HB5220 - Relating to provision of and access to services for children with certain health care needs, including access to certain Medicaid waiver programs.

  89R2653 AND-D     By: Manuel H.B. No. 5220       A BILL TO BE ENTITLED   AN ACT   relating to provision of and access to services for children with   certain health care needs, including access to certain Medicaid   waiver programs.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Subchapter B, Chapter 526, Government Code, as   effective April 1, 2025, is amended by adding Section 526.0061 to   read as follows:           Sec.   526.0061.     TEXAS PREGNANCY AND PARENT SUPPORT NETWORK   FOR CERTAIN EXPECTANT PARENTS. (a)   In this section, "support   network" means the Texas pregnancy and parent support network   established under Subsection (b).           (b)     The commission shall establish a statewide network of   service providers, including third-party patient navigators, for   expectant parents who receive a prenatal diagnosis for their unborn   child of a significant fetal anomaly, rare disorder, or other   chronic, medically complex condition or life-altering disability.           (c)     A third-party patient navigator who provides services   under the support network shall:                 (1)     connect expectant and new parents with support and   advocacy groups and services, including support groups specific to   the diagnosis for their child and relevant to their child's   condition or disability; and                 (2)     assist expectant and new parents in navigating the   process of accessing and applying for home and community-based   supports and services for their child, including medically   dependent children (MDCP) waiver program diversion slots under   Section 546.0506.          SECTION 2.  Section 532.0353, Government Code, as effective   April 1, 2025, is amended by amending Subsection (a) and adding   Subsection (a-1) to read as follows:          (a)  The executive commissioner shall develop and implement:                (1)  a Medicaid buy-in program for individuals with   disabilities as authorized by the Ticket to Work and Work   Incentives Improvement Act of 1999 (Pub. L. No. 106-170) or the   Balanced Budget Act of 1997 (Pub. L. No. 105-33); and                (2)   subject to Subsection (a-1), a Medicaid buy-in   program for children with disabilities described by 42 U.S.C.   Section 1396a(cc)(1) whose family incomes do not exceed 300 percent   of the applicable federal poverty level, as authorized by the   Deficit Reduction Act of 2005 (Pub. L. No. 109-171).           (a-1)     Notwithstanding any other law, the executive   commissioner by rule shall increase the maximum family income   prescribed by Subsection (a)(2) for determining eligibility for the   buy-in program to the maximum family income amount allowable,   considering available appropriations for that purpose.          SECTION 3.  Subchapter K, Chapter 546, Government Code, as   effective April 1, 2025, is amended by adding Sections 546.05031   and 546.0506 to read as follows:           Sec.   546.05031.     ASSESSMENT OF CERTAIN CHILDREN.   To the   extent possible, the commission shall enroll a child in the   medically dependent children (MDCP) waiver program if the child:                 (1)  is on the interest list for the program;                 (2)     receives Supplemental Security Income (SSI) (42   U.S.C. Section 1381 et seq.); and                 (3)     meets the program's level of care criteria for   medical necessity for nursing facility care.           Sec.   546.0506.     ALLOCATION AND RESERVATION OF DIVERSION   SLOTS.   (a)   To the extent possible, the commission shall allocate   and reserve a portion of medically dependent children (MDCP) waiver   program slots as diversion slots for children who:                 (1)     meet the program's level of care criteria for   medical necessity for nursing facility care; and                 (2)     are at high risk of being placed in an   institutional setting.           (b)     A parent may apply for a nursing facility diversion slot   described by Subsection (a) after the child's birth if the newborn   child is determined to be at imminent risk of being placed in an   institutional setting.          SECTION 4.  Subchapter B, Chapter 32, Human Resources Code,   is amended by adding Section 32.0521 to read as follows:           Sec.   32.0521.     ELIGIBILITY FOR TEXAS HOME LIVING (TxHmL)   WAIVER PROGRAM. (a) In this section, "Section 1915(c) waiver   program" has the meaning assigned by Section 521.0001, Government   Code.           (b)     To the extent permitted by federal law, an individual is   financially eligible to participate in the Texas home living   (TxHmL) waiver program if the individual's income is not more than   the special income limit established by the commission for other   Section 1915(c) waiver programs, including the home and   community-based services (HCS) waiver program.           (c)     The commission may not require that an individual who   has an approved primary diagnosis of a related condition meet   intelligence quotient criteria to be eligible for the Texas home   living (TxHmL) waiver program.          SECTION 5.  As soon as practicable after the effective date   of this Act, the executive commissioner of the Health and Human   Services Commission shall adopt rules necessary to implement the   changes in law made by this Act.          SECTION 6.  Notwithstanding any other section of this Act,   in a state fiscal year, the Health and Human Services Commission is   not required to implement a provision in another section of this Act   imposing a duty on the commission to take an action, including a   provision that the commission determines would require adding   additional slots under the medically dependent children (MDCP)   waiver program or the Texas home living (TxHmL) waiver program,   unless money is specifically appropriated to the commission for   that fiscal year to carry out that duty.  The commission may   implement the provision in that fiscal year to the extent other   funding is available to the commission for the implementation.          SECTION 7.  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 8.  This Act takes effect September 1, 2025.