar services to
  recipients under a medical assistance waiver program in accordance
  with this section. The commission shall monitor the performance of
  each provider of prevocational or similar services under a medical
  assistance waiver program to ensure compliance with those
  standards.
         SECTION 2.  (a)  As soon as practicable after the effective
  date of this Act, the Health and Human Services Commission shall
  apply for and actively pursue from the appropriate federal agency
  the waiver or other authorization required by Section 32.0755(c),
  Human Resources Code, as added by this Act.  The commission may
  delay implementing other provisions of this Act until the waiver or
  other authorization applied for under that subsection is granted.
         (b)  If the waiver or other authorization under Section
  32.0755(c), Human Resources Code, as added by this Act, is not
  granted, the Health and Human Services Commission shall, not later
  than the 60th day after the date the waiver or other authorization
  is denied, apply for a waiver or other authorization under Section
  32.0755(d), Human Resources 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, 2023.
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
 
         I certify that H.B. No. 4169 was passed by the House on May 9,
  2023, by the following vote:  Yeas 134, Nays 5, 2 present, not
  voting; and that the House concurred in Senate amendments to H.B.
  No. 4169 on May 25, 2023, by the following vote:  Yeas 142, Nays 0,
  2 present, not voting.
 
  ______________________________
  Chief Clerk of the House   
 
         I certify that H.B. No. 4169 was passed by the Senate, with
  amendments, on May 23, 2023, by the following vote:  Yeas 31, Nays
  0.
 
  ______________________________
  Secretary of the Senate   
  APPROVED: __________________
                  Date       
   
           __________________
                Governor