HB4117 - 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.

  89R8738 AB-F     By: Howard H.B. No. 4117       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 526, Government Code, as effective April   1, 2025, is amended by adding Subchapter R to read as follows:   SUBCHAPTER R. HOME AND COMMUNITY-BASED SERVICES           Sec. 526.0851.  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.   526.0852.     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, 2026, 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,   2027.           (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.   526.0853.     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 526.0852.           (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   as follows:                       (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, 2029.          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 R, Chapter 526, Government Code, as added by this Act.          SECTION 3.  This Act takes effect September 1, 2025.